Health & Fitness

What stool can tell you about your health



  • Constipation is very common in Kenya— a problem associated with our diet.
  • Almost one in every two patients I see will present with constipation problems.

How much attention do you give to your stool passing patterns daily? Do you stop to check on the colour and whether it is loose soft or hard? It may sound gross (unacceptable) but truth is, most people hardly stop to think about all these factors yet they are a great indicator of your digestive system health.

Here are many concerns many patients visiting my clinic have regarding their bowel movements.

How many times should I go for a long call?

For a healthy adult, going for a long call once a day is good enough. If you experience the urge to pass stool three times or more in a day, then you are likely to be suffering from diarrhea. If you pass stool about three times a week, this is considered too few to be healthy and you probably suffering from constipation.

Constipation is very common in Kenya— a problem associated with our diet. Almost one in every two patients I see will present with constipation problems. It’s important to note that patient’s perception of what is 'normal' and what is constipation can differ from their doctors. Doctors define constipation as decreased stool frequency while patients tend to define it in terms of disordered function (need to strain while passing stool), and passing of hard stool.

What could be causing my constipation?

What you eat is critical in contributing to your constipation. Lack of vegetables and fruits in your diet, and not drinking enough water are the greatest risk of constipation. To deal with constipation, ensure you stay hydrated. Water helps to clear toxins from the body. Try to drink at least eight 8 glasses of water a day. Also try fiber-rich foods like apples, carrots, beans, and whole-wheat cereals.

What stool colour should I be concerned about?

The colour of your stool depends on a couple of things: your diet and how much bile is in it. Bile is a yellow-green fluid that helps digest fats. A healthy stool, then, should reflect a mixture of all the colors of the food you eat and that bile. Almost any shade of brown, or even green, is considered normal.

What if I feel the urge but hold it?

Usually, the body will adjust to what the brain instructs and decides. In this case, your body will adjust to postpone the urge for later which is okay. However, it is not recommended to make it a habit as one may start to lose the urge to go for long calls, which may result in fecal incontinence. Other people may experience constipation.

What if I don’t get the urge for a long call even after eating?

There is usually no problem with not going for long calls after meals. Some people have a higher metabolism than others and the urge varies from one person to another.

How often should one cleanse their colon?

Never. There is no evidence that colon cleansing — whether given as pills, powder, or liquid or administered through the rectum has any value whatsoever to promote health or well-being. There are significant dangers associated with cleansing like nausea, vomiting, diarrhea, dizziness, dehydration, electrolyte abnormalities, acute kidney problems, pancreatitis, heart failure, infections among other problems.

How can I analyse my stool to keep my digestive system health in check?

Use the Bristol Stool Scale (you can Google it) to analyse your stool every time you go for a long call to help you keep track of your digestive system health. Fecal matter is 75 percent water and 25 percent solid matter, consisting of dead bacteria, indigestible food, and inorganic substances. It usually takes about three days for food to pass through your system, resulting in passing stool. But when food passes through your system too quickly or too slowly, it can affect the size, colour, and texture of your stool.

The Bristol Scale is a seven-point analysis of different types of stool.

Types 1 and 2 are hard and lumpy stools that are painful to pass. Usually, these stools have been sitting in the large intestine and colon for a long time and are indicative of someone who may be constipating.

Types 3 and 4 are considered the normal form of healthy stool. A healthy stool is mostly sausage-shaped and snake-like. It is easy to pass, and it remains intact when it is flushed. Stool types 5 through to 7 are watery and mushy. These stools stay in the large intestine and colon for the least amount of time and may present in the form of diarrhea.

Diarrhea can also be caused by many factors including medications, dietary changes or intolerance, stress, illness, or infections.

Dr Opio is a consultant gastroenterologist at Aga Khan University Hospital, Nairobi