Five years ago Dr. Oz proclaimed to the world that checking your stool was a good way to keep tabs on your health. Everyone looks at it, but do you know what your stool is telling you?
Colour
The colour of your stool can tell you a lot about the inner workings of your body. Pale faeces can indicate liver problems. If it's dark and tarry it may be that you're bleeding internally, potentially indicating a cancerous or ulcerative condition. The further down the tract the bleeding is, the more likely your stool will be maroon rather than tarry. Bleeding very close to the anus will result in smears of blood on your stools and usually a change in colour to the toilet bowl water.
But there are also other reasons why your stools may be different in colour. Beetroot can turn your stools a deep red or purple, iron supplementation can make them dark. Various food colourings will change your stool colour as well; for example blue colouring can make your stools a greenish blue colour.
Shape
You can often tell what the shape of your stool is by the sound it makes when it hits the toilet bowl. Nonetheless, take a peak next time and see how you compare to the Bristol Stool Chart.
You want to be aiming for #4 – a smooth easy to pass poop that just dives into the water with minimum splash – think Olympic gold medallist diver. Separate hard lumps that are hard to pass (a #1) indicate that the food is taking too long to transit through your body. This is because the longer it takes for stool to pass through the body, the drier it becomes. Regularly passing #7 stools of mainly water may dehydrate you, so be careful to rehydrate appropriately.
Medications, vitamins, changes in diet, changes in exercise and food poisoning can all change the consistency of your stool. If your stool changes unexpectedly then it is important to discuss it with your doctor as soon as possible.
Weight
Most people know that increasing fibre in the diet can reduce our bowl cancer risk. A recent study found that increasing fibre by 10g a day reduced colorectal cancer risk by 10%. What you probably haven't picked up is that increasing fibre consumption will increase the amount and weight of stool you pass. If you're like me and have selective memory when it comes to what you eat, then stool size and weight should give you a good indication of how well you're faring on your fibre goals.
You want to be aiming for roughly 200g per day. As you can see from the graph below, passing stools of only 100g per day can dramatically increase your colon cancer risk by four times.[2] In absolute figures this may not seem like much – a jump from ~6 per 100,000 to ~30 per 100,000. But keep in mind that increasing fibre in your diet has positive implications for other parts of your body – including reducing heart disease and diabetes risk.[2]
What's the best way to check how much your stool weighs without actually scooping it out of the toilet? If you have a highly accurate and sensitive bathroom scale you can weigh yourself before and after each motion to give you an estimate of where you sit and if you need to make any changes.
Frequency
Often we think of stool frequency in terms of being constipated or having diarrhoea. But this is not always the case. In fact, you can pass good #4 stools each time you go to the toilet, but if you only go every 3 or 4 days – you'll need to consider how much you're passing. In the section above we discussed weight. Did you notice that the goal is to pass 200g per DAY? If you are passing stools every 3 to 4 days you should be aiming for 600g to 800g each time. That's a lot of poo.
Last but not least, you may be passing your stools on a daily basis, but how long is it taking to get from mouth to toilet? For good bowel health you should be aiming for 24 to 48 hours. A good test is to consume a food that you know will change your stool colour (e.g. beetroot) and then watch how long it takes for your stool to change colour – and how long they stay that colour. If it takes over 48 hours try to increase the fibre and water in your diet, exercise regularly (walking does wonders for your bowels) and limit junk food. You'll be pleasantly surprised what these small changes can do for you.
References
[1] Better Health Channel, Fibre in Food
[2] Cummings JH, Bingham SA, Heaton KW, Eastwood MA. Faecal weight, colon cancer risk, and dietary intake of non-starch polysaccharides (dietary fiber). Gastroenterology. 1992 Dec, 103(6):1783-9
