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YOUR STOOLS CAN REVEAL A LOT ABOUT YOUR HEALTH, IF YOU LEARN TO READ THEM.
LET'S FACE IT: DIGESTION HAPPENS. Few of us, however, are able to talk about the end result without embarrassment. It's too bad we're not more willing to pay attention to our stools, because they may be just as useful in diagnosing our health as taking our temperature or our blood pressure. "People can tell a measure of their health by their bowel movement," says Ted Loftness, M.D., an internist in Litchfield, Minn. "Nothing is so overrated as sex and so underrated as a good bowel movement."
From your stool you may be able to get clues about your diet, your gastrointestinal health, and even whether your stress, anger, or anxiety levels are too high.
HOW FOOD BECOMES STOOL From the moment food enters your mouth, your body embarks on a campaign to turn it into a soupy mush called chyme. Chewing, saliva, peristalsis (the involuntary contractions of gastrointestinal muscles), bacteria, hydrochloric acid, digestive enzymes, bile, and other secretions all work to give each meal the consistency of split pea soup. While your digestive
cells are absorbing sugars, starches, fats, vitamins, minerals, and other nutrients, waste products continue traveling down the line. In the colon, all the leftovers are combined, packed together, and partially dehydrated. What remain--our feces--consist of water, indigestible fiber, undigested food (such as corn and small seeds), sloughed-off dead cells, living and dead bacteria, intestinal secretions, and bile. (The worn-out red blood cells in bile give excrement its distinctive brown color.)
If all goes as it should, you'll end up with a healthy bowel movement. Although digestive idiosyncrasies, variations in intestinal bacteria, and other variables can produce different standards for a healthy stool, in general it should be brown to light brown; formed but not hard; cylindrical, not flattened; fairly bulky and full-bodied, not compacted; somewhat textured but not too messy; and very easy to pass. And it shouldn't smell--much. "You're passing methane and bacterial, degraded foodstuffs, so there's always going to be an odor," says Patrick Donovan, N.D., a naturopath in Seattle. "But it shouldn't be a very strong, pungent odor."
Experts disagree on two other stool characteristics: the number of pieces and their buoyancy. Each bowel movement preferably should be in one piece, about the shape and size of a banana and tapered at the end, according to Melanie Ferreira, a nutritionist and instructor at the Natural Gourmet Institute for Food and Health in New York City. Others, however, object. "Stools don't have to be well-formed logs," Donovan says. "They can disperse in the toilet water; they can break down."
As for "floating versus sinking," one school argues that stools should float. Ferreira says buoyancy is a sign that the body has absorbed the minerals in the food and that these nutrients are not contained in the waste. Another camp believes healthy bowel movements should touch bottom because of their bulk and fiber content. Loftness is not impressed with either argument: "Most stools will sink," he says. "Whether it floats or sinks really doesn't seem to make any difference."
An occasional deviation from this total picture is usually considered okay; chronic deviations (or any featuring blood) are not, and should be checked with a doctor. For a list of specific characteristics that may point to health problems, see our chart below.
If Your Stool Looks... It Could Mean...
BLACK, TARRY, AND STICKY Bleeding in your upper digestive
tract. The black color comes from
digested blood cells.
VERY DARK BROWN You drank red wine last night or
have too much salt or not enough
vegetables in your diet.
GLOWING RED OR MAGENTA You've eaten a lot of reddish foods
such as beets.
LIGHT GREEN You're consuming too much sugar, or
too many fruits and vegetables with
not enough grains or salt.
PALE OR CLAY-COLORED Minimal amounts of bile are being
excreted, perhaps because of problems
with the gallbladder or liver.
BLOODY OR MUCUS-COVERED Hemorrhoids, an overgrowth of certain
bacteria in your gastrointestinal
tract, colitis (inflammation of the
colon), Crohn's disease (also known as
inflammatory bowel disease), or colon
cancer. Red blood usually means the
ailment is located near the end of
your digestive tract, whereas black
blood signals partially digested blood
coming from an ailment higher up the
tract. Seek medical advice promptly.
PENCIL-THIN AND RIBBONLIKE A polyp or growth in your colon that
narrows the passage for stool.
LARGE AND FLOATING, WITH Malabsorption--your digestive system
GREASY FILM ON TOILET WATER isn't getting the full nutritional use
of food.
LOOSE AND WATERY, SOMETIMES Diarrhea. Possible causes are food ,
WITH UNDIGESTED FOODSTUFFS poisoning lactose intolerance,
antibiotics, antacids, dietary
changes, travel, anxiety, stress,
inflammatory bowel disease, or
irritable bowel syndrome.
SMALL, HARD, ROUND PELLETS Constipation--even if you're
defecating frequently. Possible causes
are eating too much dry food,
including protein, and not enough
vegetables and raw foods; laxative
abuse; worries; or irritable bowel
syndrome.
ALTERNATING BOUTS OF Irritable bowel syndrome. This chronic
DIARRHEA AND CONSTIPATION condition can be aggravated by red
meat, spices, sugar, alcohol, lack of
fiber, allergy-causing foods,
irregular hours, and chaotic
relationships.
REALLY BAD-SMELLING An imbalance of intestinal bacteria or
eating too much animal protein, which
can putrefy in your digestive tract.
WHEN MOVEMENTS STALL One of the most common gastrointestinal complaints is hard feces and infrequent and difficult elimination --better known as constipation. If chronic, it may contribute to autoimmune diseases and colon or breast cancer. "The longer stool stays in the colon, the more one reabsorbs some of the metabolic products [such as estrogen] that have been excreted in the bile," says Donovan, who treats people with cancer in his naturopathic clinic. "We can see increased risk of breast cancer in women with a history of constipation."
Experts agree that regularity is important, but they disagree sharply how often the average person should eliminate. The National Institute for Diabetes, Kidney, and Digestive Diseases says three times a week is normal and healthy for some people. According to Ayurveda, the Indian healing system, once a day provides an ideal, complete evacuation, says Virender Sodhi, M.D., an Ayurvedic doctor and naturopath in Bellevue, Wash. Ferreira thinks once or twice a day is the right frequency, while Donovan says a person should have a bowel movement within two to three hours of a major meal--or two to three times a day.
Regular bowel movements may contribute to more than better physical health. "The act of digestion and elimination can be seen as a metaphor for our ability to absorb what is useful from our experiences and eliminate what is unnecessary, harmful, or holds us back," Ferreira says. "If you have a healthy bowel movement each day, you're letting go of the past and bringing in the new."