What should your stool look like?

Nobody likes to talk about their poop. As a Clinical Nutritionist, I know that your stool is a very valuable source of information about what’s going on in your body. It was taught to me as part of my functional medicine training back in the 90s, and “How does your poop look?” is a standard question during each initial consultation, despite how uncomfortable it makes my new patients.   I usually have to come right out and ask, as most people leave that section of the health history form blank. It’s not the easiest subject to bring up, it can create some tension, and I wasn’t crazy about asking my clients in the early years but I quickly learned how important it is diagnostically and I ask detailed questions. Do you have watery stools or diarrhea? Are your stools like hard little rocks or pebbles? Are your stools so large that they hurt? Do you have constipation? Do you see undigested food in your poop? These are all questions that have to be asked and answered if you really want to get to the bottom of your health issues.  I have learned to throw in some humor which usually helps. (Bottom of your health issues…..) OK, I did not say it was good humor. Many poor health conditions stem from poor elimination in some way. If you are a Nutritionist or consulting with a Nutritionist or even a doctor and the subject of your stool has not come up, you may be missing out on valuable health information. The fact that many doctors and even gastrointestinal medicine specialists do not ask what our stools look like or even what we are eating illuminates an area of healthcare that has been lacking for decades. Checking digestion and stool health has been a large part of my success as a functional nutritionist. Functional medicine essential means we look for root causes of conditions rather than just treating symptoms with quick fixes or band-aids as traditional medicine has historically done.

Checking out your stool is a free and easy way for a person to figure out what could be going on with their digestive health. I know that many people do look and wonder if it’s normal. A lot of my patients do ask me once they get to know me.  I decided to write an article on stool analysis to save my patients from having to ask me, educate the public, take the stigma out of it, and highlight the importance of it. I wrote this article back in 2004 but have updated over the years.

How Many Bowel Movements Should Per Day Are Normal?

I get this question so often I should make business cards or a YouTube video with the answer.

For healthy digestion and elimination, a person should 1 to 3 bowel movements a day. Yes, a day!  I’ve had clients come to me and insist that they have “normal” digestion and that they go 2 times a week regularly. That is not normal under any circumstances. It’s constipation. Some people say they go every hour and that isn’t normal either. That is usually called diarrhea. Ideally, a person should have a bowel movement within a few hours after each meal. Normal transit time through the digestive system is about 12 hours. Most Americans don’t eliminate as often as they should. You should be eliminating the meal you ate 6 to 8 hours earlier soon after a current meal. So, after you eat breakfast, dinner should be on its way out soon if you have healthy digestion and elimination.

What Does Normal Healthy Poop Look Like?

A healthy bowel movement should be light to medium brown, shaped like a small banana but without the curve, light enough to float and not drop heavily to the bottom of the toilet bowl, it should be formed (not liquid or runny) and easy to pass with no pain or straining. If this sounds like your stools, you are doing well. If not, maybe you will recognize some of the issues below which should be addressed by a gastrointestinal specialist, your regular doctor, or well-trained nutritionist.

• Stools that are too large to pass without straining, bleeding, or pain can be a sign that you are eating too much dairy or other foods that you are sensitive too.  Both casein and lactose are found in dairy products like cheese and milk and can cause digestive pain and symptoms in many people. Casein can also be found in considerable amounts in cheese, protein powders, protein bars, and non-dairy cheese products. Casein is the number one cause of constipation that I have seen in my nutrition practice over the past 20 years, with inadequate water intake as a close second. Try removing casein from your diet and adding more water.

If these methods do not work a good combination magnesium product should help. My favorites are Biotics Research Mg-Zyme and Vital Nutrients Tri-Mag. Both should be taken 1 per night before bed increasing by 1 per evening until you have at least 2 healthy bowel movements a day. If you get runny stools cut back by one per night until they are formed again. Find the dose that works for you. This is called dosing to tolerance, a functional nutrition technique, and is used with certain natural supplements.  If low magnesium was causing your constipation you should be able to lower your dose until you no longer need it. The body is a miraculous, self-regulating entity.

• Stools that are hard and pebble-like can be a sign of poor liver and gallbladder function and or a lack of digestive enzymes. The small hard “rabbit pellets” that many children have are also from too much cheese and too little water. Try eliminating casein and adding water and then magnesium. This also is oftentimes a sign of low fiber. Many people think bran muffins and wheat bread are reliable sources of healthy fiber. They are not. Both are usually loaded with sugar and gluten, and no one needs to add that to their diet. They are also both mainly insoluble fiber and can sometimes make constipation worse instead of better. Again, for rabbit pellets or constipation try; removing casein from the diet, increasing water intake, adding healthy oils like coconut oil to the diet and adding at least a cup of raw or lightly sautéed vegetables to 2 or more meals a day and this problem should go away.
• Thin stringy or flattened looking stools can be a sign of a polyp or other obstruction that causes a narrowing of the elimination pathway. This is also present with Irritable bowel syndrome, inflammation, digestive diseases or a spastic colon. This should be checked out by a GI doctor.
• Stools that are greasy, fatty and messy and leave a film or grease in the toilet can be a sign of pancreas dysfunction, pancreatitis, fatty liver, fat malabsorption issues, and an inability to absorb the nutrients in your foods.
• Pale and very light brown, grayish, whitish or light yellow colored stools can indicate liver and gallbladder problems and even gallstones. See a specialist or your doctor asap.
• Runny stools, diarrhea, frequent stools and having to run to the toilet right after you eat or risk an accident can all be signs of food sensitivities or intolerances, celiac disease, allergies, too much fruit, yeast or bacterial infection in the gut or any of the diseases mentioned with blood in your stool. A GI assessment from your doctor and nutritionist, food sensitivity testing, and an elimination diet are good starting points. Specialty lab testing of your stool is a great way to find answers as well.
• Dark black stools or blood in your stools could mean bleeding in the digestive tract. Stools with blood or mucus can be a sign of Ulcerative Colitis, Crohn’s disease, celiac disease, diverticulitis, hemorrhoids, or colon cancer. See your physician right away if there’s blood in your stool. While some of these issues are diet related and should be discussed with an experienced nutritionist, many more could be serious health concerns and you should see a doctor as soon as possible.

Is it Normal For My Poop Smell So Bad?

Yes and no. A healthy stool while not smelling great, should not be extremely strong and foul smelling. The worse it smells the higher degree of toxicity is present. Poor diet alone can cause odor problems. but other health issues can contribute. The odor may signal a lack of healthy bacteria or probiotics like Lactobacillus and Bifidobacterium that your gut needs to stay balanced and to assist in the digestion and assimilation of foods you eat. You may also have an overgrowth of unhealthy bacteria like Klebsiella, Citrobacter, or yeast such as Candida Albicans. If you are having an issue with any of the above-listed issues, serious odor, chronic diarrhea or constipation, then a stool test from an accredited specialty lab can give you a useful report of what is going on in your gut. Your Physician or Nutritionist should be able to help you get the testing ordered, interpret the results and figure out a plan for you. Either way – I suggest you take a look at what’s going on, and if your poop is on the list, now you know it’s not normal, so go get it checked out. By Juli Keene, BSc, CN Licensed Clinical Nutritionist June 2009 Revised November 2017

Juli Keene B.Sc, CN is not a physician. She does not diagnose or treat disease. This information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended to provide medical advice. For medical advice, always seek a physician. This information is intended solely as a sharing of knowledge and information based on the experience and research of Juli Keene, CN and Nutrition Solutions. This disclaimer applies to all articles and content on this website. JuliKeene.com All content is copywritten by Juli Keene and is not to be copied without written consent from Juli Keene Nutritionist.