As I get older, I’ve noticed that my friends are talking more about subjects we once considered taboo. Maybe it’s the Facebook effect, or maybe it’s a function of having young kids at home, so the subject of bodily functions becomes as common as the weather. Whatever it is, I’m finding that the topic of poop comes up in conversation. A lot.
The truth is, this doesn’t bother me a bit. It’s not a coincidence that I wound up working as a dietitian in gastroenterology practice at a gastroenterologist’s office. I’ve long been fascinated by the digestive process in general, and the intestines in particular.
My favorite diagram of the gut — a veritable road map of the twisty turns through the small intestine into the colon that marks the site of each nutrient’s absorption along the way — is faded and dog-eared from my frequent and intense study. Some consult tea leaves to read clues into the universe. I consult poo.
To be clear, only a medical doctor can diagnose diseases, and I have no such credential. If your bowel movements are of concern, you should always consult your doctor. However, I’ve discussed enough poops in the context of their owners’ diets to become pretty good at helping my patients hone in on what dietary factors may be behind their bathroom woes. And if you’re not too squeamish to continue, I thought I’d share some of my best — ahem — nuggets.
Different Poops and What They Mean
Green or yellow generally hint at rapid transit, or poos passing abnormally fast through your intestines. Poo gets its typical brown color from bile, a greenish emulsifier that’s secreted by your liver and gallbladder to aid in the digestion of fats.
Bile needs to spend several hours in the colon to develop this color, which means that poos passing through too quickly may retain the greenish hue. Furthermore, if you’ve recently eaten green veggies — like spinach — that green poo may also result from chlorophyll, due to incomplete digestion from rapid transit.
If you’ve eaten beets in the past few days, your normal brown poo may be tinted magenta from the beet pigments; totally normal and harmless. Other shades of red — or even blue — can result from food dyes; take special note, ye Froot Loop and Kool-Aid lovers among us.
Black poos may often result from high intake of supplemental iron. However, if yours is black and you haven’t used iron, it could suggest bleeding in the GI tract that’s worth checking out.
Unless you’ve recently used Pepto-Bismol, poos that are pale (or white) in color are not likely the result of something you’ve eaten and are worth having checked out by a gastroenterologist sooner rather than later.
[READ: What Is Normal Poop?]
Undigested Food Particles in the Poo:
Fragments of fibrous foods, like corn kernels, tomato skins, quinoa grains, whole flaxseeds, raw leafy greens or fruit seeds often show up recognizably intact in a poo.
This is normal, and it shows that your high-fiber diet is doing its job of providing indigestible material to bulk up the poo and feed the beneficial bacteria that live in your colon. Rest assured, it doesn’t mean you’re not absorbing the nutrients in your food.
Loose, poorly-formed poos that resemble Shredded Wheat generally suggest rapid transit. In other words, the poo is moving too quickly through the colon to allow for the excess water to be re-absorbed by the body.
One dietary strategy to correct this is to go easy on the raw veggies, and choose foods at each meal that will help slow down transit time while contributing to fecal bulk. The best foods for the job are those high in gummy, soluble fibers:
— Oats or oat bran.
— Rice and barley.
— Root vegetables (including carrots and potatoes).
— Applesauce or peeled apples, banana and papaya.
In some cases, a soluble fiber supplement like Benefiber, Citrucel or psyllium husk can also work wonders toward achieving the Platonic ideal of stool: soft, bulky, well-formed and easy to pass. Talk to your doctor or dietitian to see if a fiber supplement is appropriate for you.
Hard, lumpy poos or little balls of poo that resemble ‘rabbit pellets’ are often a sign that your stool has been sitting around for quite some time in the colon, such that most of their moisture has been reabsorbed back into the body. In these cases, osmotic laxatives, which draw more water into the bowels, can help speed things along internally and keep more moisture in the stool.
Examples of osmotic laxatives include magnesium in doses of 350 mg-1,000 mg (start low and work your way up gradually) or PEG 3350 (marketed as MiraLAX), which is a safer bet than magnesium for pregnant people or those with kidney disease.
Sometimes you may start to experience hardier, lumpier poos after adopting a low-carb or keto diet as a result of eliminating most sources of soluble fiber from your diet. As you may notice from the list of soluble fiber examples above, these are foods higher in carbohydrate that often get tossed out on low-carb diets in favor of “roughage” type forms of insoluble fiber that don’t do a very good job of retaining moisture in the stool.
If you’re committed to your low-carb way of eating, you may benefit from a super-duper, water-absorbing bulking fiber supplement, like calcium polycarbophil (marketed as Fibercon) or psyllium husk to help get regular. You can use it alone or paired with a gentle osmotic laxative.
Poos that are visibly oily tend to hint at malabsorption — or, abnormally poor absorption, of fat — and this can have multiple underlying causes. Often, such oily poos will be unusually stinky as well.
Dietary causes of this condition include consumption of a type of fish called escolar (often improperly labeled as “white tuna” on sushi menus) or oilfish (often mislabeled as “butterfish” or even cod) or the fat replacer Olestra in a reduced-fat product.
If diet is the cause, the problem should resolve itself once the offending ingredient leaves your system within a day or so. Otherwise, the cause may be medical, and you should consult a gastroenterologist.
Multiple, Urgent BMs First Thing in the Morning:
Morning is a very common time to move our bowels due to natural rises in the hormone cortisol, which take place early in the morning and peak by around 10am.
Separately, there’s a normal, hormonally-induced phenomenon called the gastro-colic reflex that takes place soon after waking and throughout the day in response to eating, which explains why many people find the need to poop soon after eating breakfast (and sometimes, only a few bites in.) It’s a contraction of the digestive system’s muscles designed to keep food moving along to make room for whatever’s coming down the pike.
Thirdly, there’s a compound in coffee called chlorogenic acid which is a natural colon stimulant. Note that it’s not the caffeine in coffee, but rather a compound called cholinergic acid. Caffeinated tea should not have the same effect, but decaf coffee will. Pair these three things together — waking up before 10 a.m., eating breakfast and drinking coffee — and you can understand why morning is prime pooping time for many — if not most –people.
However, for the 10% to 15% of Americans who have irritable bowel syndrome, the digestive tract tends to be hypersensitive or over-reactive to the standard set of stimuli. What this can look like for many folks with IBS is that the morning becomes a time of repeated, urgent and sometimes even crampy trips to the bathroom that make it hard to get out of the house on time.
So guzzling two cups of Joe and downing your breakfast within an hour of waking may overstimulate your irritable bowel and set off this spasmodic symphony of pooping. In these cases, I often recommend a soluble fiber supplement like Citrucel, Benefiber or acacia fiber at bedtime to help promote formed, more complete stools the following morning, often paired with a dose of enteric coated peppermint oil for its natural anti-spasmodic effects.
If this alone doesn’t do the trick, I suggest, spacing out the timing of these three stimuli over the course of your morning — or saving your coffee and/or breakfast for after 10 a.m. when your cortisol levels have started declining. Taken together, this regimen may help keep things running a little more smoothly.
If you’ve got poo woes that this primer doesn’t address, don’t be afraid to snap a digital photo, and make an appointment to share it with your friendly, local gastroenterologist. As the popular children’s book by Taro Gomi correctly asserts, “Everyone poops!” There’s no shame in discussing yours with a qualified health professional.
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