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What your stool can reveal about your health

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The consistency, color and shape of your bowel movements say a lot about what’s happening inside your body. Here’s how to read the tea leaves in the toilet bowl. 

Emily Shiffer

By Emily Shiffer

Most people blush at the thought of talking about their bowel movements. But there’s nothing to be embarrassed about here. Everybody poops. And the critical waste product can provide important information about your health. That’s why it’s smart to always glance in the toilet bowl before you flush.

“Your poop can tell you a lot about your gut health,” says Rajiv Sharma, MD, a gastroenterologist with Gastroenterology of Greater Orlando. “From smaller issues to very serious ones, looking out for some key signs is very important to your overall health.”

Peeking into the toilet regularly helps you understand what your “normal” looks like. But when things change, that’s when you should pay close attention.

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What changes in stool consistency mean

The Bristol Stool Chart is what doctors use to classify bowel movements. It was created in 1997 by Ken Heaton, MD, at the University of Bristol in the U.K. It classifies stool into 7 types. They range from type 1 (hard lumps) to type 7 (entirely liquid).

“The Bristol Stool Chart is the gold standard for gastroenterologists,” says Sabine Hazan, MD, a gastroenterologist in Ventura, California. She’s also the founder of ProgenaBiome, a research lab focused on gut bacteria. “When you look at the Bristol Stool Chart, it shows you a picture that makes it easier to describe bowel movements. We also use this chart to determine whether your treatment is working or not.”

If you’re evaluating the health of your stool, this is a good place to start. Ideally, you want it to fall right in the middle of the Bristol Stool Chart. Here’s how the 7 types break down:

Type 1: Separate hard lumps (very constipated)

Type 2: Lumpy and sausage-like (slightly constipated)

Type 3: A sausage shape with cracks in the surface (normal)

Type 4: Like a smooth, soft sausage or snake (normal)

Type 5: Soft blobs with clear-cut edges (lacking fiber)

Type 6: Mushy consistency with ragged edges (inflammation)

Type 7: Liquid consistency with no solid pieces (severe diarrhea)

Stool types 3 and 4 are considered ideal, while 1 and 2 indicate constipation, and 5 to 7 point toward diarrhea. (Read about constipation relief here.)

If your stool irregularity is a onetime occurrence with no other symptoms, you may simply need to adjust your diet. But if it’s ongoing or tied to other symptoms, you should probably schedule a doctor visit.

“If you are questioning when you should see a doctor for your stool, some telltale signs could be blood in the stool, severe constipation, abdominal pain, weight loss without an obvious cause, nonstop diarrhea or yellow discoloration of the eyes, which could signal jaundice,” says Dr. Sharma.

But consistency isn’t the only problem indicator. Here’s what else to look for:

Change in stool color

The color of your stool is determined by bile, a yellow/green fluid in your intestines that helps digest fats. As waste travels through your gastrointestinal tract (GI), enzymes change the color to poop’s typical brown.

So if you notice that the color of your stool has changed to a green, white or clay shade, it could be due to a liver or bile duct blockage, says Dr. Sharma. If your stool is black or red, it could be a sign of gastrointestinal bleeding. Yellow, meanwhile, may signify a malabsorption issue, and it is caused by excess fat in your stool. These are all situations in which you should see a doctor.

The presence of blood

Blood in the stool can be bright red or it can show up as dark, black-looking streaks. In either case, schedule an appointment with your doctor as soon as possible. It could be a sign of colorectal cancer or colitis.

“If there is any blood in your stool — it doesn’t matter if you think it's rectal or hemorrhoids — you should contact your doctor,” says Dr. Hazan.

Change in the frequency of bowel movements

If you find yourself pooping more or less than usual, it could also signify an issue, says Dr. Hazan. That’s especially true if the frequency change has lasted more than a week.

“A change in the frequency of your bowel movements could have multiple causes,” says Dr. Sharma. “We’d want to check for a blockage of the bowels, malabsorption, colitis or celiac disease.” He adds: “If you are seeing too much oily discharge, it may suggest pancreas issues.”

Related: 4 signs that your bathroom problems might be related to IBS

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How to keep your GI tract on track

To help keep your gut healthy and your bowel movements regular, here are 5 tips from gastroenterologists.

Tip #1: Drink lots of water

Constipation is often a symptom of dehydration. Daily water needs will vary from one person to another, but as a goal to shoot for, the Mayo Clinic recommends drinking 8 ounces of fluid 6 to 8 times a day.

Tip #2: Eat a fiber-filled diet

Fiber helps to soften stool while increasing the bulk and weight. That will help prevent constipation, says Dr. Sharma.

According to the Dietary Guidelines for Americans, an adequate fiber intake for women is 25 grams per day, and 38 grams per day for men. But Americans average only between 10 and 15 grams per day, according to Harvard Medical School.

Tip #3: Minimize red and processed meats

Try to limit your intake of burgers, hot dogs, ham and sausage. People who eat red or processed meat 4 or more times per week are 20% more likely to develop colorectal cancer than those who eat it less than twice a week, according to a study from the International Journal of Epidemiology.

Tip #4: Consider a probiotic

Probiotics are live microorganisms that you can take in pill form. They’re designed to help maintain and improve the good bacteria in the gut. Research indicates that for people with gastrointestinal conditions such as irritable bowel syndrome or ulcerative colitis, a probiotic may ease symptoms. In that case, “it’s important to take your daily probiotics to keep your GI tract healthy,” says Dr. Sharma.

Tip #5: Make time for relaxation

Stress and anxiety stimulate the release of hormones and chemicals that throw off the balance of the bacteria in your gut. This can cause symptoms such as diarrhea and constipation, and it can even worsen your emotional health, according to the American Psychological Association.

To decrease your stress and anxiety, Dr. Hazan suggests breathing exercises, meditation, minimizing screen time and checking news sources less often.

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Additional sources
Probiotics in ulcerative colitis and Crohn’s disease: Inflammatory Bowel Diseases (2013). “Effect of Probiotics on Inducing Remission and Maintaining Therapy in Ulcerative Colitis, Crohn’s Disease, and Pouchitis: Meta-analysis of Randomized Controlled Trials
Probiotics and IBS: BMC Gastroenterology (2016). “Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis
Typical fiber intake is only 10 to 15 grams: Harvard Health Publishing
Red meat increases the risk of colorectal cancer: International Journal of Epidemiology (2020). “Diet and colorectal cancer in UK Biobank: a prospective study
The effect of stress on the body: American Psychological Association