Health clues from your stool
Anywhere from three bowel movements per day to three per week is normal and healthy.

YOUR stool offers important clues to your overall health as it can reveal signs of infections, digestive problems, and cancer.

1)What is stool made of?

Water makes up about 75 per cent of your stool. The other 25 per cent is a combination of fibre, mucous, dead and live bacteria, and other cells. Soluble fibre which is found in foods such as beans and nuts is broken down during digestion. As it dissolves, the fibre creates a gel that may improve digestion. The gel-like substance becomes part of your stool. Insoluble fibre which is found in foods such as corn, oat bran, peas, beans, carrots attracts water into your stool, making it bulkier, softer and easier to pass with less straining.

2) What colour should stool be?

Stool colour can vary depending on the kinds of food eaten and other factors. I know of persons who have become very concerned about passing bright red stool which turned out to be related to consumption and passage of beet root. However, the passage of red stool must never be ignored as this may be due to rectal bleeding, a potentially serious health problem. The consumption of leafy vegetables like callaloo and kale can cause green stool.

White or clay coloured stool is caused by a lack of bile, which may indicate a serious underlying problem. Bile is a digestive fluid produced by the liver and stored in the gallbladder. Stool gets its normal brown colour from bile, which is excreted into the small intestine during the digestive process. If the liver does not produce bile or if bile is obstructed from leaving the liver, stool will be light coloured or white. Interestingly, certain medications can make your stool look white or clay coloured.

Look out for black stool. Though it could be from something as harmless as iron supplements, black stool could be a sign of bleeding or tumours in the upper gastrointestinal tract.

3) Does the shape matter?

The stool shape and consistency matter.

The Bristol stool form scale identifies seven types of stools:

• Type 1: Separate hard lumps, like pebbles, that are difficult to pass

• Type 2: Hard and lumpy, resembling a sausage

• Type 3: Sausage-shaped with cracks on the surface

• Type 4: Thinner, more snake-like that is smooth and soft

• Type 5: Soft blobs with clear edges

• Type 6: Mushy pieces with ragged edges

• Type 7: Liquid consistency with no solid pieces

Types 1 and 2 signal constipation. Types three and four are considered normal, and the shapes are signs of a healthy diet. Type five typically indicates a lack of fibre in the diet. Types 6 and 7 indicate diarrhoea.

4) Does the smell matter?

Stool never smells pleasant. Terrible-smelling stool can be a sign of an infection caused by Giardia parasites. It can also suggest more serious digestive problems such as ulcerative colitis, Crohn's disease, food allergies and intolerances.

5) Are my bowel actions regular?

In general, anywhere from three bowel movements per day to three per week falls within the normal range. It should be noted that a decrease in consistency of bowel actions could be caused by a change in diet, for example, when persons are on vacation. Disorders of the gastrointestinal system, underactive thyroid or colon cancer can also affect the output of stool.

7) Should stool float or sink?

Stool should sink as it hits the water in the toilet. Floating stools are often an indication of high-fat content, which can be a sign of malabsorption, a condition in which the body is not absorbing enough fat and other nutrients from ingested food.

8) Is it normal to pass gas?

Passing gas is normal and healthy; the result of harmless bacteria breaking down food in the large intestine. Your colon is filled with bacteria that release gas as a by-product of digesting the food that you eat. This gas is expelled from the body.

9) Does it matter how long I sit on the toilet?

Sitting too long on the toilet can cause haemorrhoids (piles) or swollen blood vessels in and around the anus. The longer you stay on the toilet trying to pass stool, the more pressure is placed on your bottom. Sitting for too long on the toilet can also restrict blood flow around the anal area, which can make haemorrhoids worse. Hard stool resulting from a diet lacking in fibre can cause constipation and this contributes to the development of haemorrhoids.

Remember to wash your hands after using the bathroom. Studies have discovered the presence of E. coli (a bacteria responsible for causing many illnesses) on cellphones.

Dr Jacqueline E Campbell is a family physician, and radio show host. She is the author of the book A Patient's Guide to the Treatment of Diabetes Mellitus.

Email her at or follow her on IG: dr.jcampbell

Dr Jacqueline E Campbell.
Dr Jacqueline E Campbell

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