Your bathroom habits and bowel movements offer important clues to your health. Here’s what changes in colour, texture and frequency mean…
Most of us flush and forget. But there’s a reason to pay attention to what’s in your toilet bowl.
Bowel movements can reveal whether we’re eating right, staying hydrated and maintaining our systems. And it can clue us into health issues.
“Daily attention can tell you whether you eat enough fibre or have health problems, like cancer or inflammatory bowel disease,” says Anish A. Sheth, MD, a gastroenterologist at University Medical Center of Princeton in New Jersey and co-author of What’s Your Poo Telling You? (Chronicle Books).
So what are you looking for when you go No. 2? Changes in appearance, colour and smell, Dr Sheth says.
You have plenty of chances to spot any issues because it’s normal to go anywhere from three times a day to three times a week.
1. Pebbly poop
What it means: You’re probably not getting enough fibre in your diet, so your bowel movements aren’t clumping in larger lumps.
“The recommended amount of fibre is 25-35 grams a day,” Dr. Sheth says. “That will take care of pebble poo.”
Consuming that much fibre is more natural than you think:
A cup of raspberries = 8 grams
A half-cup of lentils = 8 grams
A half-cup of cooked greens = 4 grams
A cup of whole-wheat pasta = 6 grams
Hydrate: Small poo clumps could also mean you’re not drinking enough fluids, says Mariam Fayek, MD, a gastroenterologist at the Center for Women’s Gastrointestinal Services, Women and Infants Hospital in Providence, RI.
“Women have long colons, so the waste has a longer transit time,” she explains. “And the longer it’s in the colon, the harder [and drier] it gets.”
Drink at least six 8-ounce glasses of water a day if you suspect that’s the issue, she advises.
When to worry: By itself, pebbly poo isn’t worrisome, Dr. Sheth says.
But if you also feel that you’re not emptying your bowels, something could be wrong with your rectum.
For example, pregnant women’s pelvic floor muscles weaken, which can cause an internally herniated, or protruding, rectum.
Waste can get stuck in the pocket the hernia creates, existing only in pebbles, Dr. Fayek says.
Pelvic floor exercises can strengthen muscles. Or your doctor may recommend surgery.
2. Your poop is runny
What it means: Runny stools can signal several issues:
Infection with a virus (like the flu)
Food intolerance or allergy – for example, to lactose-rich dairy products
A gastrointestinal condition, such as colitis (inflammation of the colon) or Crohn’s disease, a chronic inflammatory condition of the intestinal tract
Your diet, for example, a lack of fibre or drinking too many diet sodas
“The artificial sweetener sorbitol and fructose [sweeteners] used in sodas [act as a laxative],” Dr. Fayek explains. “They pull water into the colon because they can’t be absorbed, which makes bowel movements lose.”
Cutting down on sodas and artificial sweeteners and consuming fibre supplements might help solve the problem, Dr. Fayek suggests.
When to worry: If you know it’s the flu, stay well hydrated, says Kevin Dolehide, MD, a gastroenterologist at Advocate South Suburban Hospital in Hazel Crest, IL, an assistant professor of medicine at Midwestern University in Downer’s Grove, IL.
If it lasts more than a day, make an appointment with your doctor if you:
Are losing weight
Have a family history of Inflammatory Bowel Disease
Find blood in your stool
Have just returned from a foreign country
3. It’s black- or red-coloured
What it means: Certain medications – such as Pepto-Bismol and iron supplements – can turn poo black.
So can some foods, like beets or tomato sauce.
If blood is causing the colour, it could signal haemorrhoids, rectal bleeding or even cancer.
When to worry: Blood is always a concern and requires a doctor’s visit.
If stools are black and you’re not taking iron or Pepto-Bismol, “you need to rule out gastrointestinal bleeding,” Dr. Dolehide says.
This would show up as black, tarry and foul-smelling stools, Dr. Sheth says.
4. You’re wiping a lot
What it means: Sticky, gel-like stools could be a sign of gastrointestinal bleeding, especially if it’s dark and has been happening for only a short time, says Dr. Sheth. Large haemorrhoids – enlarged blood vessels in the rectal area – can also make it hard to clean after a bowel movement.
When to worry: If the signs point to gastrointestinal bleeding, see a doctor as soon as possible.
If not, you should still see a doctor to confirm whether you have haemorrhoids and to rule out other conditions, such as cancer.
If you’re over age 50, your doctor may schedule a colonoscopy – a visual exam of the colon done with a colonoscope – to be sure, says Dr. Sheth.
5. It hurts to go
What it means: If you’re straining like a heavyweight on the toilet, you’re probably constipated. And your efforts may have caused haemorrhoids or tears in your sphincter muscle, Dr. Sheth warns.
Soothe the rectum and anus with over-the-counter remedies, such as a cream ointment or an acetaminophen suppository, Dr. Dolehide says.
You might also take a stool softener, like docusate sodium or polyethene glycol, which makes stools easier to pass.
When to worry: Call the doctor if over-the-counter treatments don’t resolve the problem within two weeks, and you have ongoing pain, Dr. Dolehide advises.
Large tears may require surgery to repair.
6. You’re constipated
What it means: You’re eating too many burgers and fries. The typical Western diet doesn’t give us enough fibre, Dr. Fayek says.
Constipation can also be caused by medications, like those prescribed for high blood pressure.
As with pebbly poo, eating 35 grams of fibre a day – lots of beans, fruits, vegetables and whole grains – and drinking at least 48 ounces of water can ease constipation, Dr. Sheth advises.
Regular exercise aids regularity too.
And go when you have the urge: The longer you wait, the drier the stool becomes and the tighter it is to pass.
When to worry: If constipation doesn’t get better for several weeks, causes pain or is accompanied by other changes, such as bleeding, see your doctor.
This is especially important if you’re around 50 and haven’t yet had a colonoscopy, Dr. Sheth says.
7. It’s light-coloured
What it means: Stools get their colour from bile (fluid secreted by the liver), so a light grey or tan poo could mean an obstruction – a stone, for example – in your bile duct, Dr. Dolehide says.
Even worse, it could indicate pancreatic cancer or a liver disorder.
When to worry: One day of light-coloured poo isn’t a problem. That could be a shift in digestive bacteria, Dr. Fayek says.
If it continues, however, consult your doctor to rule out other health conditions.
8. It’s greenish-yellow
What it means: “If you’ve eaten a can of spinach or green Jell-O, that’s probably enough explanation,” Dr. Sheth says.
But if it’s happening consistently and you’re going to the bathroom more often, “green-goblin poo is a classic symptom of infection,” Dr. Sheth says.
“A particular kind of colitis causes seaweed-green poo,” he explains.
When to worry: Isolated incidents? Stay calm. But if the green continues, see a doctor.
If colitis is the culprit, you’ll probably have fever, cramping and diarrhoea too.
9. Pencil-thin poo
What it means: Again, not enough fibre is the likely cause.
But if it lasts over weeks or months, it could mean rectal cancer. The condition narrows the rectal opening, Dr. Sheth says.
When to worry: If you’re eating enough fibre and the stool is still thin, see your doctor rule out cancer.
10. Hold-your-nose-extra-smelly poo
What it means: The usual odour of excrement comes from mercaptans, sulfur-containing compounds.
Brussels sprouts, onions and red wine produce more of them in your body, so your poo might be odorous after you consume these foods, Dr. Sheth says.
But if the odour is unusually foul, it may signal conditions, like gastrointestinal bleeding or trouble digesting fat, possibly from other health problems.
“Fat makes its way into the stool and causes a terrible aroma,” Dr. Sheth says. “People with pancreatic or liver problems can’t digest fat appropriately.”
When to worry: If your poo smells worse than usual and it can’t be traced back to dietary changes, see your doctor.
11. Mucousy stool
What it means: “Most of the time, I see [this sort of stool] in young women with irritable bowel syndrome,” Dr. Fayek says.
This gastrointestinal disorder, which can cause pain, diarrhoea and or constipation, is most common in young women and at least twice as likely in females than in men.
It could also be a sign of inflammatory bowel or celiac disease.
When to worry: See your doctor if:
It happens chronically
You’re losing weight
You have rectal bleeding or abdominal pain