Bowel Movements: Understanding What's Normal and Abnormal

Every Person Is Different When It Comes to Bowel Movements

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What does it mean to have a normal bowel movement? Many people aren't sure if their bowel movements are "normal," which is probably because bowel movements are a difficult topic to discuss, even with a physician.

The truth is that there is no one definition or description of a normal bowel movement. Bowel movements are individual, and rather than one "normal" type of bowel movement that fits everyone, there is an entire spectrum of what would be considered in the range of normal.

Instead, be on the lookout for any signs that a bowel movement is outside a personal range of normal and bring that up at a doctor's visit.

Should Everyone Have a Bowel Movement Every Day?

It's a common belief that having a normal digestive system means having a daily bowel movement. However, this is not true for everyone. In fact, "normal" could be anything from having a bowel movement a few times a day to a few times a week. In other words, there is no hard and fast rule as to what is normal because it varies from person to person. The general range is from 3 times a day to 3 times a week. Less than 3 movements a week may indicate constipation, and more than 3 watery stools a day could indicate diarrhea.

If you do not have a daily bowel movement, it does not mean you are constipated. Having more than one movement a day does not mean that you have diarrhea. Constipation is hard, dry stool that are difficult to pass, and diarrhea is watery stool more than three times a day.

Most healthy adults experience diarrhea or constipation at some point, but a consistent change in your normal bowel habits (such as color, frequency, or consistency) should be discussed with your physician. This is especially important if you are over the age of 50 years.

Size and Shape of Bowel Movements

A bowel movement should be soft and easy to pass, though some people may have somewhat harder or softer stools than others.

In general, stool should be brown or golden brown, be formed, have a texture similar to peanut butter, and have a size and shape similar to a sausage.

In many cases, a stool that varies a bit from this description is no cause for alarm, especially if it is an isolated incident. If your stool suddenly changes, it is something that is worth talking about with your physician.

How to Know If You're Constipated

Constipation is a common problem and is estimated to be the cause of about 2 million doctor visits each year. Constipation is hard, dry, lumpy stool that is difficult or painful to pass and which may be accompanied by bloating and discomfort. Chronic dehydration, lack of exercise, and low amounts of dietary fiber can all lead to developing  constipation.

Drinking enough water each day can help prevent dehydration. At least 30 minutes of exercise most days of the week is recommended for better overall health (even brisk walking is better than no aerobic activity) as well as better digestion. There should be enough fiber in the diet to ensure that stools are soft and pass painlessly and easily.

Long-Term Effects of Constipation

Women and older adults are especially at risk for having constipation that occurs frequently, which is called chronic constipation.

Unfortunately, more than just being uncomfortable, chronic constipation could lead to other complications. Straining to pass stool could lead to the development of hemorrhoids or an anal fissure (a tear in the skin of the anal canal).

Another potential issue is fecal impaction, which is when stool becomes hardened and gets stuck in the intestine and won't move. This could require treatment in a hospital or a doctor's office if it gets severe. Rectal prolapse, where part of the rectum can come out of the anus, can also occur after straining too hard to pass a bowel movement. A rectal prolapse could be treated at home, but may require surgery in some cases.

What It Means to Have Diarrhea

Diarrhea is loose, watery stool that occurs more than 3 times in a day. For most adults, diarrhea is a common problem that happens a few times a year, usually lasts a day or two, and does not need any treatment. Causes of diarrhea include infection, side effects of medication, and food intolerance. Diarrhea may need treatment if it lasts more than 3 days and is accompanied by fever, severe pain or dehydration, or if it looks black, tarry, or contains blood.

When You Have a Change in Bowel Habits

A normal bowel movement is different for each person and may vary in consistency and frequency. There are, however, several indications that a bowel movement is abnormal and may be the sign of a more serious problem.

A change in bowel habits includes any constant change in bowel frequency, color, consistency, or shape of stools. This sign warrants special concern in people who are over the age of 50 years because they are at a greater risk of developing a digestive disease.

Blood. Frank blood in the stool is never normal, and could be a result of several conditions that range from mild, such as hemorrhoids, to serious, such as infection or colon cancer. Bloody stools can indicate bleeding in the lower digestive tract and should always be evaluated by a physician as soon as possible.

Black stools. Black, tarry stools with a foul odor can be the result of eating certain foods, taking iron supplements, or possibly from internal bleeding high up in the gastrointestinal tract.

Red or maroon stools. Red or maroon stools could be from something harmless, such as eating red-colored foods, or it could be caused by several different conditions, including hemorrhoids, anal fissures, colon polyps or colon cancer, diverticular bleeding, or inflammatory bowel disease.

Green stool. Green stool may be caused by green or artificially-colored foods, iron supplements, or decreased colonic transit time. In newborns, green stools are common in the first few days of life.

Pale or clay-colored stools. Stools that appear pale or look like clay could be the result of lack of bile salt (which gives stool a brownish color), antacids, barium from a recent barium enema test, or hepatitis.

A Word From Verywell

If there's one thing that causes almost everyone anxiety about seeing a doctor, it's bowel movements. Many people keep their concerns about their bowel movements to themselves, but that could be a mistake. When something has changed with digestion it should be brought up at a doctor's visit.

A digestive problem is easier to deal with if caught early, rather than letting it go until it becomes more difficult to treat. Many digestive problems can be managed with changes to lifestyle like eating more fiber, drinking water, or going for a walk, so make sure to bring any up at a doctor's visit.

Sources:

ASCRS. "Hemorrhoids: Expanded Version." The American Society of Colon and Rectal Surgeons. 2016.

Morken J. "Rectal Prolapse: Expanded Version." The American Society of Colon and Rectal Surgeons. 2016.

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