Is My Poop Normal?
To learn more about if your poop is normal, watch The Gut Show episode above (read the episode transcript here) or continue reading!
Everyone poops. It’s a natural process all bodies have to go through, but that doesn’t mean everybody is doing it right!
As a digestive health specialist, I’ve learned that many people have no idea what normal poop should actually be, and sometimes they are completely thrown off when they actually start pooping normally. So if you’re asking the same question and really aren’t sure, you’re not alone!
Poop is made of food leftovers from digestion, water, organisms, mucus, and old red blood cells and it is considered the “waste” from the process of digestion.
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How is poop made and formed?
It’s obvious that what you eat doesn’t come out the other end in the same form, color, or shape. That’s because there’s a lot that happens between ingestion and elimination. Food starts to break down in your mouth, then comes together as a more liquid mass, mixed with liquids consumed and digestive juices, when it leaves your stomach.
In your small intestine, you break down and absorb macro and micronutrients, and the liquid mass of food starts to come together more. Bile is also released in the small intestine to help with digestion. What’s left from digestion in the small intestine makes its way to the large intestine for bacterial fermentation. As things move through your large intestine, water, bile, undigested food particles, bilirubin, dead cells, and organisms form together to go from a liquid mass to a more formed mass, known as your stool. This is also where the coloring of stool happens, and the color is mostly influenced by bile and bilirubin.
Bile is made by the liver and is released by the gallbladder to help break down foods you eat, primarily fats. Bile has a yellow-green color, and while most is reabsorbed by the body, some bile will add to your poop and contribute a yellow-green color. If your body is not reabsorbing bile, you will notice more of the yellow-green tint. Bilirubin is a substance from your blood that is formed after red blood cells break down. It has a yellow color to it and will add to your poop. The mixture of bilirubin, bile, and leftover food matter are all what lead to a brown color range - from dark brown to a more pale brown.
What’s wrong if stool isn’t formed properly?
Issues with forming stool can include:
Poor fiber intake - not enough of the non digestible foods that add bulk to stool
Poor water intake - not enough water to add to stool and keep it soft to move at the right pace
Fast or slow motility - either too slow and water is reabsorbed, leaving it dry/hard, or too fast to actually form
Low digestive capacity - malabsorption, poor bile release or absorption, or other issues with digestive organs that interfere with proper formation
How should poop be released?
Once stool is formed, it makes its way to the rectum, which is a holding place at the bottom of the colon. This is kinked off by a pelvic floor muscle, called the puborectalis muscle. Typically the signal to release stool comes when the rectum is full or the gut is stimulated. When you wake up, either upon waking or with your first meal, the digestive tract is stimulated and signals to clear the rectum so you can form and pack stool throughout the day ahead. This is called the gastrocolic reflex.
The signal to release can also come when the gut is over stimulated or the rectum is very full and ready to be emptied. Some people struggle to feel this signal or even get the signal. Some people are more sensitive to the signaling and may feel the signal even when it’s not time to release, which can cause frequent toilet trips that aren’t productive. When you sit on the toilet, a normal passing of stool means that the puborectalis muscle unkinks and the pelvic floor muscles surrounding the anus fully relax. As these muscles relax, the formed poop in your rectum is able to easily pass.
When poop does not easily pass, it can be due to:
Poor relaxation of muscles
Poor coordination with abdominal muscles needed to help push stool through
Harder stool
Proper toilet posture, with your knees above your hips, diaphragmatic breathing to help release muscles, and pushing on your inhale versus exhale can all help with releasing poop.
So what’s actually considered normal?
Normal poop characteristics:
Brown color
Smooth form, like. sausage or snake
Passes easily
Clean exit
1-3 per day
What other Poop colors may mean:
Green - foods you eat, like green veggies, green food coloring, or iron supplements. Can also be due to diarrhea and bile not mixing with bilirubin to turn brown.
Yellow - can be normal for some but if it is also greasy or fatty-looking, it can be a sign the body is poorly digesting fats. Can also be a sign of celiac disease.
White or clay colored - medications (bismuth is a common one), barium, lack of bile, or liver disease.
Black - eating large amounts of blueberries or black licorice, iron supplements, other medications, or bleeding in the upper part of the GI tract.
Red - intake of beets, large portions of tomatoes, gelatin, red drinks, or bleeding in the lower part of the colon.
Orange - high intake of orange foods, orange food coloring, antibiotics, antacids, or signs of poor bile release.
What about other shapes and textures?
If your poop is very hard or pebbly, that may be a sign of constipation. This can be due to poor water or fiber intake, lack of movement, poor routines, or slowed motility due to another cause.
If your poop is mushy, this is a sign of poor stool formation. Increasing soluble fiber and reducing gut stimulants may be helpful. It is also important to look at overall digestive capacity and assess for food intolerances.
If your poop is liquid, this can either be a sign of more severe constipation (known as overflow diarrhea) or diarrhea. The best way to assess this is to look at actual stool output. Are you releasing a lot of poop when you go, and are you going multiple times a day?
If you’re releasing a lot of poop, this may mean you have diarrhea, which can be due to hyper-motility, food intolerances, stimulants, or infection. If you aren’t releasing a lot of poop, this may mean you are actually constipated. With severe constipation, it is recommended to clear the backup and then focus on healthy gut motility to prevent reoccurrence. You can test for this with a KUB x-ray of your colon.
Where do you stand?
If you’re noticing signs that your poop isn’t normal or you’re honestly not sure, you may benefit from individualized guidance from a specialist dietitian, like the ones here at Gutivate! You can schedule a consult call here to see if this is the right fit for you.
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