And to do some investigative work?
I know it’s a bit of a weird topic to talk about….but …
How much do you know about poop? And how much attention do you pay to your own poop?
From my own personal experience as well as my experience with clients, I knew that this was an important topic to cover. But when I looked around the Internet, I realised it was even more important than I thought! In fact, I found out that there is an incredible amount of questions asked around about poop!
In hindsight, that should not have surprised me after all.
Despite having struggled with constipation or alternating diarrhoea and constipation for most of my life, I personally had never been educated about what is normal vs common vs healthy vs worrying…
And honestly…when I was not in the middle of one of my crises of acute pain or discomfort, I didn’t give it much thought either. I was also hardly ever asked details about it from conventional (and, in some cases, also alternative medicine) doctors and practitioners, despite all my gastrointestinal and non-gastrointestinal related symptoms.
So, that must not have been so important! Right?
Absolutely NOT!
On the contrary, it is so important that my teacher and mentor Andrea Nakayama never tires of repeating that poop is part of the “3 NON-NEGOTIABLE TRIFECTA, the 3 factors that must be addressed, no matter the signs, symptoms, or diagnosis” - together with blood sugar balance and sleep, also among my favourite topics to talk about!
Each of these areas is crucial to resolving any health conditions and if even one of the three is not functional, no matter what protocols or interventions, they don’t stand a chance to obtain the maximum or desired results!
And paradoxically, even in the world of functional medicine, this important aspect is sometimes overlooked in favour of more “sexy” aspects to work on… including very advanced, and expensive, stool testing. So in my practice, not only do I ask lots of questions about poop, but I invite my clients to track their bowel movements (among other things such as food intake, sleep, symptoms and lifestyle aspects) so they can learn more about their own bodies and their digestive function.
And I’d like you to start doing the same.
Even before (or without) going to advanced stool testing, in fact, our poop can be an important source of information and a diagnostic tool. Shape, colour, consistency, frequency of bowel movements can tell us a lot and help us make more informed food and lifestyle choices.
First of all: what is poop?
Faeces are the waste products from food that are removed through defecation. Food that is not digested and absorbed in the small intestine is further processed by bacteria in the large intestine. What is left composes our faeces.
They consist of water, salts, dead cells from GI mucosa, bacteria, products of bacterial decomposition, unabsorbed food and indigestible food.
Interesting notes:
About 1/3 of the weigh of faeces is actually gut bacteria (30 to 40% according to estimates from some decades ago [1]).
Many of those bacteria are still alive. In one study, about 50% of the bacteria were found to be intact [2].
1 g of faeces (wet content) is estimated to contain 10^11 bacteria [3]. That means: 100000000000!
And now let’s take a look at what an ideal situation is and get some questions answered. Some of those questions…come straight from Google!
What’s the shape of a perfect bowel movement?
The Bristol stool chart comes in handy here. It is a chart that has been developed to describe faeces. It has 7 points ranging from 1- Separate hard lumps indicating constipation to 7-diarrhoea, see chart and description below.
BRISTOL STOOL SCALE
Separate hard lumps
Lumpy and sausage-like
Sausage shape with cracks in the surface
Smooth, soft sausage
Soft blobs with clear- cut edges
Mushy consistency with ragged edges
Liquid consistency with no solid pieces
The perfect poop should be a 4 in the scale: so the perfect bowel movement should be solid, “sausage” shaped, smooth (but also with some cracks on the surface that’s ok.)
What should be the colour of a perfect bowel movement?
Ideally, poop should be of a light or golden brown colour, but yellow, green or even red might be ok too, depending on what you ate (e.g. have you eaten red beets?).
However, if you see a red or black (without explanation from the food you ate) or a pale colour, it might be advisable to go to your doctor!
Red or black, for instance, might be due to the presence of blood, while a pale colour might be due to an insufficiency of bile.
What is the ideal frequency for BM?
I found lots of questions about that in the Google search bar!
Is it normal to poop 3 times per day? YES
Is it normal to poop once a day? YES
Is it normal to poop every 3 days? MMM! While this might be common and not medically concerning, it is for sure far from ideal.
Is it normal to poop once a week? NOT REALLY, though not so uncommon.
While medically there is not an agreed upon normal number of bowel movements per day, ideally you should have 1 to 3, also depending on the number of your meals. If you have 3 meals per day, 2 or 3 would be ideal.
How should you feel upon having a bowel movement?
You should feel that the evacuation is complete and the stool should be easy to pass, without any need to strain.
Should food particles be visible in your poop?
No, they should not (on a regular basis)! Visible food particles are signs of incomplete digestion.
Should poop float or sink?
Ideally, poop should sink. If, instead, it floats on a regular basis, this could be a sign of incomplete fat digestion. Other signs would be that it leaves an oily coat to the toilet bowl or that mucus is noticeable in the stool. Floating poop could also be due to a high presence of trapped gas or insufficient fibre intake.
Is poop supposed to have a foul smell?
Well, poop is supposed to have an unpleasant odour. However, particularly bad or intense smells though can be an indication of something going wrong in digestion or in the digestive tract.
For example, incomplete digestion of proteins might result in putrefaction in the colon and sulphur- or ammonia- smelling stools.
Foul smelling stools might also be signs of other problems such as infections (e.g. parasitic infections).
Is it normal to poop right after a meal?
It can be.
It can in fact be due to something called the gastrocolic reflex which takes place when we eat and peristalsis (the wave-like motion that allows to push food down the digestive tract) is initiated. If there is waste in the colon, that might need to be eliminated.
And no, generally food is not going right through you!
Pooping right after a meal, however, can also be a sign of something else, e.g. food sensitivities, especially if there is a sense of urgency or there is pain, diarrhoea etc.
Why is it important to have daily bowel movements (and the perfect type)?
There are several reasons. Here some of them:
the longer the stools sit in the large intestine, the more water gets reabsorbed, the more they can irritate the lining of the colon
defecation is one of the major ways you have to remove waste substances from your body and these can include metabolised toxins and hormones. Such substances might be reabsorbed if the stool sits in the large intestine for too long (this is one of the connections between hormonal health and digestive health!)
if the waste matter sits too long in the large intestine, unwanted fermentation or putrefaction might be instigated.
Why is it important not to have watery stools? Or too frequent bowel movements?
We need to give our gastrointestinal tract time to properly break down food and absorb nutrients from the food we eat!
Diarrhoea or watery stools may be a sign of food sensitivities or intolerances. A quite common example is lactose intolerance. If there is a deficiency in the lactose-digesting enzyme “lactase” (this is probably a lot more common than you realise!), lactose is not broken down in its single sugar molecules (the monosaccharides glucose and galactose) and it cannot be absorbed in the blood stream as such. It stays therefore in the small intestine where it tends to attract water molecules and cause diarrhoea.
What are some of the factors that might be affecting your poop?
Of course what you eat, in different ways: composition of your meals, fibres in your diet, but also food sensitivities and intolerances…(and how you actually digest and assimilate what you eat!) but also hydration and lifestyle factors such as stress levels and movement! And your position while pooping is important too!
While there is a lot more to say about poop, and a lot that can be done about problems such as constipation and diarrhoea, today I’d like to offer just ONE TIP:
Get curious and do some detective work for a few days!
How can you do that?
For 3 to 5 days, keep a detailed journal. It should look something like the one in the picture below.
If you’d like, leave me your email and I’ll be happy to send you my template to print out/use!
With or without my template, here's what you should track:
Time: Time of the day (when you eat and go to the loo)
Food: Exactly what you eat and drink (except for water), listing all the ingredients.
Poop: use these questions as a guideline:
What’s the Bristol stool chart type?
What is the colour?
Are there undigested food particles visible?
Does it float?
Does it leave an oil slick?
Do you feel the elimination was incomplete?
Is there mucus in your stool?
Do you smell a specific odour? E.g. a sulphur-like smell?
…
At the end of the 3 or 5 days, go back to the journal.
What do you observe? Is there any significant change between days? How are the changes related to what you ate?
If you don’t feel squeamish about it, go ahead and comment below to share your own experience. Or get in touch with me via email. Are you struggling with specific issues and would you like me to address them in a new blog article? Let me know!
Or are you ready to go further and would like to receive 1:1 support from me?
Get in touch for a free 20-minute functional nutrition and lifestyle consultation and let’s find out how I can further support your healing journey.
References
[1] Stephen AM, Cummings JH. The microbial contribution to human faecal mass. Journal of Medical Microbiology. 1980 Feb;13 (1):45-56.
[2] Ben-Amor K, Heilig H, Smidt H, Vaughan EE, Abee T, de Vos WM. Genetic diversity of viable, injured, and dead fecal bacteria assessed by fluorescence-activated cell sorting and 16S rRNA gene analysis. Appl Environ Microbiol. 2005;71(8):4679-4689.
[3] Sender R, Fuchs S, Milo R. Are We Really Vastly Outnumbered? Revisiting the Ratio of Bacterial to Host Cells in Humans. Cell. 2016;164(3):337-340.
Comentários