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Stool Gazing

Looking at and evaluating one’s bowel movements, commonly known as stools, for consistency, shape and color can be very insightful and revealing as you evaluate your overall health. The body has a natural process for the elimination of its wastes. We tend to examine everything else to give us an indication of our health status. We look at the condition of our skin, eyes, hair, teeth, and mouth so why not examine the stool? The following guide provides descriptions of problematic stools based on consistency, shape, and color. Probable causes and therapies are listed. You may have an indicator in your stool of a serious condition which requires a physician's expertise.

For comparison, the model stool is described, which ideally, should be what you are striving for.
Model Stool is bulky, soft, and easy to pass with a uniform shape (torpedo like).

Consistency

Hard stools

Hard and difficult to pass (may be small separate pellets or lumped together).

Possible causes

Slow transit time — the stool is moving too slowly and becomes drier as fluid is absorbed.

Lack of fiber results in a dry stool (fiber retains fluid).

Low carbohydrate diet (proteins and fats do not contain fiber).

Cures

Increase fluids, especially water

Add fiber —wheat bran (will absorb water and add bulk to the stool)

Increase raw fruits and vegetables which contribute natural fluid and fiber.

Alter transit time — try specialty yogurts.

Too soft

Liquid stools which move very rapidly and sometimes with great urgency.

Possible causes

Rapid transit time (little fluid being absorbed along the way). (The GI tract handles about eight liters of fluid provided for digestion and ease of transport each day. If the contents are moving too rapidly, the fluid is not absorbed).

Changes in diet (increase in fiber or raw foods which contribute fluid and indigestible material to the stool).

Pathogens (bacterial or viral infections can result in soft watery stools as your GI tract tries to rid the body of these harmful organisms).

Cures

Eat a diet without raw foods and visible fibers. Cook your foods and chew thoroughly so they are easier to digest.

See an MD for treatment of your infection or suggestion of medications to slow transit time.

Stool Gazing Alerts

Skinny stools

This is an alert for something that is abnormal in the colon and the only way the stool can pass is in a very thin form. It could mean polyps or a mass in the colon. See an MD for evaluation.

Floating stools

Stools are not supposed to float on water. If they do, you may well be excreting fat in your stools which means you are not digesting and absorbing it. Floating stools with fat have such a strong odor the entire house might smell. So unless you are eating foods with Olestra (an indigestible fat substitute) or taking a medication for weight loss that causes you not to absorb all the fats you eat, you should see your doctor.

Black stools

May be due to the supplements you are taking (e.g. iron). Stop the supplement for a while to see if the color changes.

Or there could be bleeding in the upper intestinal tract (the esophagus) due to reflux which can damage the lining of the esophagus, or the bleeding may be in the stomach. You need to see an MD.

Green stools

If you are eating or drinking foods with green coloring or naturally green foods that can be the cause. If you are not eating green foods, but you are taking iron, the iron could be the culprit. If none of the above are true and you also have loose stools, it may be that bile excreted from the liver is not breaking down. You should see a physician.

Gray stools

May be caused by medications (e.g. anti-diarrheal medications). Or it could be a lack of bile (excreted by the liver and necessary for the digestion of fats). If you see this type of stool and are not taking an anti-diarrheal medication, see an MD.

Red stools

May be related to something you ate with red food coloring (candies or drinks) or a food that is naturally red such as red beets. If you have not eaten red foods possibly you are bleeding from hemorrhoids (internal or external) or you could have something more serious, so seek medical care.

Yellow stools

May be associated with floating stools and excess fat in the stool. It could be a sign of a serious malabsorption disorder meaning you are not digesting and absorbing your food. If this is the case, you should see your doctor. Yellow stools are normal in breast fed infants.

Source: Hattner JAT, Anderes S. Gut Insight: probiotics and prebiotics for digestive health and well-being. San Francisco: Hattner Nutrition; 2009. Pp. 109-111

©2009 Jo Ann Hattner MPH RD, Susan Anderes MLIS. All rights reserved. 

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