Everything You Always Wanted to Know About Bowel Function But Were Too Embarrassed to Ask
Bowel movements are hardly the stuff of polite dinner table conversation, so it’s not surprising that many people don’t know exactly what “normal” bowel habits are. The reality is they may vary from person to person, and my normal is not necessarily your normal. And whatever normal is, it needs to stay that way in order for you to avoid other health challenges down the road. What changes might be worrisome? For answers to all those questions that seem too awkward to ask, I spoke with our own digestion guru, Daily Health News contributing editor Andrew L. Rubman, ND.
NORMAL OR NOT?
Bowel movements vary in their degree of regularity, color, texture, odor and difficulty. It can be normal to have three a day or as few as three a week. The normal, healthy stool color is dark butterscotch, says Dr. Rubman, but that can be affected by what you eat –especially if you had spinach or beets, for instance. The shape should be something like a sausage — soft but solid… relatively easy to pass… and emerging in one nearly continuous movement, as the different segments of the colon consecutively empty. Dr. Rubman said “normal” circumference should be about the thickness of the tips of the four fingers and thumb pressed together.
CONSTIPATION & DIARRHEA: WHEN TO WORRY
Constipation and diarrhea are the most common complaints, affecting most people from time to time, and not particularly worrisome on an occasional basis. You qualify as “constipated” if you have fewer than three bowel movements a week, with stools that are hard, dry and difficult to pass. There’s often related abdominal discomfort and bloating as well. Dehydration, inadequate dietary fiber and a lack of exercise are the usual causes, according to Dr. Rubman.
As many people already know, you can help move matters along by eating more fiber-rich foods (e.g., whole grains, vegetables and fruits) and fewer processed foods. Various fiber supplements may also be helpful — discuss with your doctor what type you should take. Exercising about 30 minutes most days of the week will also help ease constipation.
Diarrhea refers to loose, watery stools (as though anyone needs to be told this) more than three times in a day. It’s usually temporary — perhaps caused by something you ate, taking antibiotics or a stomach flu — and typically clears on its own without treatment. In the meantime, good foods to eat include bananas, rice, applesauce and toast (called the BRAT diet) and Dr. Rubman also recommends egg drop soup, since diarrhea depletes not only water but salt and albumin (protein) as well. Consult your doctor if diarrhea persists longer than three days… if you become dehydrated… or you see blood, frothiness or large amounts of mucus.
WHAT CHANGES DO YOU NEED TO REPORT?
Occasional digestive disturbances are part of life, but if you notice significant changes in regularity, color, texture or experience difficulty in passing stool for longer than a few weeks, it’s time to figure out what’s happening. Dr. Rubman suggests keeping a journal to help you identify what is different, including dietary factors, and advises seeing your doctor. Such changes may signal any of a number of digestive challenges — e.g., hemorrhoids, irritable bowel syndrome, ulcerative colitis or colorectal cancer (especially if you’re past 50). In particular, always call your doctor if you see blood in the stool. The earlier you diagnose and address any gastrointestinal disorder, the more successful the treatment.
BLOOD IN THE STOOLS
Be alert for inexplicable changes in color. You can expect the foods you eat will make one day different from the next. For instance, beets can cause red stools… blueberries, red meat, iron and green veggies can cause black stools… and sulfur foods can cause a foul smell. But maroon or, especially, bright red blood in your stool, may be a sign of bleeding in the lower gastrointestinal tract, such as hemorrhoids, anal fissures (tears in the lining of the lower rectum), intestinal infection or occasionally colon polyps or cancer. Stools that are the color and consistency of coffee grounds suggest a problem in the upper gastrointestinal tract, such as a bleeding ulcer in the stomach or duodenum. Take special note if these stools are also foul-smelling and/or accompanied by gas — the more frequent and noxious the gas, the faster you need to see your doctor, advises Dr. Rubman.
Pale cream- or putty-colored stools can point to a constriction or blockage in the ducts of the liver or gallbladder, since bile is what makes stools brown, says Dr. Rubman. Indeed any abnormal color that lasts more than a few days and can’t be traced to something you ate is a reason to call your doctor — most especially if it is accompanied by other symptoms, such as abdominal pain or unexplained weight loss.
KEEP YOUR DIGESTIVE TRACT ON TRACK
To keep digestion on the right track, Dr. Rubman advises that you watch your diet and get regular exercise… avoid prolonged use of antacids or anti-inflammatory drugs such as ibuprofen, naproxen or aspirin… refrain from alcohol or tobacco use… chew food thoroughly… and limit water with meals. If you notice changes or are concerned about any symptoms, a naturopathic physician, specially trained and attuned to digestive issues, will be able to examine the state of your digestive function by ordering diagnostic tests, recommending diet and lifestyle changes and prescribing medicines, such as nutrients in which you are deficient. If necessary, he/she will refer you to a gastroenterologist for further treatment.
