Your bathroom habits say a lot about your health. Many doctors are familiar with the connections between how often and what kind of stool is passed and the risk of major diseases like cancer and heart disease. 

 

Frequency and appearance matter

 

In the largest recent study related to going number two, Chinese researchers assessed the individual and joint correlations of stool frequency and consistency with all-cause and cause-specific mortality, using 2005–2010 US data from the National Health and Nutrition Examination Survey (NHANES).

Peng X, Li J, Wu Y, et al. Association of stool frequency and consistency with the risk of all-cause and cause-specific mortality among U.S. adults: results from NHANES 2005-2010. Healthcare (Basel). 2022 Dec 22;11(1):29.

 

Researchers assessed faecal patterns in 14,574 participants over a 7.6-year span, during which there were 1,502 deaths (357 attributed to cancer; 284 attributed to cardiovascular disease [CVD]). In total, 50.7% of participants had a bowel movement 7 times/week. The most common form, described by 51.8% of participants, was labelled “like a sausage or snake, smooth and soft.”

“Infrequent soft stools were associated with a higher risk of all-cause, cancer, and CVD mortality, while regular or moderately frequent hard stools may contribute to a higher risk of CVD mortality,” the authors concluded. “These findings suggest that self-monitoring of stool frequency and stool consistency may be a simple yet useful tool for informing about major chronic illnesses.” They noted that public health education “should consider including similar bowel health evaluations.”

 

Useful stool tool

 

A literature review conducted by UK researchers revealed some shared characteristics pertaining to bowel movements.

Rose C, Parker A, Jefferson B, et al. The characterization of faeces and urine: a review of the literature to inform advanced treatment technology. Crit Rev Environ Sci Technol. 2015;45(17):1827–1879.

They found that most people typically defecate 1.2 times in a 24-hour period. They also found that the main variable affecting faecal mass was fibre intake. In low-income countries—where people eat more fibre—the faecal mass was twice that of high-income countries. 

 

 

The stool is graded on an ordinal scale from type 1 (ie, hardest) to type 7 (ie, softest). Types 1 and 2 indicate constipation, whereas types 6 and 7 represent diarrhoea. Types 3, 4, and 5 are considered healthy.

According to the Cleveland Clinic, the most common reason for type 1 or 2 is dehydration.

Poop Shape, Color and Smell: What’s Healthy and What’s Not. Cleveland Clinic Health Essentials. February 11, 2022.

The addition of increased fibre and exercise is helpful with decreasing intestinal transit times, therefore reducing constipation occurrence. 

 

Type 5 could indicate insufficient fibre, or it could be a signifier of bowel disease. Type 6 or 7 could represent infection, food poisoning, bowel disease, or chronic stress.

Fecal matter that is pencil-thin or difficult to pass might be a sign of colon cancer or small bowel obstruction. Suspicion is heightened when patients who used to have large bowel movements suddenly experience smaller ones.

The Scoop on Poop: 5 Facts You Need to Know. Cleveland Clinic Health Essentials. March 2, 2018.

 

 

Navigating the color spectrum

 

Different colours of faecal matter could indicate the following:

Poop Shape, Color and Smell: What’s Healthy and What’s Not. Cleveland Clinic Health Essentials. February 11, 2022.

 

• Green: Infection with a bacteria, virus, or parasite; this colour could also be due to IBS or medications 

• Black: Upper GI bleed; less nefariously, a black colour could be due to taking iron supplements or bismuth subsalicylate (Pepto-Bismol)

• Red: Rectal bleeding secondary to hemorrhoids, IBS, anal fissures, ulcers, or colorectal cancer

• Yellow: Disorders of the liver, pancreas, or gallbladder; acholic stools refer to pale-coloured stools due to a lack of bile pigment

  Acholic stools. MedGen UID: 436478.

   

While you don’t want to be surprised by the colour of your movement, strange hues can sometimes be temporarily caused by the consumption of food dyes.

Acholic stools. MedGen UID: 436478.