Ep. 52 – Is Your Poop Normal?

Ep. 52 – Is Your Poop Normal?

We all learned it as a kid: everybody poops. But that’s kind of when we stop talking about it, outside of the occasional joke.

This topic may be uncomfortable, but it’s so important for you to know what makes a healthy “poop” because it can tell you a lot about your digestion. And if your digestion is off, this could be an indication that something else is going on that you need to address.

You’ve probably noticed that your bowel movements can reflect your physical, and sometimes even emotional, health. You may get constipation or have diarrhea when you eat something that “doesn't agree with you,” or when you're super-nervous about something.

And what about fiber and water? If you’re not getting enough, it’ll probably show in your poop. What about the all-important gut microbes? If they're not happy, it'll probably show in your poop.

Here are some questions to ask yourself:

  • How often are you going?
    • One to three bowel movements per day = ideal.
  • How does it feel?
    • Assuming you didn’t eat spicy street meat last night, bowel movements should be quick and painless. They shouldn’t require straining, a panicked run to the toilet, or sitting long enough to do the entire New York Times crossword.
  • What color is it?
    • Healthy poop is brown. The color comes from bile, which emulsifies dietary fat and helps us digest it. However, you may notice some normal day-to-day changes, like green poop after eating leafy greens or red poop after eating beets.
  • How does it smell?
    • It’s never going to smell like roses, but extremely foul-smelling poop can point to underlying issues.
  • Does it sink or float?
    • Healthy poop may do either, but this offers hints as to the fat (float) to fiber (sink) ratio of your diet.

Here’s a trivia question for you:

Did you know there is an “official” standard for poop? I mean a university-created chart! One that is used to help diagnose conditions like irritable bowel syndrome (IBS)? It’s called the Bristol Stool Scale!

Meet the Bristol Stool Scale

The Bristol Stool Scale was created at the University of Bristol in the UK in 1997, developed by Dr Stephen Lewis and Dr Ken Heaton. You can see the chart here.

The scale breaks down type of poop into seven different categories ranging, from type 1 (very constipated) to type 7 (diarrhea).

Types 1 and 2 are less than ideal.

They indicate stool that has been in the colon for a longer period of time.  

This will present as constipation, and the stool will be drier, harder, and lumpier. These bowel movements are often more than 1 day apart and can be difficult to move out of the body.  Evacuation can feel incomplete, like you cannot pass any more stool, however there is still a feeling of fullness in the rectum that you cannot pass without difficulty.

If seen consistently, this could warrant further investigation by your healthcare practitioner, especially if combined with other symptoms.

Common Physical Possibilities: Lack of fat, fiber, or water in the diet.

Common Emotional Possibilities: Stress, fear, anxiety, travel (often people find it difficult to have regular bowel movements while away from home).

Common Medication Possibilities: Pain relievers, NSAIDS, antibiotics, antidepressants, anti-diarrheal, iron, calcium, and more. If you’re taking a medication or supplement check the side effects to see if this could be the cause of this type of bowel movement.

Types 3 and 4 are ideal.  

This stool moves easily through the digestive tract and is eliminated without difficulty. Minimal effort is required and there is minimal toilet paper required. These do not cause pain or difficulty upon elimination.

Steps to take to see more of this type of stool: Adequate hydration, electrolytes, exercise, balanced diet with plenty of vegetables for fiber, adequate fat, and regular intake of probiotics or probiotic rich foods (especially after antibiotic therapy). Make sure to take time to rest, relax, and manage stress.

Types 5, 6, & 7 are also less than ideal.  

These represent food that has moved too quickly through the digestive tract. This type of stool can create an urgency to get to the bathroom as quickly as possible. Possible irritants can include viruses, parasites, bacteria, food illnesses, medications or supplements, sensitivities to common foods, or just even overdoing it with a single food. These can result in 5-6 or more bowel movements in a day.  

If seen consistently, this could warrant further investigation by your healthcare practitioner, especially if combined with other symptoms.

Common Physical Possibilities: Overtraining, food reactions, bacteria, virus, food poisoning

Common Emotional Possibilities: These can be the same or similar to the other end of the Bristol chart; Stress, fear, worry, anxiety

Common Medication Possibilities: Antibiotics, antiacids, antidepressants, chemotherapy meds are some of the most common. If you’re taking a medication, or supplement check the side effects to see if this could be the cause of this type of bowel movement.

The Ideal Bowel Movement

An ideal bowel movement is one where you feel the urge to poop, but if you weren’t near a restroom you could wait a while longer (though not ideal, your body could handle this). You sit down and, with little effort, produce a #3 or #4 bowel movement 6-8 inches in length and snake-like.

There should be no ribboning or breaks in the poop and, when you wipe, you should see nothing on the toilet paper. 

That is the ideal poop. You should have 2-3 of these daily, usually after your meals. Use the Bristol Stool Chart to help guide you toward more 3’s and 4’s in your daily average.

Other “poop” factors to consider.

You probably guessed that the shapes described in the Bristol Stool Scale are not the only thing to consider for poop health.

Think about how often you go. At least once per day and up to three times per day is pretty good. Less than one or more than three can mean there is something going on.

What about how hard you have to try to go? You want it to be as effortless as possible.

And the color? It should be brown from the bile that you need to break down the fats you ingest. If it’s green after a day of massive veggies, or red after that large glass of beet juice, you’re just fine. But if you see an abnormal color, like red or even black, that you can't explain based on what you ate or drank in the last day or two, you probably want to get that checked out,

What do you do when you have “imperfect” poo?

Well, the first thing to consider is how imperfect it is, and how often it is like that? Once in a while, things aren't going to be perfect, and that's A-OK.

If you know you need to get more fiber or water, then try increasing that.

If you haven’t had enough probiotic foods, then try getting more of them.

If you’re super-stressed, then try deep breathing, meditating, or having a warm bath.

Oh, and don’t forget the two most basic pieces of nutrition advice:

  • First, eat a variety of nutrient-dense, minimally processed foods, including a lot of fruits & veggies (and their “fibrous” skins, wherever possible). The fiber in these is not only helpful for pushing food through your gut, but they also feed those millions of amazing helpful critters that live there (your friendly gut microbes.)
  • The second piece of advice is to eat slowly and mindfully, chewing thoroughly.

These are good habits for anyone and everyone, even when you have perfect poop!

If you want to go the extra mile, many Functional Medicine practitioners and other health experts who understand the connection between bowel movement and digestive health will ask their patients to track their Bristol score. This provides valuable feedback to the practitioner on how the patient’s digestive health is trending and how they are reacting to different meals. Tracking your Bristol score can also help you correlate digestion with other aspects of our lifestyle such as stress and sleep.

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Disclaimer: The activities and research discussed in these podcasts are suggestions only and are only advised to be undertaken following prior consultation with a health or medical professional. Fitness training, nutrition, and other physical pursuits should be tailored to the individual based upon an assessment of their personal needs.

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