By: Melissa Cugliari
Digestion is truly a window into the greater health of a person, and bowel movements are a key part of this picture. Bowel movements are top of mind for me whenever I conduct a patient visit; normalizing talk of your stool with your medical provider is integral in catching health issues before they become chronic disease. Everything starts and ends in the gut, and when the gut is healed and bowel movements are regulated, the human body will function optimally in most cases.
An individual with an optimally functioning gut will experience anywhere from one to three bowel movements daily. Not all bowel movements are created equal however, and the quality of the bowel movement is very important. Ideally the stool is smooth, formed and easy to pass. There is no straining or urgency involved. The stool should be “S” shaped, and the length of your forearm. The colour may range from light to dark brown, and the stool should be free of undigested food, blood, or mucous. Stools may sink or float, but if they float and there is any oiliness noted either in the stool or toilet bowl, this is worth noting as it may indicate an issue with digestion.
If your bowel movements do not fit this picture, consider the following:
Type and frequency: if you are having greater than three or fewer than one bowel movement per day, this is worth discussing with your naturopathic doctor as the causes are various. Either may result from food intolerance or sensitivity (i.e. lactose intolerance), celiac or other bowel disease, hormone imbalance, concerns with your microbiome, liver or gallbladder dysfunction, stomach acid insufficiency, parasitic infections, etc. Constipation refers to fewer than one bowel movement per day while diarrhea refers to greater than three loose bowel movements daily, usually with urgency. If either of these apply to you, consider increasing water intake to 2-3L of filtered water per day, add in 2 tbsp of high quality flax or extra virgin olive oil daily, and incorporate 2 tbsp of ground flax into your diet. Consume at least 2 cups of cooked vegetables daily. If irregular stools persist, it is imperative to speak to your doctor to delve deeper if these concerns so that you may catch any issues before they become more problematic.
Colour: black stools warrant immediate medical attention. This indicates potential bleeding in the upper gastrointestinal tract and should be assessed immediately. Stools with bright red blood also warrant medical attention. They usually indicate issues toward the end of the gastrointestinal tract, like hemorrhoids or fissures. Remember: eating beets can also cause red stool. Yellow stool could indicate concerns with your liver, gallbladder or pancreas. If yellow stool is persistent, you should speak to your doctor.
Other: Mucousey or greasy stool can indicate an issue with fat absorption; this occurs in people with untreated celiac disease, concerns with the liver and gallbladder, amongst other issues. Undigested food in the stool may be indicative of gut inflammation or poor eating habits; if you eat quickly and do not chew enough, this may be the cause.
As a reference, the Bristol Stool Guide is a helpful tool that includes illustrations and stool descriptions, and can assist you in understanding healthy versus unhealthy bowel movements. As always, if something does not feel right or any of the above descriptions apply to you, it is important to speak with licensed medical and naturopathic doctors to receive the appropriate guidance, testing, and treatment according to your unique needs.