What your stool says about your health

Very few of us think much about our stool habits. However, stool can offer valuable insight into the state of your digestive system and your health in general.

Frequency

There is no fixed number of stool passages per day that are considered ‘normal’ in an adult. Some people go 2-3 times a day while others go once a day. For yet others, they only go every other day.

As long as you are not uncomfortable and have fairly regular stool passage, you should not worry about the number of times you pass stool in a day. If you develop new onset constipation without change in diet or you suddenly get loose stools, you should consider going to your doctor for a check-up – especially if the symptoms are persistent.

If you also get constipation which then alternates with loose stool, you also need a medical review. One of the most common symptoms of colon (large intestine) cancer is change in bowel habits.

Another cause of change in bowel habits that is not as sinister in nature is ‘Irritable Bowel Syndrome’. This is a relatively common medical condition in which you develop disturbing intestinal issues such as excessive gas, bloating and either constipation or loose stool. In most cases, it is treated with dietary changes.

Stool colours

Brown:
The colour of stool normally is brown. The reason for the brown colour is the presence of bile in the stool. This is a fluid made by the liver and secreted into the intestine each time you eat to aid in the digestion of food. It is normally dark green in colour as it leaves the liver.

As it travels through your intestines with your ingested food, it is chemically altered - changing its colour from green to brown. This change in the colour is what gives stool its brown colour.

Black:
Bleeding into the stomach or the intestines can change the colour of stool to black. It is usually also sticky and foul-smelling. This change in colour and consistency occurs because of the chemical reactions to blood within the intestine that are caused by the digestive juices. Bleeding can be as a result of ulcers, abnormal blood vessels or tears in the stomach or food pipe. People taking iron supplements (given regularly to pregnant women, children and other people with anaemia) also notice that their stool becomes black but it is not sticky. Eating too much black licorice can also temporarily give you black stool.

Green:
As earlier explained, bile entering the intestine is usually very dark green. If food moves through the large intestine too quickly, the bile does not have time to break down completely. The result is green (usually loose) stool. Green stool with normal consistency can occur in those with high consumption of leafy vegetables and dishes with green food colouring. Green stool is also normal in new born babies.

Grey/whitish:
If stool contains little or no bile, it often looks whitish or grey. If you have white stool, you may be having blockage of the bile system (revolves around the liver, gall bladder, pancreas and the intestines). This obstruction could be from stones, tumours, worms or narrowing in the different parts of the bile system.

In most cases, it is accompanied by yellow eyes and skin (jaundice). It always requires medical review. Patients using certain medication to stop diarrhoea may notice that their stool becomes slightly paler than usual – especially if they are using the drugs in high doses.

Yellow:
Stool may become yellow and float in the toilet bowl if it has excess fat content. This can be due to eating foods that are very high in fat. If it occurs constantly, it can also be due to the fact that your intestines are not able to absorb fat efficiently or your pancreas is not functioning properly.

Red:
If bleeding originates from the lower parts of the intestines, blood does not come into prolonged contact with digestive enzymes – this means it does not get a chance to be broken down and become black. Instead, it causes the stool to be passed out with reddish streaks or dark red/maroon in colour.

Bleeding in the lower intestines can be due to tumours, tears and issues around the anus such as piles. Usually, these need medical review.

People who eat food with red food colour, beetroot and sometimes large quantities of tomato soup may notice a similar change in their stool colour.

Shape and size
Generally speaking, if you have normal stool consistency (soft), the size and shape of it does not matter. Small, hard stool (almost like goat stool) is common in constipation.

Why does stool smell so foul?

The answer lies in the intestinal (gut) bacteria. This bacteria is vital in the breakdown of digested food products. The smell is a result of the gases produced during this breakdown process. Smell is, however, influenced to a certain degree by what you eat. For example, you may notice when you eat certain meaty or spicy dishes, your stool may smell different than when you primarily eat fruits/vegetables.