How do we gauge the health of any system? It is by looking at the output of the system. That's the most straightforward way. An example is the exhaust of a vehicle. When you put an incorrect fuel like kerosene into an engine designed to run on petrol, you can see how the exhaust is black and smelly. It's the same with our digestive system. Poop is the output of the digestive system. As any new parent would attest, we feel very relieved when our baby poops for the very first time. It confirms that the digestive system is functioning. How well it functions will depend on the smell and the texture.
We all get conditioned as we grow up. We are taught that poop is disgusting. Poop is not something to be mentioned let alone to be discussed. Because of this conditioning, many digestive disorders are missed early on when they could be treated like colon cancer. Many kids grow up ashamed to talk about constipation because of this taboo about poop. These kids suffer unnecessarily in their childhood and are left to deal with the complications of chronic constipation as they grow older. As adults, many silently bear with bloody poop hoping that it will go away rather than getting a diagnosis and treating the condition. Many women do not know it's common to get hemorrhoids after delivering a vaginal birth.
There was a time when doctors used to analyze poop and make changes to diet accordingly. So, food was medicine before pharmaceutical products came along. Of course, it was only done for the royalty. Poop analysis was the gold standard of diagnostics before blood analysis and imaging became the norm and is the least intrusive of all. Many ancient medicine systems also used poop for diagnosis. For example, Siddha doctors use the output of different systems like urine, poop, and sweat, for diagnosis.
Now with affluence, we eat like kings and queens. So, I see why not we analyze our poop like the royalty of yester years. No doctor today will analyze your poop daily though you can send it to the lab to get it analyzed. There are smart toilets with built-in poop analyzers[1]. The smart toilets are not available widely yet. So, until then, let's use our very own eyes, nose, and brain to analyze our poop. So, what should we be looking for? Since we habitually poop in the morning which is a busy time, it should be something easy and quick. There is a guide called the Bristol stool chart which classifies poop based on size, shape, and texture. That's the picture you see above.
Before we get into the different types, let's see what's poop made of. The majority of our poop is water. Undigested or partially digested food like fiber makes up a significant portion of our poop. The rest is made of our gut bacteria. The brown color comes from our bile, secreted to digest fat.
Type 4 is the ideal state of our poop though Type 3 is acceptable. Since most of us use Western toilets, we should see coiled snakes in the toilet bowl for Type 4. We have to ensure our poop stays in the third or fourth type by changing our input accordingly. So, any diet plan that you follow can be judged based on the poop type. Pooping Type 3 or Type 4 will be quick, 1-2 minutes without much effort.
Type 1 poop means that we are constipated. Poop only gets this hard when it stays in the colon for a long time losing all its water. As we saw earlier, the majority of our poop is water. If the water is lost, it will shrink in size. So, we must be regular in pooping and get rid of all of it when the urge comes. Western toilets are very convenient but not good for removing all of our poop. One potential solution is to use a squatty potty [2]. The main remedy is to drink more water to prevent the poop from becoming so dry. We also need to add more fiber to our diet. Fiber provides the mass for the poop to become well-formed so that it moves through the large intestine faster and also serves as food for the gut bacteria which is another big part of our poop. Physical activity also helps to move the poop through the large intestine faster. Type 2 poop means we have to do more of the things listed above for Type 1.
On the other side of the spectrum, Type 6 and 7 means we have diarrhea. Typically the poop will stink when we have diarrhea. The frequency matters as we would be pooping multiple times. Our digestive system does not like what we ate before (food poisoning) and is getting rid of it as fast as it can. Typically the cause is a bacteria or a virus. As seen in Type 1, as poop goes through our colon slowly, the water is absorbed. Since the body is in a hurry to get rid of the food, the poop in these types comes out as liquid. The only thing to do is to stay hydrated as we are losing water every time we poop. No solid food of any sort as it will come right out.
Type 5 means the body is getting rid of poop faster than normal. Just like we saw in Type 1, we need to add fiber to our diet to bulk up our poop. Another potential cause is sugar. Sugar holds on to water and does not let water get absorbed in the colon. You might know of some elderly folks who eat something sweet as a cure for constipation. Eating could cause Type 5 poop. It's called the gastrocolic reflex. The poop is moved through the large colon to make space for the new food. For some the gastrocolic reflex is strong, and poop gets moved through the colon rapidly and they have to poop right after eating. Folks with Irritable Bowel Syndrome or Leaky Gut may have Type 5 poop.
Though we have attempted to classify the poop, as you will see, not everything in nature will fall into a single type as defined by us. So, you will have a mix of types and you will have to use your judgment.
Now let's move on to color. As seen above, poop should be typically brown for all who are on solid foods due to bile. Various foods and medications could cause temporary color changes in your poop. If it is unusually light brown/yellow and falls in Type 1-4, then you need to consult with a doctor who would typically check if your bile duct is blocked.
Blood in your poop is always bad. But if it's bright red, it means bleeding in the rectum or anus (hemorrhoids/piles), which is less worrisome. You need to stop straining hard and aim for Type 4 so that pooping does not aggravate the injury and helps to heal faster. Black poop is common for folks taking iron supplements. If you are not taking any iron-rich foods or supplements, maroon/dark red poop could be a sign of bleeding in the upper GI tract like the colon, which is far more serious, and must consult with a doctor immediately.
Some Quick Tips:
Keep your toilets well-lit.
Wear your glasses when you poop.
Do not sit on the potty for a long time as it weakens the pelvic floor muscles, leading to potty accidents as we age.
To summarize, stay hydrated, eat fiber in every meal, avoid antibiotics, and be physically active throughout the day for good digestive health.
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