***This post is intended for use in examining bowel movements in the average, healthy adult. For other individuals as well as babies and children, please book an appointment to discuss your questions and concerns with your physician or Alex or Stephanie!
Well, it’s something we all do but rarely talk about… bowel movements.
But the thing is, your bowel routine can be a very helpful indicator of your overall health. And a lot of people may not realize that bowel movements which are out of the ordinary can be a sign to have a conversation with your healthcare provider.
First of all, what exactly is poop? Stools are made up of mostly of water - the rest is a mixture of bacteria, waste products of digestion (e.g. bile and mucus), and indigestible food remnants (e.g. corn, nuts, seeds).
Diet, exercise, lifestyle, medications, supplements, diseases, disorders, and infections can all affect your bowel habits.
So, to help breakdown the barriers around discussing poop, let’s talk about what a normal bowel movement actually is.
Firstly, there is no magic number for everyone - healthy bowel movements can range from 1 every 3 days to 3 in 1 day. As long as you are sticking to your normal, there is no cause for concern.
It’s the sensation, sight, and (yes) smell that can tell us what’s going on internally.
First of all, bowel movements should be formed, but soft, and passed easily with minimal pushing. Bowel movements should definitely not hurt (unless you ate a particularly spicy meal… remember: if it burns going in, it’ll burn coming out!) - if you are experiencing pain, please discuss with your physician.
Once you have completed your bowel movement, you should feel relief and like you’ve completely emptied your bowels.
Bowel movements are going to smell… sorry, it’s just a fact of life! Animal-based foods tend to produce a stronger fragrance than plant-based foods so your bathroom smells can vary a lot based on diet. However, if your stools are particularly foul-smelling or are unusual in colour, texture, and consistency this is definitely a reason to bring it up with your physician!
Now it’s time to look in the toilet bowl (sorry!) to do a health check…
First, look at the size, shape, texture, and consistency. Then look at the colour. And lastly, where is it sitting in the toilet water? Has it sunk to the bottom or is it floating at the top? Is there any oil or mucus also present in the toilet water? Let’s break down what all of these things mean…
Health researchers have developed a handy tool to help evaluate bowel movements called the Bristol Stool Chart. Taking a look at the Bristol Stool Chart, normal stools can range from Type 3-5 although the ideal bowel movement probably looks something like Type 4 - medium brown, long, smooth, soft, and easy to pass. Causes for concern can happen at either end of the spectrum: stools which look like Type 1-2 may indicate constipation, whereas stools which resemble Type 6-7 may indicate diarrhea.
Now let’s think about colour - the most common and normal colour for stool is brown. This colouring is caused by the presence of byproducts of digestion (bile and bilirubin). Here is what other colours of stool may mean:
Black: this is a must-have conversation with your physician as black stools may indicate bleeding somewhere along the gastrointestinal tract. Other causes may include medication (like Pepto-Bismol or iron supplements) and dark-coloured/black food.
Red: if stools are accompanied by frank red blood, this is also a must-have conversation with your physician. Red/maroon/purple coloured stools can also happen after consuming red-coloured foods like beets, some breakfast cereals, and tomato sauce.
Pale-yellow/grey/pale brown: stools which are this colour are another reason to talk with your physician as liquid, yellow stools may signify an infection and consistently pale-coloured stools may indicate a problem with your liver or gallbladder.
Orange: Often a product of excessive beta-carotene intake from either supplements or large amounts of vegetables such as carrots, squash, herbs, and dark green, leafy vegetables.
Green: Green stool may be a result of too short transit time (the time it takes for food to move through your bowels) and can be normal if it happens occasionally. Other causes of green stools may be, large amounts of green-coloured food (e.g. dark green, leafy vegetables) and medications such as iron supplements.
Blue: Consuming large amounts of blue-coloured foods like blueberries or food with added blue colouring can cause your stool to turn blue.
Okay, so why does some stool sink and some float?
Typically, your stool should sink to the bottom of the toilet water as fecal matter is more dense than water. However, the odd bowel movement which floats at the top is not a cause for concern as this may be due to the gas content of your stool or a change in fibre intake.
However, stools which consistently float at the top of the water, or are accompanied by abnormal colour, mucus/oils and/or foul smell may indicate a digestive issue and warrant a discussion with your physician.
Some medications have common side effects on bowel habits, such as: pain medications, antibiotics, antacids, proton-pump inhibitors, iron supplements, and magnesium supplements. If you are taking any of these types of medications and experiencing unpleasant side effects, discuss with your physician.
Signs you may be constipated:
Decrease in sizes and/or frequency of bowel movements from your normal habits
Less than 3 bowel movements per week
Straining or pushing when passing a bowel movement
Stool which looks like Bristol Stool Type 1-2 (hard, lumpy, or pellet-like)
Feeling of incomplete defecation or bowel obstruction
Abdominal pain, bloating
Requiring manual evacuation (e.g. using your hands)
Signs you may have diarrhea:
Watery, loose bowel movements that happen more than 3 times per day
Stool which looks like Bristol Stool Type 6-7 (mushy, fluffy, or completely liquid)
Abdominal cramps/pain, bloating
If you are experiencing multiple loose stools per day (but not diarrhea), we encourage you to talk to your physician about getting tested for Celiac disease. Other causes for abnormal and/or unpleasant gastrointestinal symptoms are:
Irritable bowel syndrome (IBS)
Irritable bowel disease (IBD such as Crohn’s or ulcerative colitis)
Gastroesophageal Reflux Disease (GERD)