I think people have a lot of misconceptions about poop. No, really, they do. Since I am a board certified poop doctor (that’s what my kids think, at least), I hear a lot of people’s concerns about their pooping habits and I know that the public out there is confused. Confused and sometimes obsessed. Obsessed with their bowels. I sometimes feel like I should start teaching a class or start a support group for people with pooping issues so I can do my shpiel for a bunch of people all at once. This is what I would say:
1. Normal frequency
People are obsessed with the idea that they have to poop every day, once a day. This is not true. Normal is actually anywhere from 3-4 times a day to once every 3-4 days. Even once a week might be normal if it’s comfortable and you’re not straining. Keep that in mind if you skip a day. Now, if you’re normally a twice a day person and suddenly you’re not going for days, or vice versa, there could be a problem, so ask a doc. Bottom line (pun intended): major change from your normal, not some arbitrary normal is what would worry me.
2. Normal consistency
People always want to tell me if they’re producing pudding or fluff or goat poops or whatever other simile their creative minds come up with. To make things easier, there is actually a chart someone made up – we love charts in medicine. Actually, I remember the first time I saw this chart. I was a senior resident who somehow magically got her abstract accepted at Digestive Diseases Week (a huge conference for all GI professionals), and I decided to take the post-graduate course too, which was silly, because I was not a post-graduate, I was more like a pre-matriculant. But anyway, there were probably three or five thousand people taking this course (mostly bald men in club jackets, but that is a whole other discussion), and they put up this chart on the screen, and I seriously could not understand why no one was laughing.
I’ve matured a lot since then. But if you’re anything like I was at that time in my life, this might make you chuckle, and you’re welcome. You want to aim for like type 2, 3, or 4.
3. Normal color
Here’s another thing to which people assign great significance, and in reality, it is really not as important as everyone think. Poop, like people, comes in all sorts of colors and hues, and most of them are not abnormal. So, if yesterday it was chocolate brown, and today it’s more like cappuchino… Please don’t tell me about it, it’s ok. I care if you’re producing bright red blood (for obvious reasons, especially if there are clots or if you’d describe it as a gush), or if your stool is black and tarry, which means you might be producing blood up top somewhere, and it’s getting digested along the way and coming out black. And FYI, if you take iron, you might have this, but that’s normal. Black stool from bleeding is called “melena,” and you’d recognize it because in addition to being black, it stinks to high heaven. You’d notice that. I might also care if your stool became white; that’s called “acholic,” and it could mean there is a liver problem, but honestly, if we’re at the point where your stools are acholic, we would already know about a liver problem because you’d have other symptoms, and you’d be really sick. And if your poop turns forest green (like my son’s did once, freaking me out to no end), stop eating Fruit Loops (the culprit in my son’s case).
4. Normal reflexes
Something I hear all the time is, “All my food goes right through me!! As soon as I eat, I have to run to the bathroom!” So, no, your food isn’t ACTUALLY going right through you. That would be impossible unless your food has like a jetpack or something. People usually have 30 feet of intestine it has to go through, and no inanimate object can do that in seconds to minutes. You’d have to have more than two thirds of your small intestine taken out for food to literally “go through you,” and if that happened, you’d also be severely malnourished and dehydrated because nothing would get absorbed. What’s actually happening is something called “gastro-colic reflex.” Basically, when you eat and your stomach stretches, it sends signals to the rest of your GI tract: “INCOMING!!” and the intestines start moving things out to make room. It’s normal for that to happen. Some people have an exaggerated gastro-colic reflex, and find it happens too close to mealtime, or that they cramping and urgency with it. That’s still really not necessarily abnormal, but ask your doctor, they might want to rule out food intolerances.
5. Normal digestion
Sometimes, they say “No, really, it goes right through me! I see undigested food all the time!” This may or may not be abnormal, but keep in mind that a lot of the things we eat we don’t actually digest or absorb. Mostly, vegetable matter. So, things like lettuce, peels and skins (on tomatoes and grapes, for example), beans, seeds, and, how can we forget, corn – these things don’t get absorbed and are excreted just as they came in. That’s normal. You don’t always see them, because it’s usually buried in the rest of the crap (pardon the pun) that comes out. But if you’re having a looseish stool, you might, and that’s more or less expected. I’d run it by your doc if it’s a consistent thing, but don’t freak out.
That’s what I have to say about that. But remember, if you’re worried, you’re still better off running it by a professional, and by that I don’t mean any famous neurosurgeon on TV, or the venerable WebMD. I mean an actual person who can lay hands on you, listen to you, and make all your troubles go away. Well, maybe not, but someone who can make you feel better about your poop.
And Why Not! 