Having a bowel movement is a critical part of digesting the food we eat. Stools (or poop!) are formed in the large intestine and are made up of water, undigested fibre, dead bacteria and other substances such as cholesterol, fats and a little protein.
What does a healthy poop look like?
The Bristol Stool Chart is a tool that helps to classify our poop into 7 categories. When talking about poop, it is important that you know what is normal for you, so it is recommended you pay attention to the type of stool you pass.
As a general rule, types 1 and 2 indicate constipation, 3 and 4 show a generally healthy stool, while types 5 to 7 may indicate diarrhoea. Healthy poop should be soft yet well-formed and passed as little as 3 times a week or up to 3 times a day. Any more, or any less than that may indicate a problem with digestion or your diet.
Now, let’s look at common concerns regarding bowel habits and what they really mean.
Paying attention to the type of stool you pass can tell you a lot about the function of your body.
No.1: Rocks and pebbles
Passing hard, pebble-like stools, often associated with discomfort, straining and bloating, may be a sign of constipation. You may also find that you are opening your bowels less frequently than three times a week. Importantly, you can be constipated even if you go to the toilet every day if your bowel habits cause you discomfort as above. Common causes of constipation include dehydration, a diet low in fibre, certain medications e.g. painkillers, lack of physical activity or stress. Depending on the cause, you can increase your fluid intake, aiming for 2 litres every day, gradually increase the fibre in your diet alongside good hydration, incorporate gentle exercise and movement into your routine, or ask your medical team to review your medications if taking any regularly.
No.2: Loose and watery poo
Watery and loose stools often indicate diarrhoea. Once again, there may be many causes, including infection, medications e.g. antibiotics, certain foods e.g. alcohol, spicy or oily foods or drinks containing caffeine. Diarrhoea, especially when out of character and in the absence of other obvious causes, may also be a symptom of a variety of gut conditions including Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD). While the treatment will differ depending on the cause, it is important to stay hydrated and temporarily avoid foods that you identified as potential triggers – many people find following a plain, low-fibre diet helpful in controlling their symptoms during an acute episode of diarrhoea.
No.3: Colour changes
Moving on from stool texture, our poops also come in different colours. Certain foods have the ability to dye our poop e.g. beetroot may make it pink while spinach and leafy greens may result in a green-ish tint. Our poop may also have a green colour during or following an infection, especially when treated with antibiotics. These changes are not concerning. However, consistently pale and whiteish in colour stool – especially when accompanied by bloating, gas and stomach ache may be a sign of malabsorption. A stool with bright red blood in it might be alarming, especially alongside symptoms such as weight loss, fatigue or a change in bowel habits. Consistent blood in stool should always be discussed with your GP.
No.4: Black and tarry
Black and tarry stool is a common symptom of taking iron tablets. It may also occur following eating foods containing black liquorice or squid ink. However, it may also indicate that there is a source of bleeding higher up in the gastrointestinal tract e.g. in our stomach or small intestine. It should always be discussed with your GP as you may require further tests to rule out any malicious causes.
No.5: Oily or greasy stools
If you notice your poop is oily, floats in the toilet, and is difficult to flush, it may indicate that you are not absorbing your nutrients adequately (known as malabsorption). There may be many reasons for this and it would be best to discuss it with your GP to rule out conditions such as pancreatic exocrine insufficiency, which is when your pancreas does not produce enough enzymes or when they do not work properly. Other symptoms to look out for include weight loss, stomach ache and cramps, excess gas and bloating.
Just like everyone is different, so are our poops! But it is so important to know what is normal for you and discuss any concerning changes with your GP. If you feel awkward talking about bowel habits, the Bristol Stool Chart may be a handy tool to have on your phone/printed out with you to help you with this discussion. The Bristol Stool Chart can be found here.
