Normal vs. Abnormal bowel movement: What does your poop say about your health?

Your bowel habits isn’t the nicest and most socially appropriate topic to talk about, but it’s a huge part of our functioning body and a greater indicator of your health than you might think. When I see patients, I usually try to get a gauge of their bowel movement to assess their colon health — how often are they pooping? Is the process difficult? 

Although there is no fixed rule on how often a person should poop, generally pooping anywhere from three times a day to three times a week is normal. Pooping also shouldn’t be a painful process. If you frequently experience bowel movements that are painful to pass or result in lots of cramping after, you should see a doctor as you could have a condition such as ulcerative colitis, irritable bowel syndrome (IBS) or Crohn’s disease. Also, while it’s normal to experience episodes of constipation or diarrhoea occasionally, they should not be a consistent part of your stool pattern.

What does normal poop look like?

The appearance and consistency of poop can vary from person to person, but generally there are a few indicators of healthy stool. 

Colour

If there’s anything the poop emoji on your phone has gotten right, it’s the brown colouring. Bilirubin, a pigment formed from the breakdown of red blood cells, is what gives our poop that healthy brown colour. However, there are instances where poop deviates away from brown and results in another colour. This might not always be necessarily bad. For example, hints of green might just be a result of extra vegetables in your diet — I will touch more on the different poop colours and what they mean later. 

Shape

While poop comes in different shapes and sizes, it should somewhat resemble a log-like shape to be considered healthy. Here is a chart known as the Bristol Stool Scale I often show patients to explain the different types of poop. The shape and form of their poop based on the chart usually points me toward a diagnosis of some digestive problems.

Source: https://www.researchgate.net/figure/Bristol-Stool-Form-Scale_tbl1_267742644

Ideally, we want to aim for type 3 and 4, as those are easy to pass without being too watery. Type 1 and 2 usually indicate constipation, and types 5, 6 and 7 point towards diarrhoea. Type 5, though easy to pass, could suggest that you are lacking fibre and should find ways to add in more fruits and vegetables into your diet. 

Size 

Poop shouldn’t come out in small separate pellets (type 1), as that could mean you have constipation. It should be a couple of inches in length and easy to pass. 

Frequency 

Most people poop once a day everyday, but it’s not uncommon to poop up to twice or thrice daily either. You should pass stool three times a week minimally. Any less than that could suggest constipation, which means you need to drink more water. 

Length of time 

A healthy poop should take only about a minute to pass out. Of course, some people need more time, but as a general rule, your time spent in the toilet trying to get your poop out shouldn’t take more than 10-15 minutes. 

What do different colours of poop mean? 

While brown coloured poop is considered the normal or acceptable colour of poop, some greenish brown hues are acceptable. Spinach, kale and other green foods can cause tinges of green in poop. But full green poop could mean your poop passed through too fast and has too much bile. 

Apart from vegetables, other substances can cause changes in poop colour as well. For example, black stout, iron supplements, liquorice and bismuth medications can cause black poop, and beets, cranberries and tomato juice can cause red poop. But if you’ve haven’t had any of those, it could be a sign of gastrointestinal bleeding. 

If your stools are white, gray or pale, it could be an issue with your liver or gallbladder; and if your stools are yellow and greasy looking, it could be a sign of too much fat and absorption issues. 

Most people will experience variation in their stool colour at some point. This is usually down to diet or some minor temporary cause. However, if you experience poop changes for more than 2 weeks, it is best to see a specialist. 

Why does my poop look abnormal? 

A lot of factors can cause abnormal poop. For most people, it is usually caused by stress, dehydration, lack of dietary fiber and food intolerances and allergies. In more severe cases, abnormal poop can be caused by medical conditions such as cancer, Crohn’s disease, irritable bowel syndrome, ulcerative colitis or even hyperthyroidism. 

As a rule of thumb, I would advise seeing a doctor if changes to your poop persists over 2 weeks. If your stool is bright red or black or resembles coffee grounds, seek medical treatment immediately. Remember — our poop tells us a lot about our health, so don’t neglect your toilet time!

References

  1. Anderson, J. R., Carroll, I., Azcarate-Peril, M. A., Rochette, A. D., Heinberg, L. J., Peat, C., Steffen, K., Manderino, L. M., Mitchell, J., & Gunstad, J. (2017). A preliminary examination of gut microbiota, sleep, and cognitive flexibility in healthy older adults. Sleep medicine, 38, 104–107. https://doi.org/10.1016/j.sleep.2017.07.018
  2. Badal, V. D., Vaccariello, E. D., Murray, E. R., Yu, K. E., Knight, R., Jeste, D. V., & Nguyen, T. T. (2020). The Gut Microbiome, Aging, and Longevity: A Systematic Review. Nutrients, 12(12), 3759. https://doi.org/10.3390/nu12123759

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