by Dr. Katie Lewis, Naturopathic Doctor – Nourishing Life Collective
Bowel movements are a reflection of certain aspects of our health, and we should be paying attention. When I ask patients if their poop is normal, more often than not, they readily agree. As a young doctor, I took this as confirmation and moved on. As I’ve grown wiser, I’ve learned to ask the question, and then follow up with: "What, exactly, is a normal poop to you?" Do you know if your pooping habits are normal?
The poop experience: A healthy bowel movement should be non-urgent, easy to pass, and leave you with a sense of completion when you are done. Toilet paper should be necessary for 1–2, or possibly 3 wipes max, to achieve proper hygiene. Poop smells like poop. It’s not the most pleasant smell, but it should not be room-clearing, and it should not linger for more than a minute or two. A healthy stool should come out well-formed with zero or minimal gas.
How often: In an ideal world a healthy poop would occur every single day. A single healthy log at a consistent time of day can be normal for some people. Others poop 2–3 times a day after each meal, much like dogs. Pooping more or less frequently is a sign of constipation, diarrhea, irritation, or all of the above. While pooping every other day may seem normal it may not be, even if it’s normal to you.This is worth discussing with your doctor.
Size and shape: Simply put, poop should be a log. It should not be thin, bubbly, runny, or pellet-shaped. It should hold its form in the bowl. Any other shape suggests an underlying issue and should be taken just as seriously as classic constipation.
Color: Poop should be brown; that one is easy. Colors that should alert you that something is off are black or very dark brown, red streaks, yellow, green, or pale. However, don’t forget to consider what you ate the day before, as certain foods like beets tend to color your stool.
Constipation and diarrhea: Chronic constipation (which can be: missing days of stool, passing stool which feels incomplete, difficult, or stool which is atypical shapes) along with chronic diarrhea (which can be passing liquid, fluffy, or urgent stool) are both extremely irritating and a sign something is off. Constipation can be an indication of a simple human need, like hydration or fiber. Chronic diarrhea can be caused by something as simple as needing to chew your food more thoroughly or a food allergy. Both can lead to longer-term problems like hemorrhoids or nutrient deficiencies and should be addressed. Hemorrhoids are also a signal that something is off in either the digestive tract or an adjacent organ and should be discussed with your doctor.
Gas, bloating, and belching: 1-2 episodes of passing gas (either burp or fart) can be normal for certain people who have difficulty digesting certain foods or specific food preparations. Large amounts of bloating after a meal are never normal and should be addressed, even if they are normal for you. Frequently farting or belching - associated with most meals should also be discussed. Again, room-clearing farts are not normal and can be a sign of digestive stress, changes in the gut flora, or other forms of malabsorption.
Fiber and hydration are safe tools to try on your own before your appointment, but it’s important to remember that because fiber is a binder, it can bind to medications and supplements and should be taken separately from them.
Dr. Katie Lewis, ND