Let’s talk about poo.
Did you know that the average human produces over 4000 kg of poo over the course of their life?
No one likes to talk about it but it is one of the few things we all have in common. Poo. Stool. Faeces. Number 2. Excrement. Whatever you want to call it, it’s a normal part of the digestive process that can tell us a lot about our gut health.
Poo varies in colour, texture, amount and odour depending on what we eat. But how do we decode the messages in our excrement? What is normal variations and what is not?
If you stop reading here, these are the first two most important messages. 1) a person should be able to pass a normal healthy poo easily and with minimal strain; and 2) if you have blood in your stool, seek urgent medical attention. If you’d like to find out more, please keep reading.
What is “normal poo” like?
Colour
Normal: Medium to dark brown. This is from a pigment called bilirubin which forms from red blood cell break down.
Not normal:
Red. Although sometimes red poo can be from eating red foods (such as beetroot) it can indicate lower gastrointestinal bleeding.
Green. May be a product from undigested bile, antibiotic use or lots of leafy greens.
Yellow. Can indicate gall bladder problems or a sign of a parasite called Giardia in the intestines.
White. Some antacids or anti-diarrhoea medication can cause white poo however this may be an indicator of liver or pancreatic problems.
Black: Black poo may be from eating lots of meat or being on iron supplements however can also indicate an upper gastric tract bleed [1, 2].
Smell
Normal: Strong smelling. Yes this is normal. Bacteria in your colon emit gases containing the unpleasant odour associated with poo
Not normal: unusually strong smelling and floats. This may be an indicator that you are mal absorbing fats.
Shape/ texture
Normal: A poo passed in one single piece or a few smaller pieces that are soft but hold their shape.
Not normal:
Small chunky pieces or a hard dry large motion: Usually means it is staying in the intestines too long and water is being reabsorbed. A lack of dietary fibre (think whole grains, fruit and vegetables) can lead to these hard pellet like lumps.
Liquidy: This means it is moving through the intestines too quickly and water is not being re-absorbed adequately. A rapid increase in fibre, a cleanse or an infection may be the cause of this. Some people with irritable bowel syndrome (IBS) or other gastro-intestinal issues may suffer from this frequently. A modified diet may be needed to manage ongoing symptoms.
Pencil thin: A mass in the colon might be compressing the stool. This mass could be colon cancer or polyps. Make sure you seek medical help if not resolved swiftly.
Non-existent: If you are not passing a bowel motion, you’re constipated. Drinking more water, physical activity and adequate fibre in your diet can help resolve this.
Regularity
Normal: anywhere from three times a week to three times per day is a good guide. Passing a stool at least every second day is a good guide.
When to worry
As you can see, sometimes our poo changes just because we ate a beetroot salad or sweet potato was on special this week, so it is important not to jump to conclusions without seeking a medical opinion.
Our poo can change in relation to our diets and stress levels. If you see a change, monitor it carefully and make sure you consult a doctor if it does not resolve within two weeks.
How to promote healthy bowels
Eat enough fibre: Adults should aim at a minimum to get the recommended 25g (for women) or 30g (for men) [3]. This will help draw water into the bowel and form a nice soft stool. Good sources of fibre are whole grains and fruit and vegetable with the skin on.
Drink enough water: 8 glasses of water per day is a good guideline to start with but can change depending on your activity and sweat levels, and the temperature. It is especially important to drink enough water whilst consuming more fibre, as fibre attracts water to the bowels like a sponge.
Consider taking probiotics: probiotics are beneficial bacteria to the gut that can be taken in capsule form and/or through food and drinks such as yoghurt, unpasteurised sauerkraut and kombucha. Probiotics have been found to aid in relief from constipation and infectious diarrhoea [4, 5].
Physical activity: Staying active assists with alleviating constipation. Aim for 30 minutes of moderately intense activity 5 days per week, however any additional activity in your day is a great start.
Take away points
A well-functioning digestive system is essential for our health and wellbeing.
Normal poo is usually brown, soft to firm and easy to pass.
Persistent poo abnormalities can lead to complications. If you notice a change, monitor the change and seek help if it persist for more than two weeks.
To encourage normal bowel function, eat a fibre rich diet, exercise regularly, try to manage your stress and drink enough water to stay hydrated.
References:
[1] Snyder K. What your poop and pee are telling you about your body. [Internet]. [2018 October 27]. Available from: https://www.dailyinfographic.com/what-your-poop-pee-are-telling-you-about-your-body-infographic
[2] Leonard J. What are the different types of poop? [Internet]. [2018 October 25]. Available from:
https://www.medicalnewstoday.com/articles/320938.php
[3] National Health and Medical Research Council. Nutrient Reference Values: Dietary Fibre. [Internet]. [2018 October 28]. Available from: https://www.nrv.gov.au/nutrients/dietary-fibre
[4] Dimidi D et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, 2014; 100(4):1075-84. doi: 10.3945/ajcn.114.089151.
[5] PubMed Health. Infectious diarrhea: Can probiotics help against diarrhea? 2016. [Internet]. [2018 October 28]. Available from: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0088733/