Everything You Always Wanted To Know About Stool

Everyone Has A Different Version Of Normal, But Some Stools Are Never Normal

Carrots and Spinach
Carrots and spinach are two foods that can, when eaten in large amounts, have a significant effect on the color of your stool. Image © Wong Mei Teng

Would you know a normal stool if you saw one? Most people think they know what a typical stool should look like, but they probably only have experience with their own bowel movements. There is no basis for comparison with the bowel habits of others. This is because we have a natural aversion to stool, but also because we are taught from an early age that a bowel movement is to be done alone, in a room by ourselves.

If you never see a stool outside of your own, how do you know yours is normal?

If your physician doesn’t ask you about your stool, such as how often you move your bowels, or the consistency of your stool, how can it be evaluated? Today anyone can walk into a pharmacy and buy drugs that will modulate bowel movements — either slowing them down or speeding them up — without having to get any advice from a physician or even a pharmacist. All of this can lead to difficulty when there actually is a problem with stools or bowel movements because it’s not well understood when a doctor should be consulted. Keep reading to learn more about stool, and what signs and symptoms should be reported to a physician.

Blood In The Stool

Blood in the stool is never normal. Blood that is red, or blood that is black, it does not matter. None of it should be in your stool. Not even if it only happens once. Not even if you can’t actually see the blood (which is called occult blood), and it is only found with a fecal occult blood test.

What can be a problem is knowing if the red or black color you see in your stool is actually blood. Eating food or taking supplements that are red, orange, black, or even purple in color can lead to red stools or black stools. Artificial coloring, in particular, can pass through the digestive system and be the cause of stool appearing red or black.

Thinking back about what was eaten in the last few days may help to determine if a food is to blame. If if is clearly blood in the stool, or if it is at all unclear as to why a stool is red or black (especially if it is tarry or foul-smelling), see your doctor right away.

Mucus In The Stool

For some, such as those who have inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS), mucus in the stool is not an uncommon occurrence. With IBD, mucus may be a result of inflammation in the digestive tract, and with IBS, it could be a result of the overproduction of mucus. But mucus can also appear in the stool for other reasons, such as a bacterial infection, a bowel obstruction, or an anal fissure. When mucus is a part of chronic illness, it should be mentioned at the next doctor’s appointment, but if it is a new symptom, it should be evaluated by a physician as soon as possible.

Constipation

Constipation is a common problem, but some people may think that they are constipated when they are actually not.

One does not need to have a bowel movement every day — less than one stool a day or more than one a day can also be within the normal range. The goal is to have a soft, easily passed stool. When stool becomes hard, impacted, or causes pain when it is being passed, it could be due to constipation. Constipation has many causes, including the use of certain painkillers, a lack of exercise, or dehydration. The good news is, constipation is often not serious, and it can usually be resolved by home remedies such as drinking more water and eating more fiber. However, if constipation continues, causes pain, or can only be relieved through the use of laxatives, it’s time to talk to a physician.

Diarrhea

Many adults have diarrhea (defined as loose stools that occur 3 or more times a day) a few times each year. Most cases of diarrhea resolve on their own and don’t need any treatment. However, diarrhea that persists or is accompanied by other symptoms can be a sign of a more serious problem. Diarrhea is so common, and stop so quickly in most people, that most cases won’t require either diagnosis or treatment. By the time the cause for the diarrhea is discovered, it will probably already be resolving. People who have irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) may have diarrhea on and off as a matter of course. If intermittent diarrhea is part of your diagnosed illness, it might not need immediate treatment, but it should be discussed with a doctor. Even if you have IBS or IBD, diarrhea that is accompanied by weight loss, is constant, leads to dehydration, or is bloody, should prompt a call to the gastroenterologist.

Other Colors Of Stool

Stool can run the gamut of colors, depending on what you ate and any vitamins, minerals, supplements, or medications you are taking. In many cases, a one-off stool that is a color that deviates from the typical is not a cause for concern. Artificial food colorings or even eating copious amounts of foods with naturally vibrant colors (such as spinach or carrots) can lead to green or orange stools, or any color in between. If the unusual color persists, or occurs at the same time as other symptoms such as diarrhea, constipation or pain, it should be reported to a physician as soon as possible.

The Bottom Line

If you notice a change in how your bowels are behaving, or what is coming out of them, talk to your doctor. In many cases it's not going to be anything that's serious or even needs treatment other than a change in diet or other lifestyle habits. However, it's always better to be safe than sorry and to find out what is going on to ensure it's not the start of something bigger.

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