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Sometimes in life we have to deal with things that are less than pleasant – dirty laundry, patching up wounds, pet messes – let’s face it, moms cope with a lot of messy situations. Talking about bodily functions doesn’t generally make for polite conversation. Judging by the stunning array of constipation medications available at the drugstore, maybe we do need to talk about it. (I was looking for ipecac syrup, which they no longer carry, to keep in our emergency medical kit.)
So, what constitutes a “normal” bowel movement? Believe it or not, some scientists in England (Bristol, to be precise), came up with a chart to describe the range of typical bowel movements. The following is a summary of the chart based on information from www.gutsense.org. I encourage you to visit their site if you want more details or have specific concerns, or to speak with a qualified health care professional.
Type 1: Separate hard lumps, like nuts
These stools lack a normal amorphous quality, because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive, the typical diameter ranges from 1 to 2 cm (0.4–0.8”), and they’re painful to pass, because the lumps are hard and scratchy. 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. The diameter is 3 to 4 cm (1.2–1.6”). 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. 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. The diameter is 2 to 3.5 cm (0.8–1.4”). 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 defecations are 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 diameter is 1 to 2 cm (0.4–0.8”). 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(The authors of www.gutsense.org) consider this form ideal. It is typical for a person who has stools twice or three times daily, after major meals. The diameter is 1 to 1.5 cm (0.4–0.6”). *Note – many other sites list 4 and 5 as preferred shapes.
Type 6: Fluffy pieces with ragged edges, a mushy stool
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. 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.
We are bombarded with advertisements for FIBER! FIBER! FIBER!, but is a large amount of fiber the real solution we’re looking for? Based on personal experience, I’d have to say, “no”. I’ve read some articles that say that large amounts of fiber can actually make bowel problems worse, depending on your situation. We need to look at the colon as not only a part of your digestive system, but part of the body as a whole. Did you know that an under active thyroid can contribute to constipation? And that the gastrocolic relex (the urge to poop) typically weakens as we age?
I (unfortunately) found this information out first hand when my thyroid became sluggish. The good news is that by changing my diet, I am now happily in the 4-5 range. Here are some of the changes I’ve made during the last year or so that have helped me:
5 Tips for Better Bowel Movements
1) Eat plenty of coconut oil and other high quality saturated fats.
Fats are our bodies natural lubricants. They provide a feeling of satiation so you are less likely to overeat.
2) Eat plenty of veggies, including green and leafies, and moderate amounts of fruit
I’ve been eating less fruit lately since I am cutting back on carbs, but I do make sure to get plenty of plant material each day. Plants provide a good ratio of fiber to water that is generally easy on the digestive system.
3) Stay hydrated
I’m not fanatical about how much water I drink. I think the eight glasses a day recommendation seems a little over the top, unless you’re in a situation where you’re sweating heavily. Realistically, would our ancestors have consumed that much fresh water daily? Unlikely. That said, I think most of us have a higher toxin load from our environments, so we want to keep things moving through our systems. Don’t skimp on the water.
4) Eat and drink plenty of probiotic foods and beverages
As we age, our bodies naturally produce less digestive enzymes. Our digestive systems slow down (and sometimes even stop – not good). Live culture foods and drinks like sauerkraut, kimchi, fermented salsas and chutneys, kombucha, kefir, and kvass all help “jump start” your digestive system and often contribute to the healing of many digestive ailments. Don’t know what some of those foods are or want to learn how to make them at home? Click on “probiotics” on the labels section of the sidebar to learn more. Want to learn a lot more? Check out Enzyme Nutrition and/or Enzymes & Enzyme Therapy : How to Jump-Start Your Way to Lifelong Good Health.
5) Avoid highly processed foods
Last year, we did a little homeschool science experiment where we took samples of different foods and subjected them to “digestive forces”. We soaked them in vinegar, “smushed” them in a plastic bag, and finally forced them through on old nylon stocking. The foods we examined were a piece of meat, a piece of apple, some celery, some oatmeal, and saltine crackers. When we got to the saltine crackers, they basically coated the inside of the stocking like glue. The same thing happens in your guts.
So the next time you visit the bathroom, take a peek at what’s going on before you flush. If you’re not in the 4-5 range, you may want to consider making some changes in your diet.
Great chart. I would add one more type that is uncommon but you should keep a look out for. Feces that is foul, oily, food still in it (not corn but softer foods) and though somewhat solid comes out like liquid feces. This denoted a pancrease that is not doing it's job. My daughter has needed to use pancreatic enzymes on and off thorugh out her life because of this pancrease problem. Like I said uncommon but worth telling you doctor if you see it persistantly.
God bless
Heather L
Poo! One of my favorite topics
I'd love to learn more about the poo of traditional societies – one thing that, as far as I know, that Weston Price never reported. I think we've totally lost track of what is normal. I wonder if flatulence exists when you eat a perfect diet and have good gut flora.
BTW, I enjoy reading your posts. I have a blog hop. I'd love to share some posts.
gfcfmomofmany – oh my – yes, that would definitely be a cause for concern. Glad you shared this, in case there are others who might run into this problem, and so glad you were able to find help for your daughter.
Ruth – he was a dentist, not a protologist or gastroenterologist, so I'm guessing he was busy at the other end, but that would be an interesting inquiry. I'd be especially curious about the folks who have minimal plant products in their diets. I suspect some level of gas in "normal", but have noticed personally that I am less gassy and generally less stinky than I used to be before I consumed probiotics regularly.
What's bad is when you follow all the advice given and you still suffer with a #2 or #3. I had to give up on that "going once a day" because that's not my body's desire. I sometimes get happy if a stomach bug is going around! (not really, just kidding)
I am in the same boat and I am now going to add a bit more olive oil and walnuts each day to see if it helps.
Paula – have you had your thyroid checked? Does your menstrual cycle have any effect? Once in a while, I still get nailed with a combination of stress and other factors that stops things in their tracks – not pleasant. You can pm me at laurieneverman at gmail dot com if you wish to discuss symptoms. Don't give up hope on a more comfy bottom!
Thanks for linking your great post to FAT TUESDAY. Hope to see you next week!
http://realfoodforager.com/2011/09/fat-tuesday-september-20-2011/
I just came across your blog. I am always in the 5 to 6 range, mostly 6. Always. I have lots of problems at that end and am waiting for a January appointment with a GI doc. I've had a colonoscopy and endoscopy that were normal, but a stool test showed I was was gluten sensitive. I've been eating GF for 3 years with no relief.
Megan – can you tolerate (or have you tried) live culture foods? Many people aren't familiar with them, but they have made a HUGE difference for me. We're exposed to so many things that can upset the flora and fauna of our digestive systems that I feel these foods are critical for health. Please feel free to contact me at laurieneverman@gmail.com if you'd like to learn more about cultured foods or discuss other options. I'm not a doctor, just and engineer turned my own guinea pig, but I keep asking questions and hopefully finding answers.
Our digestive systems are sometimes referred to as our "second brains", so if your guts are hurting it impacts the rest of your health, as I'm sure you know.
Thank for your reply, Laurie. I have started using more cultured foods with my daughter. She has cerebral palsy and epilepsy, but meds and the ketogenic diet have not worked. I have been giving her marrow and bone broth (on the recommendation of a Traditional Chinese Medicine doctor), and I started giving her kefir and sauerkraut, both of which she loves. As her gut health improves, so do her seizures.
I eat pretty much a Weston A. Price diet, but I haven't been as proactive about the cultured foods and getting myself healthy. (I know, I know, gotta take care of myself too! I'm in the trap most moms get into.) I even signed up for the Cheeseslave class on GAPS, but then we moved from Connecticut to Missouri, and I never did it (I have all the videos and info, though).
So, I know in my heart (and gut!) what the answer is, don't I?! I am very nervous about making my own fermented foods, though. I'm afraid of making anyone sick! (Which I know is silly because I am a fearless cook otherwise!)
Thank you SO much for your thoughts!
Don't fear fermented food.
It's strange, but the fermentation process naturally lowers the pH and inhibits the production of pathogens. So, if it ferments, it won't rot. They are mutually exclusive operations, at least early on. Eventually the little fermentation beasties run their course and eat everything they can, and then things start to rot, but meanwhile, you're good to go. I highly recommend the book Wild Fermentation (http://www.amazon.com/Wild-Fermentation-Flavor-Nutrition-Live-Culture/dp/1931498237/ref=sr_1_1?s=books&ie=UTF8&qid=1324227149&sr=1-1)
The author's a little "out there", but he makes fermenting easy.
Don't beat yourself up about not doing this or that. Just keep at it, slowly, and make small changes that become habit. Stress can make you just as sick as not eating right.
You can do this! Our bodies were made to heal, we just need to help them do it.
Yay, I am normal!
Hi! Any advise would sure help! My husband has high blood presure it runs in his family and the dr’s have had a hard time regulating it (he is a former marine so he had a high stress job) he has a slightly less stress ful job now but still I know that plays a part. He had a colonoscopy and endoscopy in 2009 because he is on the chart as a #6 but is bloody like the water in the toilet bowl is red bright red
he goes to a gi doctor soon I’m hoping for some answers. it really worrys me, he says it’s not like that everyday, but the way he talks he’s never had a “snake” and I don’t think that’s normal!
Lauren – no, that is definitely not normal. He really should seek professional help. It sounds like his system is badly out of whack. Quality probiotics and live cultures foods may help, but there’s a good chance that for long term health a diet like GAPS may be required. The suggestions offered in the post above may provide some relief, but he should seek professional advice to rule out more serious conditions.
Ya he has appointments made for different doctors but was hoping to find some relief as the appoinments aren’t for a few months yet, I had him take a fiber pill the doc recommended a fiber supplement and I figured he would take a pill much easier an better then the mix in powder he tried it for a week and a half and said the bleeding has gotten worse
Lauren – is there any way to get an appointment sooner? That sounds very serious. At the risk of TMI, is there a chance that the blood could be from hemorrhoids or anal fissures? While uncomfortable, those conditions are generally less serious than internal bleeding. If he’s got some sort of surface irritation in the GI tract, especially the rectum or anal area, excess fiber would be the last thing you’d want to add to the diet. A gentle diet to keep things moving that includes items like apples/apple sauce (which have pectin) and chia seeds, would probably be easier on him. Both pectin and chia are hydrophilic, meaning they absorb water. Both of these foods will form somewhat of a soft, gelatinous mass, clumping waste together and helping it move through your system.
If he’s dealing with something like ulcerative colitis (http://www.umm.edu/altmed/articles/ulcerative-colitis-000166.htm), which he may be, from the symptoms you’ve described, then you need to look at internal treatment. Ted at Earth Clinic comes highly recommended by several friends for self-healing advice. The Earth Clinic ulcerative colitis page is here: http://www.earthclinic.com/CURES/ulcerative_colitis.html
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Another suggestion for those with #7. I went to several Doctors and had LOTS of tests without getting a diagnosis or help. A friend suggested NO white flour. Diarrhea stopped in 2-3 days!!!!