How healthy is your poop?

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

Research for this column won’t qualify us for the Nobel Prize in medicine. In fact, readers may say that discussing whether poop sinks or floats is just idle conversation. Years ago, when this column covered this topic, many readers admitted they peeked into the toilet bowl. One complained this triggered a stiff neck! But what you see in the toilet bowel exposes a lot about your health. It’s worth a peek.

It’s well known that the North American diet is too low in fiber. In the 1950s, D.P. Burkett, a British surgeon and epidemiologist, reported that Africans, unlike the English, had large bulky stools and didn’t suffer from constipation, diverticulitis (small hernias in the large bowel), appendicitis or colon cancer. His conclusion was that Africans consumed large quantities of natural fiber in the form of whole grains, seeds and nuts.

Today North Americans consume only 15 grams of fiber daily, when 35 is recommended. Fiber helps the stool hold onto water. Also, the more fiber the greater the number of bacteria in the large bowel which makes the stool as soft as toothpaste. A floating stool is your validation.

Low fiber results in stools as hard as rocks. This slows down their passage through the bowel causing chronic constipation. It’s tragic so much money is spent on laxatives, which can injure bowels. A dose of 4,000 milligrams (mg) of powdered vitamin C at bedtime is an easy cure. It’s safe, inexpensive and the dose can be increased by 2,000 mg every few nights until the problem is resolved.

Stool composition also depends on the amount of fat consumed. A normal stool is about 75% water and about 1% fat. If more fat is present, it’s called “steatorrhea”, perhaps the result of a very fatty meal. These stools are soft, smelly, and stick to the sides of the toilet bowl. If the trouble becomes chronic, it’s often due to a lack of enzymes produced by the pancreas.

So, why not examine the stool? After all, doctors advise us to examine our skin for potentially cancerous moles. A quick look for darkening spots or changes in shape and size can prompt early removal and save a life.

Since prevention is always better than cure, a stool peek is a prudent move. You may discover it’s become black and tarry, the result of bleeding due to an early malignancy. Keep in mind, changes in colour may be due to eating blackberries or beets. Medication such as Pepto-Bismol, containing bismuth, can be a factor too.

If a stool is the colour of pale clay, the problem may be a stone in the common bile duct that carries bile from the liver to the intestines or a cancer of the pancreas. If the stool is pencil thin, there may be a blockage in the large bowel due to malignancy. Shape, size, and colour of stool can be more important than whether the stool sinks or floats.

To learn if you are a healthy pooper, here are the qualifications. You should have a bowel movement at least once a day, but not more than three times. Your poops should be smooth and about the shape of a banana, not too hard and not too soft. The colour should be an even brown with no visible bits of food, fat, blood, or mucus. The smell should be neutral, not overly unpleasant. The more you answer “yes”, the better your poop health is.

These things are not best for a dinner party discussion. But a self-check is a good idea.  Being a health-conscious pooper can help you observe changes that merit the attention of your doctor.