Episode 18: Is your poop normal?

Have you ever wondered if your poop was actually normal? Do you know what normal poop even is?

This episode breaks down what’s normal and what’s not to help you understand what your body may be communicating to you through your poop.

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Welcome back to The Gut Show! Today we're going to talk about a common question that I get: what makes poop normal or abnormal? So you may have wondered this as well, is your poop actually normal? Whether or not you actually look at it or not, we are going to talk about things that you can be looking for, and some signs of normal, abnormal, or just some weird things that could be going on, that your poop might be communicating to you.

So whenever we're looking at a normal kind of ideal poop, when we're looking at color, it should be about a dark brown to like a lighter brown hue. So we want it to be brown, not necessarily other colors. And this can be influenced by what you've eaten, and how you've eaten throughout the day, it can be influenced by a lot of different factors. A healthy bowel movement should be fairly stress free, with minimal to zero strain, meaning, it should come out pretty easily, you might sit there for a little bit, but really anything over you know, five-ish minutes of sitting on the toilet could be stress.

Normal poop should be passed every one to three days, for some people, it's going to be one to three times a day. So this is the question that usually comes up the most: how often should I be pooping? 1 to 3 times a day is completely normal, and technically, once every three days is considered normal. What I've seen in my practice is that if you're not pooping at least once a day or every other day, then there's usually going to be some other discomfort going on, like some signs of constipation, like bloating, extra gas, maybe extra strain with bowel movements that every three days. So I like to see once a day in my practice, but it can be normal once every three days, depending on how much you're actually releasing.

The consistency of your poop will also depend on your diet and lifestyle, but it should be kind of like a smooth log. So we typically look at the Bristol stool chart. And a type four is what we call our ideal normal bowel consistency, which is just a smooth log or snake if you will. A lumpier log is also considered fairly normal. But whenever we're looking at, you know, mushy stool, or broken up or liquid stool, that can be considered more diarrhea predominant. And whenever we're looking at, you know, hard lumps, or even really lumpy and hard to pass stool, then that's going to be more signs of constipation, so it's important to notice what the consistency of your stool actually is.

So now if we want to dig a little bit deeper into different colors, and what they truly mean, this can be one of the best characteristics to look at for signs of something that might be going wrong. So brown is what we consider is our typical color, it's what we want the most. And the reason why it's brown, which we get asked about a lot, is because of a pigment called bilirubin. So it's a pigment that's produced, and that turns your poop brown. Sometimes you might see some undigested food that can contribute to some color within the brown, like you might see the skin of a tomato or some nuts and seeds, maybe legumes, maybe pieces of corn, that can be very normal, those are fibers that your body just hasn't broken down fully and they can just get kind of lumped into that log, but typically the stool itself is going to be brown.

If you notice that your stool is black and differentiating between dark brown and black can be tricky, but if you notice that it's really black, there's a few different reasons why that can happen. One can be bismuth medications like Pepto Bismol or iron tablets. So if you're taking iron, if you’re taking bismuth, then you might notice that your stool is black and that would be a normal reaction to those medications or supplements that you're taking. If you've not had any of those or black licorice, which can also contribute, then it could be an indication of upper GI bleeding, and you should seek medical attention.

So whenever we're seeing black stool, sometimes that looks like dried blood and that can be a sign of bleeding in the digestive tract, especially upper digestive tract, so it's been able to dry before it comes out, and so it's something that you would want to seek medical attention ASAP. So that would be a sign to go straight to the doctor and get it checked out. If you can save a little bit of it, take a picture of it, something like that, that might help you with that appointment and just take a quick you know, refresh. Have you had black licorice, have you had Pepto Bismol or any other bismuth medications? Have you had any iron supplementation or anything like that? That would be something to double-check first before going to the doctor.

Another color that we can see is white or even like a gray or clay color that can be caused by their lack of bile due to medications or digestive complications. It can also be another side effect of other medications, so if you are not taking a medication that you are aware is going to cause that coloring, and it seems to just come out of nowhere, then you should seek medical attention. So again, snap a picture, take a sample of it, whatever you need to do, and then go see your doctor or call your doctor to discuss what might be causing that coloring, especially if it happens more than once.

Another color that we see is green, and this is typically going to be due to a high consumption of our leafy green vegetables, or eating green food coloring. This could be an indication that food is moving too quickly through your system and so you might benefit from adding some more soluble fiber to the diet like those found in oats or lentils to kind of slow things down a bit, especially if you see green pop up every time you have some leafy green vegetables. If you haven't had them in a while, or you're having a large amount so let's say you're doing like a lot of sauteed kale or spinach or steamed spinach or something like that and you don't typically eat that, you might notice some green pigment. Or if you've had green food coloring that can definitely contribute food coloring can contribute to change in stool color fairly often. And so anytime you're eating food coloring, even like blue food coloring might translate to like a neon green poop, then that can be expected. So ideally, we avoid a lot of food colorings, but if you do have them know that those will come out and change the color of your stool, so if you had had that, then that's something that you can look for. If there's any other patterns or consistencies with that color, after you've, you know, fully passed out the green, the food coloring that you ate, and then checking too for any high consumption of leafy green vegetables. If you're noticing that they come out more whole as well, and they're never really digested, then that could be another sign that things are just moving through too quickly. So cooking them down, chewing them well, and then adding that soluble fiber to your diet to kind of get things moving a little bit more efficiently.

Another color that you may see is red, and this one can usually be scary to see because of the correlation to blood. So it could be the result of kind of lower GI bleeding, it could be a sign of hemorrhoids or even like tearing, so bleeding kind of at the opening of the of the anus. Either way, if you do notice that there is red coloring, then you may want to seek medical attention. The reasons why you would not would be if you've been eating a lot of beets, drinking beet juice, those definitely contribute to red stool, or again, food coloring that might be contributing. Usually, if it's blood thinners, we'll see the blood actually separate sometimes like fills the whole toilet bowl, if that's happening, that could be a sign of the blood being more at the opening, versus being like in the GI tract where the stool is forming, so that's something that you would want to take a picture of, or kind of note, just to make sure. And then for those that are having a menstrual cycle out there, if you are on your period, you may notice some menstrual blood that is kind of mixed in, so just take note of that as well. But it doesn't hurt to seek out help and make sure that you're talking to your doctor about it, especially if it's recurring fairly often, and you haven't had that conversation before because it could be a sign of something more serious, it could be something less serious but could still require a little bit of you know, personalization and a little bit of treatment, especially hemorrhoids or things like that.

Orange is a color that's not seen as often, but can be seen especially with high consumption of foods containing beta carotene, which is found in oranges and carrots, carrots being our most common one. And this is not something to be scared of or overwhelmed by, it would be just a normal reaction if you're doing high doses of beta carotene, so if you're eating a lot of carrots and oranges. This is going to be particularly strong if you are juicing a lot of carrots, or you're eating carrots all the time. So those of you who are dealing with digestive disorders like IBS and maybe doing low fodmap, and you're eating way more carrots than you normally would, you might notice some orange coming out, that would just be a sign of the carrots that you're eating. A way to test that is to take the carrot and orange consumption down a little bit and see if that changes and gets back to that brown color, and then as you bring them back in if it gets a little bit more orange, and that would just be a normal response to those foods.

And then the last main color that we see is yellow. So if you are noticing kind of a yellow tint, that can typically be a sign of an excess amount of poorly digested fat. If you’re malabsorbing fats, that is not a good thing and that could be a sign of some issues going on either with the liver or the gallbladder or even the digestive tract, and so we want to make sure that you're consulting with your doctor and then maybe even consulting with the dietitian to be able to kind of decrease and modify your fat consumption. If you've had your gallbladder removed, this may happen and so it's something that you want to take note of.

Some other colors that you might see or textures, if you will, in your stool would be like mucus. And so you may see this kind of milky, whitish-colored mucus or even the yellow-colored mucus, that's not necessarily part of your stool that might be kind of with it or separated it from it. If you're noticing that often, it can be from constipation, so if you've been constipated, that can contribute to mucus production. And it could be that could be a “normal” if you will response to the constipation, but it could also be a sign of some other things going on. So that would be something again, snap a picture, pictures are worth 1000 words when it comes to your provider in GI. So just snap a quick picture and then make sure you bring that up with your doctor to see what's going on.

And then looking at the consistency of your texture throughout a week or a month before your appointment with your GI doctor. Or even if you're trying to figure out you know, where you stand in terms of constipation, diarrhea, using the Bristol stool chart, as I mentioned to know are your souls leaning more towards kind of the the mushier side? Are you noticing that they're more broken up and looser? Or is it more liquid? Or are you noticing that they're more like pellets or really lumpy? Is it harder to pass like, are there some kind of weird lumps and grooves coming out versus like a really smooth log that's formed like a snake, just kind of taking note of those textures and noticing what is the most consistent over time.

So in our My Gut Journal, we actually do this where you measure these as you go, and then on the reflection pages that we offer every 10 days, you're going to actually see, okay, types one through seven, according to the Bristol stool chart, how many times have I had this bowel movement? And you can measure this over time to see okay, how many type ones have I had, how many type twos or threes or fours. And if you guys ever did those little quizzes in magazines back in the day, then you'll do the same thing where you just tally up, okay, how much of each and then what you have the most of might be your norm, or what's really going on. And that can be really helpful, because sometimes we may think, okay, I think I'm more constipated, or you may think, okay, I think I actually have diarrhea, but whenever you get into the weeds of measuring, you may notice that that symptom may feel the most uncomfortable, may highlight the most to you like diarrhea. But whenever you get into it, you might realize I'm actually more constipated and so the diarrhea could be the compensation or vice versa. So it's really helpful to note that.

Something else that I get asked fairly often is: should your stool float or should it sink to the bottom of the toilet bowl? And that's a very common question that is talked about often! So most of the time your stool should sink, that's normal, and we want to kind of sink down. If your stool is floating, it could be a sign that something's not functioning well, so it is something that you want to bring up, especially if it's happening all the time. More often than not, it's a sign of gas. So if you've been constipated, if you're noticing that you're a little bit more gassy, a lot of times your stool might float, because there's more gas built into it, so a little bit more air in it. You may notice that if you're eating a lot of fiber that can contribute to your stool changing and whether it's floating or sinking, so if you've adjusted your fiber intake, you may notice a change there. Usually, it's not something to be overly worried about, but it is something that you could track if you're noticing that every single stool you have is floating. Typically, if it's going to signify that something is wrong, we may also see a lot of like yellowy mucus tied with it, like you're going to see some other signs too, so that's why it's really important to keep a really detailed log if you're trying to figure out what's going on in your body, how your poop is communicating to you and what you can do with that.

And then, as we've talked about many times, we don't want to isolate just one symptom, it's important to look at the full picture whenever you're trying to figure out what is going on in your body. So I highly recommend tracking your stool, tracking your bowel movements using some of these characteristics, but also tracking other symptoms. And we just did a two part series on bloating (part 1, part 2), the last two episodes. And so I recommend you going back through and listening to some of those characteristics of bloat that we talked about and be able to track that.

We did an episode on preparing for your doctor's appointment, and so you can go back and look at that. We also have a free course called IBS fundamentals, and it is so helpful to understand what symptoms are happening with IBS specifically, but it will be helpful even if you're dealing with general digestive issues, and then what to track and note to go into your doctor and have that discussion to figure out what is going on.

I hope this is a helpful episode. It's a really quick and easy one. So my challenge to you now is to take this information, go check out your poop, blog it, no pun intended, for at least two weeks, and see where you stay on and what might be going on. And then if you feel comfortable, come on over to The Gut Community on Facebook and share what you're finding about your poop. What is your poop communicating to you? What are you noticing as normal or abnormal? And if you have any other questions that will be the place to ask them that. Thank you for tuning in. I hear you, I see you, and feel connected to you and I'm so glad and honored that you chose to join me in this conversation. So I'll see you in the next episode!