Pooping. It’s as natural as sleeping, eating and breathing, yet unless you have a household of boys (like I do) or again in my case it is a question I ask most of my clients, it is not usually the subject of polite conversation or something we discuss with mates. Yet, the condition of your poo (Is it squishy or pellet-like, dark brown or clay coloured, contains food remnants or mucous?), can tell you an awful lot about the state of your health.
So, if you want to know if your poo is normal, here goes. Check out your poo against the following diagram called the Bristol Stool Chart and find out what it says about your poo health. Remember they are a tool for letting you and health professional know how healthy you are. So if you are concerned or not sure if they are OK then do see a health professional
Firstly some poo facts
- The normal range for daily pooping is from three times a day to once every three days. Therefore, it would be fair to say that the average person poops about once a day.
- Faeces (poo) are mostly made of water (about 75%). The rest is made of dead bacteria that helped us digest our food, living bacteria, protein, undigested food residue (known as fibre), waste material from food, cellular linings, fats, salts, and substances released from the intestines (such as mucus) and the liver. Although faeces are made up of about 75% water, this number varies from person to person, depending on how long the faeces stay in the intestine.
- Poo is normally brown. The colour comes mainly from bilirubin, a pigment that arises from the breakdown of red blood cells in the liver and bone marrow. But adults can also have green poo if they eat large amounts of green, leafy vegetables or if they eat large amounts of foods with green food colouring. Green faeces can also occur with diarrhoea if bile salts pass through the intestine unchanged. Bile salts are substances that makeup bile, which is a fluid produced by the liver that help digest fat. Beetroot can turn poo a pinky purple too and iron supplements can turn poop black. Poop that is greyish or yellow in colour is normally a sign that mucus is making its way into your stool. This shows that likely there is a problem with the liver or gallbladder, since the liver is responsible for producing bile, givng the stool this colour.
- Poo smells rather bad because of the bacteria inside of the. These bacteria produce various compounds and gases that lead to the infamous smell.
Choose your poo:
Type 1: Separate hard lumps, like nuts
These stools lack a normal shape and consistency because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive, the typical diameter ranges from 1 to 2 cm (0.4–0.8”), and they are painful to pass because the lumps are hard and scratchy. There is a high likelihood of bleeding from laceration of the anal canal. Typical for those who have had antibiotic treatments, people attempting fibre-free (low-carb) diets and those on low fibre diets. Flatulence isn‘t likely, because fermentation of fibre isn‘t taking place.
Type 2: Sausage-like but lumpy
Represents a combination of Type 1 stools impacted into a single mass and lumped together by fibre components and some bacteria. Typical for organic constipation. The diameter is 3 to 4 cm (1.2–1.6”). This type is the most destructive by far because its size is near or exceeds the maximum opening of the anal canals’ aperture (3.5 cm). It‘s bound to cause extreme straining during elimination, and most likely to cause anal canal laceration, hemorrhoidal prolapse, or diverticulosis. To attain this form, the stools must be in the colon for at least several weeks instead of the normal 72 hours. Anorectal pain, hemorrhoidal disease, anal fissures, withholding or delaying of defecation, and a history of chronic constipation are the most likely causes. Minor flatulence is probable. A person experiencing these stools may be suffering from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls causing irritation and inflammation.
The possibility of obstruction of the small intestine is high because the large intestine is filled to capacity with stools. Adding supplemental fibre to expel these stools is dangerous, because the expanded fibre has no place to go, and may cause a hernia, obstruction, or perforation of the small and large intestine alike.
Type 3: Like a sausage but with cracks in the surface
This form has all of the characteristics of Type 2 stools, but the transit time is faster, between one and two weeks. The diameter is 2 to 3.5 cm (0.8–1.4”). Irritable bowel syndrome is likely. Flatulence is minor, because of dysbiosis (microbial imbalance in the digestive tract). The fact that it hasn‘t become as enlarged as Type 2 suggests that the defecations are regular. Straining is required. All of the adverse effects typical for Type 2 stools are likely for type 3, especially the rapid deterioration of hemorrhoidal disease.
Type 4: Like a sausage or snake, smooth and soft
This form is normal for someone defecating once daily. The diameter is 1 to 2 cm (0.4–0.8”). The larger diameter suggests a longer transit time or a large amount of dietary fibre in the diet.
Type 5: Soft blobs with clear-cut edges
This form is ideal. It is typical for a person who has stools twice or three times daily, after major meals. The diameter is 1 to 1.5 cm (0.4–0.6”).
Type 6: Fluffy pieces with ragged edges, a mushy stool
This form is close to the margins of comfort in several respects – it may be difficult to control the urge and it is a rather messy business to manage with toilet paper alone!. These kinds of stools may suggest a slightly hyperactive colon (fast motility), excess dietary potassium, or sudden dehydration or spike in blood pressure related to stress. It can also indicate a hypersensitive personality prone to stress, too many spices, drinking water with a high mineral content, or the use of mineral salt laxatives.
Type 7: Watery, no solid pieces
This, of course, is diarrhea, It‘s typical for people (especially young children and infirm or convalescing adults) affected by faecal impaction—a condition that follows or accompanies type 1 stools. During paradoxical diarrhea the liquid contents of the small intestine (up to 1.5–2 litres daily) have no place to go but down, because the large intestine is stuffed with impacted stools throughout its entire length. Some water gets absorbed, the rest accumulates in the rectum.
More on Constipation and Diarrhea
Why might we have constipation?
Constipation is usually caused by a combination of different factors, including those related to your diet, level of movement, and also your stress levels. The most common causes include eating a low fibre diet, being dehydrated from not drinking enough water, dysbiosis, and having unusual amounts of emotional stress.
When constipation occurs, several things often take place within the GI tract: there is slowed movement of stool passing through the colon or not enough stool is being formed, there is delayed emptying of the colon from the pelvis, or a combination of both.
Do you suffer from IBS symptoms?. If so, irritable bowel syndrome (IBS) could be the cause of your constipation. The abnormal digestive occurrences described above are often attributed to functional digestive disorders including IBS, which can cause persistent constipation along with other symptoms. Functional GI disorders are considered those that cause the digestive system to work an abnormal way, yet without evidence of damage due to a disease. The risk factors listed below also contribute to IBS and functional digestive disorders.
Constipation may also be caused by SIBO (small intestinal bacterial overgrowth ) which can lead to constipation or diarrhoea as well as bloating and other symptoms.
There are in fact a number of different types of constipation:
- Functional constipation. This condition commonly follows a stressful event, surgery, colonoscopy, diarrhoea, temporary incapacity, food poisoning, treatment with antibiotics – damaging intestinal flora, interfere with intestinal peristalsis, or both. A person becomes irregular, stools correspond to the BSF scale type 1 to 3, and straining is required to move the bowels. The person resorts to fibre or laxatives for help.
- Latent constipation. If the intestinal flora, stools, and peristalsis aren’t properly restored following adverse event(s), functional constipation eventually turns into the latent form (i.e. hidden), because fibre or laxative effects on stools create the impression of normality and regularity. The stools become larger, heavier, and harder, usually the BSF type 3, straining more intense, but for as long as you keep moving your bowels every so often, and without too much pain, there is still an impression of regularity.
- Organic constipation. As time goes by, large and hard stools — between type 2 and 3 — keep enlarging internal haemorrhoids and stretching out the colon. This, in turn, reduces the diameter of the anal canal, even more, causes near complete anorectal nerve damage, and slows down or cancels out completely the propulsion of stools alongside the colon (motility). At this juncture, the person no longer senses a defecation urge and becomes dependent on intense straining and/or laxatives to complete a bowel movement. If you don’t use laxatives, you fail to move the bowels even with a good helping of fibre.
There are several factors that might be contributing to your constipation:
- Poor diet: Diets high in processed food, sugar, refined carbohydrates, alcohol, unhealthy fats and synthetic additives can make it harder to produce normal bowel movements.
- Stress: High amounts of stress alters hormone and neurotransmitter production, which has a direct influence on muscle tension, inflammation, enzyme production and overall digestive functioning.
- Inactivity: Exercise helps to increase blood flow, strengthens muscles within the digestive tract and helps control stress.
- Certain medications: Some medications can cause frequent constipation including: antidepressants, antacids, calcium or iron supplements, anticholinergics, anticonvulsants, narcotics and diuretics.
- Imbalance in intestinal flora: Healthy bacteria living in the gastrointestinal (GI) tract, called probiotics, help to regulate bowel function. One of the reasons fibre is so important for gut health is because “prebiotic” fibre from plant foods helps probiotic bacteria to thrive.
- Thyroid or hormonal problems: Menopause, PMS, eating disorders, diabetes and thyroid disorders like hypothyroidism can all contribute to constipation. Other diseases that might contribute to constipation include Parkinson’s disease, spinal injuries or neurological issues that affect nerves in the GI tract.
- Magnesium deficiency. Magnesium is an electrolyte that helps with normal muscle functioning. Too little magnesium in your diet can contribute to muscle tension and also worsen symptoms of emotional stress.
- Bad bathroom habits: For some, rushing the time they spend in the bathroom and sitting in an uncomfortable position on the toilet can contribute to bowel movements that don’t feel complete.
- Older age: Sometimes older adults lose interest in food (because of things like food tasting differently, trouble chewing and not having the energy to cook), which means they stop consuming enough fibre and calories, and therefore digestion slows down.
- And more
Why might you have Diarrhea?
Diarrhoea – overly soft or watery poops and can be dangerous if it persists because it dehydrates and weakens the body. The causes of diarrhoea vary, but often the reasons are dehydration, viral stomach flu or infection, as a result of eating something with harmful parasites or bacteria, or even nerves.
Diarrhoea can also be caused by certain medications or medical conditions like gluten sensitivity or Coeliac Disease (a gluten allergy), lactose intolerance (a dairy food allergy) and Inflammatory Bowel Diseases like Crohn’s disease and ulcerative colitis, or leaky gut (an inflamed gut). This is why it’s very important to see a physician if you experience diarrhoea on an ongoing basis.
How to overcome constipation by “normalising” stools
Constipation rarely happens out of the blue in otherwise healthy adults. It is usually preceded by decades of semi-regular stools that are either too large, or too hard, or both. These abnormal stools cause gradual nerve damage and enlargement of the colon, rectum, and hemorrhoidal pads until one day the bowels refuse to move as was meant by nature — once or twice daily, usually after a meal, and with zero effort or notice.
To attain small stools and effortless bowel movements:
- Get your diet sorted – lots of fruit and veggies and nuts and seeds will provide all the nutrients you need to keep regular. No need to go crazy with a really high fibre diet – this can cause more harm than good. It is better to reduce processed foods plus meat and dairy.
- Support your Liver! Did you know that your liver is responsible for producing the bile that digests fat? Without enough bile, your fats become something like soap in your gut! This backs up and can lead to constipation and difficulty detoxing the body of toxins.
- Exercise – get out there walking and moving every day
- Supplements can help – from probiotics, magnesium, potassium and calcium to laxatives and bulking agents from psyllium, flaxseed and senna. Glutamine is also great for gut healing. Before you embark on a supplement regime it is important to see a natural health professional to make sure you are taking the right things for your condition.
- Book in to see me to find out the cause of your constipation and how to treat naturally and effectively.