Unless you’re a toddler (or part of the male race), chances are you don’t spend much time discussing your bowel movements. It’s hardly the most appropriate topic of dinner conversation, and females don’t even do them, right?
Sorry boys, but it’s time to spoil the illusion and get down to talking ‘business’. While it may not win you Trivial Pursuit, being knowledgeable about stool health can reveal a lot about your overall health.
So to help us flush the toilet taboo, we spoke to certified Colonic Hydrotherapist and founder of pH Clinic, Nicola Johnson. Because while we might come in all shapes and sizes but we’re perfect just as we are, our faeces are not so lucky.
Our faeces are made up of our food, right? Wrong. According to Giulia Enders, author of Gut, our faeces are three-quarters water, one-third gut bacteria and one-third indigestible vegetable fibre. She says the last third is made up of substances the body wants to get rid of such as the remains of medicines, food colorants, or cholesterol.
“Your stool says a lot about your health, so assessing it is important and noticing when it changes can help you monitor your diet and lifestyle to maintain health from the inside out,” says Johnson.
When it comes to deciphering our defecation, it’s important to look at a number of factors including form, frequency, colour and transit time (the time it takes your body to complete the digestive process from chewing to bowel elimination).
The Bristol Chart (above) is the age-old method used by medical practitioners for measuring stool form. Where your faeces belong on the chart is indicative of how long indigestible particles take to pass through the gut. According to Enders, in type 1 (constipation), digestive remains take around 100 hours to pass through the system while type 7 (diarrhoea) take just ten hours. Ideally, one wants a stool to sit around type 3 or 4.
According to Nicola Johnson, who’s seen them all, the perfect poop is:
Frequency: Everyday (ideally 1-3 times per day). Some people have slower transit time and will go every second day, this is still healthy so get to know your body and its habits.
Form: Like a soft sausage.
Colour: Medium brown (if your diet is high in leafy greens, this will make stool darker in colour as will certain supplements such as iron).
If that hasn’t put you off, try this recipe to make your own nut butter.
Texture: Like dense peanut butter (it should flush without leaving marks in the bowl and you shouldn’t need copious amounts of toilet paper to clean yourself up).
Transit Time: Ideally transit time from ingestion to elimination should be minimum 12 hours and maximum 48 hours.
Not producing what the expert is preaching? Read on for signs of an unhealthy stool.
Both type 6 and type 7 on the Bristol scale are considered diarrhoea. The form can be either slightly mushy or complete liquid. According to Johnson, diarrhoea is a defence mechanism.
“If you have diarrhoea, it means that you have consumed something that the bowel is trying to eliminate or that you have caught a bug. In order to help trigger the defecation process as quickly as possible, the bowel will not extract as much fluids out of the stools as it would do under healthy circumstances,” says Johnson.
“This will enable the body to get rid of the offending substance and start the healing process. If diarrhoea stops of its own accord after a day or two and gradually gets better, it means that the body has mobilised its immune defence potential.”
Diarrhoea is indicative of a short transit time which may cause malabsorption, often wasting valuable nutrients. If chronic diarrhoea persists, it’s important to maintain hydration and consult a doctor. If diarrhoea is ongoing, you may suffer from a food intolerance.
There are a number of signs that suggest constipation. Type 1 and 2 on the Bristol chart are both considered stool forms indicative of constipation. ‘Goat pellets’ or ‘rabbit droppings’ are often caused by dehydration.
“If one does not eat enough fibre, which serves as a bulking agent, and does not drink enough liquid, which helps increase the weight of the waste, then stools can be small in size and very compacted,” says Johnson. Since water and fibre are the main components of faeces, it’s important to have a diet high in both for smooth stool movement.
In other cases, people have a good diet, but still produce goat pellets. Johnson says this could be a sign of adrenal exhaustion, of an emotional blockage or of high levels of suppressed stress and anxiety that increase acidity in the body.
Another sign of constipation is straining. Often hard, sausage-like but lumpy stool is the most painful to pass.
“If you have a bowel movement less often than every day with an occasional day off, then you are almost certainly suffering from habitual constipation. It means, in simple terms that dead stuff is not getting out through the bowel,” says Johnson.
Straining occurs when the stool is too dry or dehydrated to come out on its own. It irritates the nerve endings in the lower bowel enough to create an urge, but there is insufficient moisture and bulk in the stool to build momentum for an easy evacuation.
Constipation is indicative of a long transit time, and can cause autointoxication (absorbing toxins from waste matter that remains in the body for too long). Longer transit times may be associated with low energy levels, bad skin, congested blood, decreased immunity and degenerative diseases, including colon cancer.
Skid marks: you don’t want to leave them behind but you also don’t want them. They appear when passing soft stools that can leave a slight burning sensation. They are often present after a night on the town due to alcohol consumption.
“Alcoholic drinks contain salts, and are often accompanied by meals high in salt, proteins and fat. This draws excessive amounts of water from outside the bowel wall into the bowel itself, making the stools heavier and reducing the transit time,” says Johnson.
However, if combined with sticky, foul-smelling and greasy stools, Johnson says skid marks can be a sign of fat malabsorption in the small intestine. This can be due to poor bile action or stomach acid deficiency that affects the digestion of proteins in the stomach.
“If stools are fatty and hard to flush, it means that fats are not being properly broken down – due either to bile insufficiency or to excessive consumption of fats, especially of animal origins,” says Johnson.
“Light-coloured and greyish stools can be indicative of anaemia (shortage of iron in red blood cells), gallstones or other blockages in the bile duct, as well as of insufficient production of bile by the body,” says Johnson. If this persists, it is recommended you see your health care practitioner.
White chalk-like stools normally result from a combination of factors. Johsnon says this may include a diet low in fibre and high in processed or fatty foods, anaemia and severe dysbiosis that is often caused by excessive or long-term use of prescription drugs, appetite suppressants, street narcotics and laxatives. “All this virtually brings the colon to a standstill,” she says.
If this is occurring, it is important to correct your diet and focus on restoring balance in the gut.
Aside from being extremely unpleasant for anyone with housemates, smelly stools can actually be a cause for concern. They can indicate a few things.
“Often gassy, smelly stools are evidence of a lactose intolerance (lactose is found primarily in milk). This means that the body is deficient in rennin and lactase, the enzymes that speeds up the breakdown of casein and lactose,” says Johnson.
She says other common culprits for inducing smelly stools include bacterial infections, or dysbiosis, and the over consumption of a certain foods, particularly high-fibre vegetables such as onion, artichoke, pulses and beans.
Lay off the baked beans and cheese to see if anything changes.
“The bowel produces excessive mucus mostly for its own protection, or in order to increase the lubrication of the bowel wall, and to wrap up and help eliminate undesirable wastes,” says Johnson.
If you have mucus in your stools, Johnson says it can mean several things. Firstly, it could suggest your body is intolerant to something, and the bowel lining has secreted more mucus to try to eliminate it.
On the other hand, it might mean that you are eating a disproportionate amount of proteins and fats, especially of animal origin, including meat, milk, yoghurts and cheeses. Some people process milk products, animal proteins and fats better than others.
“It could be caused by dysbiosis, bacterial infections, obstructions in the bowel, parasites, haemorrhoids and a multitude of other things. Blood-containing mucus in the stools is a good reason to have stools checked professionally,” says Johnson.
If you’ve recently eaten beetroot there should be no cause for alarm but if not, be cautious of consistent or colossal blood in the bowl.
“If there is fresh blood in the bowels this may mean that the stools are too dry and they have scratched the bowel wall, causing it to bleed. A haemorrhoid can also bleed causing discomfort and pain,” says Johnson. “If fresh blood continues to appear in the stools a consultation with the doctor is advised.”
Dark blood on the other hand is cause for concern. “Dark blood in the stools means that there is haemorrhage higher up – in the small intestine and the stomach. Dark blood is a sign that things need to be investigated. Definitely do not put off seeing the doctor,” advises Johnson.
“If your bowel movements look ribbon-like, it is likely your bowel is spastic, and the mucous coating of your bowel is inflamed or has dried out. Almost certainly, some sections of your bowel are swollen,” says Johnson.
“A ‘sore bowel’ is very much like a sore throat. If you think how difficult it can be to swallow when your throat is inflamed, imagine that the bowel lining is very similar. However, it has fewer nerve endings that are part of the central nervous system, so it takes a while for the condition to build up and for you to take notice.”
Johnson says you can deal with this problem nutritionally by eliminating spicy foods, carbonated drinks, alcohol and coffee from your diet. She also recommends having “warm, wet, boring meals like runny porridge, vegetable soups and stews with some grains, such as brown rice or barley, warm fruit compotes and jelly.” Keep your meals small and do not sit down or bend down for about 20 minutes after each meal. Also, avoid anything that is too hot or too cold.
If you have discernible bits of food in your stools, it might simply mean that you are not chewing your food properly.
However, Johnson warns, “it may also mean the bacterial colonies that live in your gut are not doing a very good job. Or it may be that you are not producing enough enzymes in the small intestine, the stomach or the pancreas and this causes inadequate food assimilation by the body.”
That being said, some foods are notoriously harder to digest than others. A lot of people do not digest tomato, potato and apple skins, seeds or nuts, sweet corn and popcorn so these are of less concern.