Get the scoop on your poop and what it says about your health

April 10, 2024

Swedish Digestive Health Team

[4 MIN READ]

The scoop on poop

What is a “normal” bowel movement?

The range of what’s considered normal when it comes to your stool varies widely from person to person. That means as long as your routine stays roughly the same every day, there’s probably no cause for concern. It’s when things change that you need to pay closer attention, according to Dr. Padhya.

“Frequency, consistency, color, contents – those are all the things we talk about when discussing gut health and your bowel movements,” she explains. “You want to know what your baseline is and tell your doctor if it changes.”

Frequency varies

“What most people don’t know is that normal frequency for a bowel movement can be anywhere from three times a day to three times a week,” says Dr. Padhya. “If someone says they go three times a week, but they feel perfectly fine in between – they don’t feel discomfort or bloating – then three times a week is their baseline. Then there are those people who go like clockwork every morning. Both can be normal.”

Dark black? Something’s out of whack

Your stool can be a wide array of browns, yellows and greens and still be healthy. The color changes according to the food you eat and the amount of bile in your stool. It’s rarely a predictor of a severe health condition.

If, however, you see dark red or blackish stool during your bathroom breaks, it could be a sign of a serious problem.

“Blood can get oxidized and turn black as it’s moving throughout the colon. Very dark black or tarry stool that looks like shoe polish suggests that there could be bleeding going on further up in the gastrointestinal tract,” says Dr. Padhya. “In addition, a significant lack of color or stool that looks like clay could signify an issue in the liver or bile drainage system.”

Check the contents

“We always want to know if you’re seeing new blood in your stool and whether it’s mixed in with the stool, in the water or on the toilet paper,” says Dr. Padhya. “If you’re seeing oily stools or fat droplets floating on the water’s surface, it could be a sign of malabsorption.”

Mucus in the stool may seem “worrisome,” but the colon is a mucus membrane, so that’s not necessarily an issue. It’s still a good idea to keep an eye out and report any significant changes to your physician, according to Dr. Padhya.

Losing control

“New urgency or even incontinence suggests that there may be something going on in the very lowest part of the colon, called the rectum. If the rectum becomes very inflamed, it’s unable to hold on to stool and you’ll have the urge to go all the time. Those can be signs of something serious like ulcerative colitis, Crohn’s disease and cancer. Or they could be a sign of something more benign like hemorrhoids or a muscular problem of the pelvic floor,” says Dr. Padhya

Keep an eye on consistency

The caliber of your stool refers to its consistency. “Pencil thin” stools are sometimes thought to be concerning for a narrowing or blockage in the colon, but occasional changes in stool caliber may be normal. Still, it is something to keep an eye on, according to Dr. Padhya.

Underlying conditions

Certain medications and health conditions can prompt changes in your stool, causing abdominal cramping, constipation or diarrhea.

“Side effects of medications, especially opioids, even if you’re taking them for a short term, can affect the frequency or the consistency of your bowel movements,” explains Dr. Padhya. “Some health conditions have the same effect.”

Health conditions that can affect your gut health include:

Diabetes
Overactive or underactive thyroid
Celiac disease
Inflammatory bowel disease
Food intolerance

Improve your gut health

“Hydration and fiber are key to keeping bowel movements as healthy as possible,” says Dr. Padhya. “A lot of good gut health is common sense: good sleep, good exercise, good hydration.”

Ways to promote good gut health include:

Eat mindfully. Slow down while eating and chew your food well before swallowing.
Don’t overfill your stomach with too-large meals.
Eat a variety of whole grains and fiber at each meal.
Limit how much you eat at night.
Develop healthy ways to manage your stress.
Eat your meals around the same time every day.

“A recent study has shown that eating kale can improve the frequency and consistency of bowel movements in certain patients with constipation,” says Dr. Padhya. “The simple recipe below allows you to customize the ingredients depending on your tastes. Massaging the kale is key to reducing bitterness and making it easy to chew.”

Simple kale salad recipe

1 bunch dinosaur (lacinato) kale
Olive oil
Lemon juice
Salt
Pepper

Strip the kale leaves from the stems. Stack leaves on top of each other, roll and cut into thin ribbons. Place kale in a large bowl with lemon juice, olive oil and salt. Massage the kale vigorously for 2-3 minutes until it is softer. Add freshly ground black pepper and any of the options below for variety:

Parmesan or pecorino romano cheese
Nutritional yeast
Toasted walnuts or pine nuts
Pumpkin seeds
Pickled peppers
Dried cranberries or golden raisins

When to call the doctor

With such a wide range of “normal,” how do you know when to get professional help?

Dr. Padhya recommends you call your physician if you experience:

Diarrhea or constipation that lasts more than two weeks.
Severe abdominal pain.
Diarrhea accompanied by abdominal pain, chills, fever, fainting or vomiting.
Deep red or black, tarry stools, or stools that are completely without color.
Sudden urges to have a bowel movement or bowel incontinence.
Unexplained weight loss

Learn more and find a provider

Gastroenterologists at Swedish provide comprehensive, compassionate care to diagnose and treat health conditions that affect your bathroom habits, such as inflammatory bowel disease, Crohn’s disease, ulcerative colitis and irritable bowel syndrome.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.

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