En español | The topic may be taboo for cocktail conversation — and it’s definitely not discussed at the dinner table — but fecal matter, when it comes to health, is an important matter.
That’s because what comes out of your body can tell you a lot about what’s going on inside of it. Changes in your stool can reflect changes in your diet, mood and physical activity; some shifts can even signal more serious conditions.
Before you start obsessing over your bowel movements, know that “everybody's stool varies some from time to time,” depending on what you eat, how much you move and the medicines that you’re taking, among other things, says William Chey, M.D., professor of gastroenterology and nutrition sciences at Michigan Medicine at the University of Michigan. So best “not to overinterpret” it.
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On the other hand, “it's also really easy to ignore things and not worry when you do need to,” Chey adds. The key is to know your normal. Some people poop a few times a day; others go a few times a week. When you want to start paying attention is “if you have an abrupt change in your bowel habits and it lasts more than a day.”
Here are a few things to be on the lookout for.
Red, maroon or black poop
One of the more concerning changes is blood in the stool, which can appear red, maroon or even black. Bright-red blood often indicates that the bleeding is coming from the lower end of your gastrointestinal (GI) tract — “and it's almost always from hemorrhoids,” Chey says. A little bright-red blood can also be due to a small tissue tear inside the tush.
Darker blood that shows up almost black suggests bleeding higher up in the GI tract, such as in the stomach or the small intestine. If you notice this, it’s important to consult your doctor. “One concerning explanation would be a tumor or a large polyp that has gotten big enough that it's developed a blood supply that has begun to bleed intermittently,” says Nitin Ahuja, M.D., a gastroenterologist and assistant professor of clinical medicine at the Perelman Center for Advanced Medicine at the University of Pennsylvania. Ulcers can also bleed anywhere in the GI tract, he notes.
But know, too, that there are other, less distressing reasons that your waste may appear red or black. “Someone who takes a new affinity for beets, for example — that would be a competing explanation for consistent change in color toward red,” Ahuja says. And taking iron supplements or bismuth subsalicylate (better known by its brand name, Pepto-Bismol) can turn your stool black — so can a meal of squid-ink pasta or black licorice.
What is poop?
It may be hard to picture, but poop is the remaining part of the food that you ate — the bits that your body didn’t want. After the small intestine absorbs all the nutrients the body wants and needs from your food, it passes what’s left (the digestive waste) to the large intestines, where it changes from a liquid to stool and starts making its way out of your body.
Source: National Institute of Diabetes and Digestive and Kidney Diseases
If your poop appears pale and even seems to float in the toilet, it may be an indication that your pancreas, an organ that aids in digestion, isn’t working normally, Chey says. Very smelly poop that looks greasy or oily can also point to problems with the pancreas, according to the Mayo Clinic, and may mean that your body is having trouble digesting fat.
A problem with the liver could be another reason for pale poop, since the organ is responsible for releasing the bile that typically gives feces its brown hue. Be sure to talk with a doctor if either of these issues — pale or greasy stool — persists for more than a few days, especially if you’re experiencing weight loss or abdominal pain alongside it.
How often are you going?
Consistency is another important feature to pay attention to — and, along with it, frequency.
If you’re someone who releases soft stools every day, for example, and then you’re suddenly not able to go — or can produce only pencil-thin feces — it could point to an obstruction, like a mass or lesion, somewhere in your GI tract, says Reezwana Chowdhury, M.D., a gastroenterologist and assistant professor of medicine at Johns Hopkins Medicine.
Trouble going can also be diet related. Increasing your water and fiber intake — try more fruits, vegetables and whole grains — can help with constipation. So can exercise.
“I tell many of my patients who have issues with constipation: The more you move, the more your gut moves,” Chowdhury says. “A sedentary lifestyle does slow your gut down.”
Constipation also becomes more common with age. “Things just slow down” as we get older, Chey explains. Often, people are less active, their diets change, and they’re taking more medications. Add all those factors together and you have a greater likelihood of experiencing constipation.
If your issues lie on the opposite side of the spectrum and your bowel movements are frequent and watery (diarrhea), it may be due to something you ate or a sign that your body is fighting a virus or struggling with a food intolerance.
Diarrhea is common and usually goes away on its own, according to Ahuja. But if it lasts more than a few days, it could signal a more serious problem. Another thing to be on the lookout for: having loose stools and frequent trips to the bathroom at night.
“We always tell people that if they're having diarrhea at night, they need to see their doctor, because that indicates that there's some underlying disease, like inflammatory bowel disease, or microscopic colitis or celiac disease. There's something else going on,” Chey says.
Many health care professionals use what’s called the Bristol Stool Scale to help patients assess the consistency of their bowel movements, with pebble-like and lumpy, sausage-shaped stools representing constipation; smoother and softer stools depicting more normal bowel movements; and mushy or watery stools depicting diarrhea. (See image on the side for more information.)
Stay on top of screenings
Any sudden changes in your bowel behaviors that last more than a day or two warrant a call to your doctor, who may order a colonoscopy “just to make sure that there's no inflammation or evidence of cancer or something else that might have led to that abrupt change in your bowel habits,” Chey says.
Adults 45 and older should get regular colorectal cancer screenings, according to the American Cancer Society. One option is a colonoscopy every 10 years; an alternative is a stool-based test, which is taken every one to three years. People at higher risk for colon cancer may need to be screened earlier and more often.
“The parting line is going to be, when in doubt, talk to a physician. We're always happy to talk about what's worrisome and what's not,” Ahuja says.
Constipated? Try these foods
Sixty-three million Americans deal with chronic constipation. Drinking lots of water and other liquids and getting plenty of exercise can get things moving. So can eating more fiber from foods including the following:
- Whole grains: Whole wheat bread and pasta, oatmeal and bran flake cereals
- Legumes: Lentils, black beans, kidney beans, soybeans and chickpeas
- Fruits: Berries, apples with the skin on, oranges and pears
- Vegetables: Carrots, broccoli, green peas and collard greens
- Nuts: Almonds, peanuts and pecans
Source: National Institute of Diabetes and Digestive and Kidney Diseases
Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.