Red flags for bowel movements, and what’s a perfect poo

You might not often discuss your bowel habits with your nearest and dearest, but sometimes it’s worth getting a second opinion. In this blog post I’m talking about a list of red flags for bowel movements you should speak to your doctor about.

I’ll also cover how to spot the perfect poo so you know what you’re looking for when your digestion is working well.

I find most of my clients with IBS are often very familiar with what goes into the toilet.

Red flags needing more attention

Firstly if you’ve had a change in bowel habits that you’re worried about, don’t be embarrassed about going to the doctor. They have honestly heard and seen it all before.

Most of my clients with IBS have been to the doctor multiple times. Maybe you’ve already had to explain more times than you’d like what your poop looks like. After all it’s not an easy conversation to have, especially if you get embarrassed.

General red flags for poop

Before I get specific about poop problems it’s important to say; any ongoing bleeding or pain that doesn’t go away needs investigating by a doctor.

Don’t ignore symptoms like sharp pain, or a constant dull ache because this is your body trying to tell you to take action.

If you’re worried about it then speak to your doctor.

How to check for red flags

You may not actually look at the toilet, but it can tell you a lot about your digestion, if you can get over the ikk factor!

Sometimes the poo can vanish down the U-bend (sometimes called a ghost poop!). But if you can see it you want to check for anything unusual.

Remember – what you eat can also affect the colour of the stool. So beetroot can turn it red. Spinach can make it dark green or black. And lots of sweet potato can make it orange.

Things you can look out for include:

Black poop

• Black looking poo, which may appear like coffee granules or tar mixed with your food waste. This could indicate bleeding in the intestines and needs checking out. Bleeding higher up in the stomach or small intestine could be lined to stomach ulcers, polyps, cancer or IBD. 
• You might also see black poo from taking iron supplements, or another supplement called bismuth. This is nothing to worry about if you see the dark colour and know you’re on these supplements. 

Mucus in your poop

Mucus can be a sign of having IBS, and often it may indicate some level of irritation in your colon. I sometimes speak to clients with constipation and explain that mucus can be a sign the body is trying to lubricate the colon to move the stool along.

Mucus could also be caused by another condition irritating the lining of the gut. For example, the NHS confirm ulcerative colitis can present with mucus and diarrhoea.

If you see mucus and it’s a new symptoms for you, speak to your GP.

Seeing red blood in your poo

• Often fresh red blood is the sign of haemorrhoids, or a small tear which is nothing to worry about if it heals up. But it’s worth checking with your doctor if this is happening a lot. A doctor can check you for piles or to see if there is a fissure (small tear).
• It’s important to speak to a doctor if you have significant amounts of blood mixed in with the poop or on tissue when you wipe.

Pale or grey poop

A pale coloured stool can indicate your bile flow is sluggish, or you’re not producing enough bile. The gall bladder releases bile when we eat, and it helps emulsify fats from your food so they can be absorbed.

Bile flow can be blocked by gallstones, or other issues with your liver like jaundice or liver disease. One symptom might be pale poop. 

If your stools suddenly go grey speak to your doctor. 

Other poop issues to watch out for

• Bloating that won’t go away also needs investigation. It could be small intestinal bacteria overgrowth (SIBO) which may need antibiotics to address the bacteria causing excessive gas and bloating.
• Abdominal pain that doesn’t go away
• Feeling a lump in your abdomen
• A change in your bowel habits by increasing the number of times you go, or significantly reducing the number of times.
• Unexplained and unintentional weight loss
• Fatigue or tiredness that won’t go away

If you’re experiencing any of these digestive issues you should ask your doctor about your symptoms. 

Other flags something is wrong (but not necessarily needing a doctor’s visit)

Some of the things I’ll ask my clients about include:

• Undigested food in your poop – can be down to eating too fast, not chewing, lack of digestive enzymes to break up the food. Some foods are not well digested and will often be visible (tomato skins, seeds, sweetcorn). 
• Yellow / orange poo – This can indicate issues with fat absorption. When food moves quickly through the small intestine and fats aren’t being digested properly then sometimes the stools can be a light colour. 
• Foul smelling odour – if you’re leaving the bathroom smelling really eggy, or rotten this might indicate your gut microbes need some attention. Stinking poops can also be down to food intolerance (e.g. lactose). 
• Sticky poos – if you need to wipe multiple times, or find the poos are always sticking to the toilet this might mean you need to eat more fibre. 

What should a perfect poo look like?

So now we know what’s a red flag, how would you know what kind of poo you should aim for?

Well, in summary, it’s when you don’t have any concerns about going to the bathroom. There is no pain, nothing worrying and generally you’re not thinking about poo other than when you need to go!

This is the dream for most of my IBS clients!

• A healthy poo is one that is easy to pass, with no straining, and no urgency.
• Your poop should be well formed, not too loose and not too dry.
• The colour should be medium brown, without lots of food visibly in the waste
• It’s considered normal to go for a poo 1-3 times a day. Less than this could indicate a slow digestion. If you’re every other day or less, you might get more bloating, gassy and stomach pains. This is down to gas getting stuck in the digestive system. Large poos stuck in your colon can also stretch the smooth muscles of your gut, causing the nerves to be irritated and send pain messages to your brain. 
• If you’re going for a poop less than 3x a week this means you’re constipated.

The Bristol Stool chart

We normally use the Bristol Stool Chart to describe poop. It’s easier for most people to point to a diagram, or say the type rather than explain details about the consistency and structure of their poop. This helps make conversations with your doctor less embarrassing!

See the NHS guide to using the Bristol Stool chart. 

Type 4 is the perfect poo!

If you’re experiencing pebbly hard poos you could be constipated, even if you go to the toilet every day. This often means a slow transit time where more water is being absorbed back into your body.

How to get the perfect poop

The best poops are made from a varied diet, rich in different types of fibre. When we eat a range of vegetables and fruits, whole grains, nuts, seeds and pulses then we are giving our body the fibre it needs to form a poop.

You should include these types of fibre:

• Insoluble bulk forming fibre – from whole grains, skins of vegetables etc. This creates more waste to trigger a healthy poop moving through your intestines.
• Gel forming fibre – from fruits and vegetables. This helps create a soft stool that retains water and keeps it easy to pass.

You need to eat both types of fibre to help keep your bowel movements regular.

To get a perfect bowel movement you also need to work on your stress levels, exercise regularly, stay hydrated, and all the other non-food IBS strategies I give in my FREE DOWNLOAD.

So do you have any questions about your bowel habits and whether they are normal?

Check out any red flags with your doctor, but if you have other questions please get in touch on my Instagram @goodnessme_nutrition