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Published on February 17, 2017

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What Your Stools Are Telling You about Your Health

It’s not a tidy topic or one we share widely in polite company.

But it is something with which we’re innately familiar. You know – almost everyone looks when they are done with their No. 2s or “their business.”

Knowing the basics about what your stool is telling you can provide insight on your health, especially the health of your colon.

Steven Condron, MD, FACP, Avera Medical Group Gastroenterology, said there are lessons to learn from our stools, but does encourage almost everyone to do one thing: relax.

“Don’t fixate on things like one day you went three times and then you didn’t go for a day or two,” he said. “There’s no magic number. The shape and consistency, and whether it floats are not – those changes come and go. As a general rule, it’s not too crazy to see some changes in frequency.”

There are things that you can see in the bowl that should make you seek medical attention, Condron said. They include any bloody stools – visible red blood in the water or mixed with the stoo. Bloody stools can come out as tar-like black and sticky as well.

“It’s a concern and one that should lead you to set up an appointment with your doctor, if you have loose, bloody stool,” said Condron. “We sometimes will see clay-colored stools, they are pale or almost white, and that can indicate a bile obstruction, since the bile from the liver is what makes most stools brown.”

Oily stools, or sheens of oil on the surface of the water, especially when accompanied by frothy stools, can indicate pancreatic insufficiency and also should be checked by a doctor.

Beyond the visual, many people consider or have questions about the shape of their stools, and Condron mentioned the Bristol Scale (below) and said it helps him, and other professionals, to save time. It can help you, too, to avoid a long description of what you saw in the water.

Returning to the question of frequency, Condron said when you cannot go without pain or you cannot go at all, then it’s time to seek medical help.

“It will vary, and the only exceptions to the rules are when you have accidents or if you have to get up in the night from sleep to stool,” he said. “That’s not normal, and could indicate a disease. The variations come, but if your quality of life is suffering and your stool frequency is dictating your life, then you should consider coming to see us.”

A final consideration is factors outside of the bathroom. If you notice changes in your weight, especially weight loss, or unpleasant feelings and fatigue, you should make note and perhaps, an appointment.

“When it’s an episode now and then, it’s no big deal, but if you have a pattern of any of these symptoms, then it’s something we need to address, and timely care can make a big difference in outcomes,” said Condron. “Again, I remind you to not get too fixated, but to take action if a pattern develops, if you notice blood in your stools, or if you have pain when you go.”

Bristol Stool Scale

The Bristol Scale can help patients as well as health care professionals when it comes to explaining what they see in the bowl:

  • Type 1: Separate hard lumps, like nuts, and can be hard to pass
  • Type 2: Sausage-shaped, but lumpy
  • Type 3: Like a sausage but with cracks on its surface
  • Type 4: Like a sausage or snake, smooth and soft
  • Type 5: Soft blobs with clear cut edges that’s passed easily
  • Type 6: Fluffy pieces with ragged edges, a mushy stool
  • Type 7: Watery, no solid pieces, entirely liquid

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