Let’s talk about our number two, poop, doody, stool, excrement, sh&*!, bowel movement….whatever you call it, the one thing we all have in common is, we all do it.
Just as wildlife experts track poop to understand more about location, diet, habit and well-being of animals, we can also do the same tracking in our lives to stay conscious of what is going in and coming out of our own bodies.
In a recent study many of us were not able to identify a healthy normal stool and what it should look like.
Diet plays a very large role in not only frequency, but also texture, size, shape, and smell of our stool. As well as diet, water intake, exercise, sleep deprivation, alcohol, stress, smoking and medication can all influence your bowel movements in one way or another.
We seem to remember times of constipation (it can be very painful!) and the other extreme of diarrhoea, but we’re all looking for the big B word, the balance in the middle. Constipation is when you have a hardened stool or separated lumps. The large intestine functions to remove water from the stool as it passes through the gut. If the stool sits in this place for longer due to decreased motility – either by problems with muscles lining the intestines, or by a diet low in fibre – more water is drawn out from the stool, making it harder and therefore more difficult to pass. Eating a diet that’s rich in fibre helps bulk up the stool, making it act like a sponge, helping to retain some water and move through the system easier. Consuming your 5 a day high fibre foods, fruit and vegetables as well as drinking several pints of water keeps your bowel movement, quite literally, running smoothly.
The Bristol Stool Chart – this was devised in 1997 by doctors at the Royal Infirmary, Bristol
The ideal stool is generally type 3 or 4, easy to pass without being too watery.
If yours is type 1 or 2, you're probably constipated.
Types 5, 6, and 7 tend towards diarrhea.
Type 1 – Separate Hard Lumps, like nuts (hard to pass)
These stools lack a normal amorphous quality, 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‘re painful to pass, because the lumps are hard and scratchy. Typical for post-antibiotic treatments and for people attempting fibre-free (low-carb) diets. Flatulence isn‘t likely, because fermentation of fibre isn‘t taking place.
Type 2 – Sausage shaped 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. This type is the most destructive by far because its size is near or exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s bound to cause extreme straining, 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 is most likely to suffer from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls. 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 hernia, obstruction, or perforation of the small and large intestine alike.
Don’t fret, a few small lifestyle changes can get your body back in a more regular rhythm. Try upping your water intake to two litres a day or drinking a ginger tea before bed. If you’re hydrated it’s a lot easier for everything to move through your body, in turn keeping your bowels more regular.
Type 3 – Like a sausage but with cracks on its surface
If your type 3 your poo is normal
This form has all of the characteristics of Type 2 stools, but the transit time is faster, between one and two weeks. Typical for latent constipation. The diameter is 2 to 3.5 cm. Irritable bowel syndrome is likely. Flatulence is minor, because of dysbacteriosis. 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
In fact, if you’re type four – you share your poo type with over half the country.
This form is normal for someone defecating once daily. The diameter is 1 to 2 cm. 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 (Passed easily)
I consider this form 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.
To fix this, it may just be a matter of upping your fruit and veggie intake. Leafy greens, such as spinach, are a great source of fibre.
Type 6 – Fluffy pieces with ragged edges, Mushy stool
If you’re seeing these types, you may have eaten something that’s a bit iffy or you could have had an allergic reaction. If you regularly see this type, you could suffer from a condition such as irritable bowel syndrome, so it may be worth consulting your doctor.
All and all, the most important thing when it comes to your bowel health is if you have concerns, you should speak to your GP. Especially when you see blood in your stools, as that is a symptom of bowel cancer. There's nothing to be embarrassed about, so if you are feeling a bit worried about what you’re seeing in the loo, don’t be afraid to speak up.
This form is close to the margins of comfort in several respects. First, it may be difficult to control the urge, especially when you don‘t have immediate access to a bathroom. Second, it is a rather messy affair to manage with toilet paper alone, unless you have access to a flexible shower or bidet. Otherwise, I consider it borderline normal. These kind of stools may suggest a slightly hyperactive colon (fast motility), excess dietary potassium, or sudden dehydration or spike in blood pressure related to stress (both cause the rapid release of water and potassium from blood plasma into the intestinal cavity). It can also indicate a hypersensitive personality prone to stress, too many spices, drinking water with a high mineral content, or the use of osmotic (mineral salts) laxatives.
Type 7 – Watery, no solid pieces. Entirely Liquid
Type 7 isn't always diarrhoea unless it's accompanied by more than three bowel movements in a day. If your diarrhoea lasts for 24-48 hours, there shouldn't be any need to see your GP, however if it lasts longer, or comes with symptoms such as blood in your stools, chronic diarrhoea and tiredness, make an appointment with your doctor.
Other factors
Colour changes - The colour of stool is impacted by the foods you eat and the kind of bacteria living in your colon. There are a lot of food colourings added to what we eat and drink, so colour of your stool is going to change. A change in the colour of stool is usually not cause for concern, unless it appears to be black or bloody, which could signal other problems with the digestive system.
Black and Tarry - The most common cause of black and tarry poop is from taking iron supplements or a medication containing bismuth, such as Pepto-Bismol. However, it could mean you’re losing blood somewhere in your gastrointestinal tract, such as in the stomach or small intestine.
Oily or greasy stools - If you have poop that appears oily, has a greasy consistency and is difficult to flush, it could be a signal that your body is not able to properly digest fat. The consistency changes could be caused by an infection, nutrients not being digested due to celiac disease or a problem with the pancreas, such as pancreatic cancer or pancreatitis.
Holiday Factors
There’s no toilet like home. It’s a fact. However exciting a holiday trip can be, your gut seems to know when its back in it’s comfortable, natural surroundings.
The reason our bowel movements can change so drastically while we are away can be down to the lack of gut friendly food and drink we may consume on our hols, as well as unfamiliar bacteria in new environments throwing out our gut microbiomes. Jet lag can play a part in an upset system to an upset routine. We are creatures of comfort after all. We are sensory human beings and in turn we are affected by seen and unseen states of change. The moment we waltz back through our safety threshold can immediately trigger a relaxation response in the comfort of our own homes which activates the hallelujah moment of the returnee’s release! This change in movement isn’t just contained to holidays or factors abroad. I’m sure all of us can remember an over-nighter that kept us on edge. There is much more to our toilet habits than we can ever understand in the atmosphere stimulated around us.
Summary
Water and fibre, coupled with a balanced diet seem to be the best medicine for our bowels, as well as reducing alcohol, smoking and stress. Make sure you contact your doctor if you are in any doubt, especially if you have any blood in your stool.
Plus don’t forget….exercise helps your system get mobile and responsive!!!
Brett’s view
I never really think about it as it usually occurs after my early morning coffee and before a run. The only time I do notice a change is when the surroundings aren’t so familiar, which is crazy..I guess "home is where the loo is”.
David’s view:
Since lock down, I have experienced more of a normal routine with less stress and travelling, which has definitely had a positive impact on my body. Over the years of being constantly on the road in different countries and cities for work, I definitely feel I have had an irritable bowel. I take a turmeric tablet every day which is supposed to be good for inflammation. Ginger tea is also good for making things run smoothly.