Whats your poop telling? (Are you Constipation?)

Looked in the toilet lately?

Your bowel movements can tell you a lot about your digestive health. Here’s a chart ?StoolChart

Researchers at the Bristol Royal Infirmary, developed a visual guide for bowel movements.  Its a good reference to distinguish normal stools from abnormal without getting embarrassed over personal details.

Type 1: Separate hard lumps, like nuts

Typical for acute disbacteriosis. These stools lack a normal amorphous quality, because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive,  they‘re painful to pass, because the lumps are hard and scratchy. There is a high likelihood of anorectal bleeding from mechanical laceration of the anal canal. Typical for post-antibiotic treatments and for people attempting fiber-free (low-carb) diets. Flatulence isn‘t likely, because fermentation of fiber isn‘t taking place.

Type 2: Sausage-like but lumpy

Represents a combination of Type 1 stools impacted into a single mass and lumped together by fiber components and some bacteria. Typical for organic constipation. This type is the most destructive by far because its size is near or exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s bound to cause extreme straining during elimination, and most likely to cause anal canal laceration, hemorrhoidal prolapse, or diverticulosis. To attain this form, the stools must be in the colon for at least several weeks instead of the normal 72 hours. Anorectal pain, hemorrhoidal disease, anal fissures, withholding or delaying of defecation, and a history of chronic constipation are the most likely causes. Minor flatulence is probable. A person experiencing these stools is most likely to suffer from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls. The possibility of obstruction of the small intestine is high, because the large intestine is filled to capacity with stools. Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstruction, or perforation of the small and large intestine alike.

Type 3: Like a sausage but with cracks in the surface

This form has all of the characteristics of Type 2 stools, but the transit time is faster, between one and two weeks. Typical for latent constipation. Irritable bowel syndrome is likely. Flatulence is minor, because of disbacteriosis. The fact that it hasn‘t became as enlarged as Type 2 suggests that the defecation is regular. Straining is required. All of the adverse effects typical for Type 2 stools are likely for type 3, especially the rapid deterioration of hemorrhoidal disease.

Type 4: Like a sausage or snake, smooth and soft

This form is normal for someone defecating once daily.  The larger diameter suggests a longer transit time or a large amount of dietary fiber in the diet.

Type 5: Soft blobs with clear-cut edges

I consider this form ideal. It is typical for a person who has stools twice or three times daily, after major meals.

Type 6: Fluffy pieces with ragged edges, a mushy stool

This form is close to the margins of comfort in several respects. First, it may be difficult to control the urge, especially when you don‘t have immediate access to a bathroom. Second, it is a rather messy affair to manage with toilet paper alone, unless you have access to a flexible shower or bidet. Otherwise, I consider it borderline normal. These kind of stools may suggest a slightly hyperactive colon (fast motility), excess dietary potassium, or sudden dehydration or spike in blood pressure related to stress (both cause the rapid release of water and potassium from blood plasma into the intestinal cavity). It can also indicate a hypersensitive personality prone to stress, too many spices, drinking water with a high mineral content, or the use of osmotic (mineral salts) laxatives.

Type 7: Watery, no solid pieces

This, of course, is diarrhea, a subject outside the scope of this chapter with just one important and notable exception—so-called paradoxical diarrhea. It‘s typical for people (especially young children and infirm or convalescing adults) affected by fecal impaction—a condition that follows or accompanies type 1 stools. During paradoxical diarrhea the liquid contents of the small intestine (up to 1.5–2 liters/quarts daily) have no place to go but down, because the large intestine is stuffed with impacted stools throughout its entire length. Some water gets absorbed, the rest accumulates in the rectum. The reason this type of diarrhea is called paradoxical is not because its nature isn‘t known or understood, but because being severely constipated and experiencing diarrhea all at once, is, indeed, a paradoxical situation. Unfortunately, it‘s all too common.

Interestingly, the interpretations and explanations of the BSF scale that accompany the original chart differ from my analysis. To this I can only say: thanks for great pictures, but, no thanks for the rest…

Excerpted from Fiber Menace, page 117-120;
BSF Chart: wikipedia.org

 

How to interpret BSF scale

 

Referencing, types 1, 2 and 3 = hard or impacted stools. Type 4 and 5 = normal or optimal. Type 6 = loose stool, subnormal, or suboptimal, and type 7 = diarrhea.

In such cases as acute hemorrhoidal disease, anal fissure, or the inability to attain unassisted stools, loose stools (type 6) are acceptable. It‘s a messy experience, but which would you rather have — a bucketful of blood, pain, and a wound that won‘t heal, or a little lukewarm douche afterwards?

To restore and maintain normal stools (from type 4 to 6), the colon and rectum must first be free from hard stools (from type 1 to 3). In our case, the opposite of “hard” isn‘t “soft,” but difficult (not easy) or irregular.

As you can see from the illustration “hard” stools can be “small,” “regular,” and “large.” A “small” stool for one person can be “large” for another, because the perception of size is determined by one‘s anal canal. If the anal canal is constrained by enlarged internal hemorrhoids, even “small” stools, such as type 4, may be “difficult” to pass.

If stools are hard as in difficult, or not easy, or irregular, they are HARD. Normal stools are not noticeable during defecation!

Unless your stools are type 4 to 6 (normal), they are impacted. Impacted stools can be small, large, hard, soft, dry or moist. Impacted means that they had a chance to pile up and compress in the large intestine. If yours are “formed,” they are impacted.

Normal stools don‘t have to be round. After all, your anal canal isn‘t really round (when shut, it‘s actually flat), particularly if you already have enlarged internal hemorrhoids. So a flat shape is okay. When stools are already round as in type 4, it means you already have a slight degree of impaction. Otherwise their shape would be flattened up while passing through the anal canal.

Summary

  • Abnormal stools require straining and/or pressure from stools passing through the anal canal.

  • Abnormal stools may be small or large size-wise, depending on fiber consumption, and frequency of defecation.

  • Normal stools can be loose or slightly formed (Such as BSF type 5).

  • Normal stools (between BSF type 4 and 6) aren‘t perfectly round.

  • Normal stools require zero effort and zero straining for elimination.

  • Normal stools pass through the anal canal without any perception of pressure.

Once you have damage to the anal canal, achieving absolute “normality” may be hard. So you may have to accept a small degree of “abnormality” such as type 6 stools.

You may also have to live with the fact that after a certain degree of prior damage, caused by fiber, you won‘t be able to attain “unassisted” defecation and “normal” stools because of irreversible nerve damage, stretching of the large intestine, significantly enlarged hemorrhoids, and similar factors.

 

Types of constipation

iconFunctional constipation. This condition follows a stressful event, surgery, colonoscopy, diarrhea, temporary incapacity, food poisoning, treatment with antibiotics, the side effects of new medication, pregnancy, or injesting foods that you cannot break down such as lactose.  The circumstances that damage intestinal flora, interfere with intestinal peristalsis, or both. A person becomes irregular, stools correspond to the BSF scale type 1 to 3, and straining is required to move the bowels. The person resorts to fiber or laxatives for help. If the intestinal flora, stools, and peristalsis aren’t restored following adverse event, functional constipation turns into the latent form (i.e. hidden), because fiber‘s or the laxative’s effects on stools creates the impression of normality and regularity.

iconLatent constipation. Here the stools have become larger, heavier, and harder, usually the BSF type 3,  straining more intense, but for as long as you keep moving your bowels every so often, and without too much pain, there is still an impression of regularity. This, without correction will lead into organic constipation.

iconOrganic constipation. As time goes by, large and hard stools,  between type 2 and 3, keep enlarging internal hemorrhoids and stretching out the colon. This, in turn, reduces the diameter of the anal canal even more, causes near complete nerve damage, and slows down or cancels out completely the moving of stools. At this point the person will no longer have a defecation urge.   Moving your bowels dependent on intense straining and/or laxatives. If you don’t use ‘hard’ laxatives, you fail to move the bowels even with a good helping of fiber. That is, in fact, what most people mean nowadays when they say: “I have been diagnosed with constipation.”

Diseases that tend to slow down the movement of the feces through the colon, rectum, or anus are more likely to cause constipation. They include the following:

  • Neurological disorders MS (Multiple Sclerosis), Parkinson’s Disease, Stroke, Spinal Cord Injuries, Chronic Idiopathic Intestinal Pseudo-Obstruction
  •  Endocrine and metabolic conditions Uremia, Diabetes, Hypercalcemia, Poor Glycemic Control, Hypothyroidism
  • Systemic diseases (Diseases that affect a number of organs and tissues, or affects the body as a whole) Lupus, scleroderma, and amyloidosis
  • Cancer Mainly due to the medications for pain, and chemotherapy. Also if a tumor blocks or squeezes the digestive system.

 

Color of your poop


A diagnosis cannot be made by stool color.  It is important that you contact your doctor and they complete a full intake, history and testing to determine an actual diagnosis.  The color of your bowel movements will tell you alot, so any change in the color should be monitored.  The color of your bowel movements reflect what you’ve eaten, how your system has digested it, transit time and will reflect if you have any digestive or bowel issues. The color of your bowel movements should be a honey brown color brown in color. The color reflects the bile produced in the liver and mixed with the material.

The color is also based on the transit time, which should be 12-48 hours from when you ate.  If it takes a shorter time, the result may be greener stool because green is one of the first colors in the rainbow of the digestive process.

Green stools are generally seen when diets are high in vegetable and fruit fiber, especially spinach.  However, it also generally accompanies diarrhea.  If stool passes through the intestine too quickly, there is not be enough time for bile to be digested and broken down.  This process gives stool the brown colon. Bile is a greenish brown fluid that is manufactured in the liver and stored in the gallbladder. Bile helps digest fats in food. When stool passes through the intestines to quickly, this process doesn’t happen in full and you will see the green-ish color bile.

White, light color or grey clay,  this can can indicate a block in the flow of bile or liver disease. Lack of bile is what makes the poop pale.

Yellow stool is generally greasy and foul smelling. Yellow stool is caused when your intestine cannot digest fat due to malabsorption from issues like celiac disease and cystic fibrosis, or because the pancreas is unable to manufacture adequate digestive enzymes. Yellow poop can also be caused by gastrointestinal infection caused by giardiasis, a protozoan infection that can cause significant diarrhea.

Red coloring indicates bleeding somewhere in the GI track, while the general rules for black, red or maroon are indicative of the are of bleeding, it is more dependent on the transit time as well. If your stool passes within 12 hours, bleeding from your upper GI track will not give enough time for the blood cells to be digested before it is eliminated. So these are general rules.

Black stool can mean internal bleeding and may be also a sticky or tarry texture and will smell bad.  Red blood cells are broken down by digestive enzymes and turn the stool black.  Black stool are also found in people who have high protein diets, from the iron, or iron supplements or taking medication that contains  subsalicylate. Often this can be from your upper GI track as the transit time allows the blood cells to be digested, turning black.

Bright red stools Bright red stool is bleeding from hemorrhoids, or other inflammatory disease (Crohn’s disease, ulcerative colitis), diverticulitis bleeding, tumors, and arteriovenous malformations (AVM).  This is a result of active bleeding in the lower digestive area such as the large colon, transverse sigmoid or rectum.  Beets can also give stool a red color.

Maroon stools This is also bleeding but from the small intestine area.
Mucus in the stool is indicative of an inflammatory disease or cancer. When accompanied by abdominal pain or blood, you should seek medical attention quickly.

Stool that floats is generally due to malabsorption of nutrients. This should be monitored. Diets that change will usually have this type of stool in the beginning but should change. If it continues you will want to look at your diet as it is indicative of lactose intolerance, celiac disease, cystic fibrosis, and short bowel syndrome.

Correction of these events is imperative as you can see they continue to lead to a worse scenario. At some point you’ll also end up with damaged bowels, and a life-long dependence on more and more fiber, and ‘hard’ laxatives. If you are in your teens today, you’ll pay the price in your early forties, if you are in your early forties, damnation will come by your early fifties..