What our poo can tell us about our bowel health
Our poo can be an important indicator of our digestive health and the consistency of our poos is a central component in helping us ascertain whether our poos are normal or not, or whether they have recently changed (1). A change in poo’ing habits can indicate something might be going on inside, for example, in IBD it could be a sign of a change in inflammation.
The consistency of our poos is largely determined by their water content which is linked with transit time (the time it takes our food/poo to travel through our intestines (2). If things are moving through very quickly (rapid intestinal transit time), there is limited time for water absorption which can lead to loose or liquid poos (3). On the other hand, if things move through very slowly (slow intestinal transit time) lots of water can be absorbed which created harder poos (4).
How can we measure our poo?
The direct measurement of poo consistency or poo water content requires laboratory analysis and is impractical for routine everyday purposes, but we can all measure our own stool form (shape, texture) visually everyday to keep an eye on whats happening and to help us ascertain whether anything has changed, indicating whether we need to see the doctor.
To help us classify our poos form, a scale and imagery can be really useful. The Bristol Stool Chart, also known as the Bristol Stool Form Scale (BSFS) is one of the most widely used and ordinally classifies stool form into seven categories ranging from the hardest (Type 1) to the softest (Type 7).
The BSFS is widely used throughout the world in both clinical and research settings.
What can our poo tell us about the health of our bowels?
Types 1 and 2 are considered abnormally hard poos and, in conjunction with other symptoms, indicative of constipation (1).
On the other end of the scale, Types 6 and 7 are considered abnormally loose/liquid poos and, in conjunction with other symptoms, indicative of diarrhoea (1).
Type 3, 4 and 5 are generally considered to be the most ‘normal’ poo form (1).
The BSFS was originally developed with written descriptions only but later pictures of stool types were added to help patients decipher which poo type most accurately represented their own. And now I have added real life comparisons for you too!
What should I do if my bowel types are abnormal?
If your bowel habits change or you notice any blood in your poo, its really important you go to your GP and discuss this with them.
If you have abnormal poo types and, either you have had GP tests and they have come back clear, or you have had a diagnosis of IBS or IBD, dietary and lifestyle changes can really help to improve your symptoms and help you have more normal poos!
If you think you need help with your poo consistency, lets have a chat. You can book a (free) 20 minute no obligation phone call with me to find out how I can help you. During this call I love to hear about you; your journey, your struggles, your life, and we can chat about the best route forward for you.
If that sounds interesting click here so you can find a time that works for you.
Take Aways
Monitor your poo consistency every time you poo - use the above chart to help you!
If anything changes, report this to your GP.
If you still struggle with hard or loose poos when you have been to your GP or if you have a condition like Crohns Disease, Ulcerative Colitis or IBS, then getting support from a Nutritionist or Dietician can be really helpful. We can help guide you as to what dietary and lifestyle changes may help to normalise your poos, help reduce your symptoms, and improve your quality of life.
References
Blake, M.R., Raker, J.M. and Whelan, K. (2016), Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 44: 693-703. https://doi.org/10.1111/apt.13746
Seppanen S, Niittynen L, Poussa T, Korpela R. Removing lactose from milk does not delay bowel function or harden stool consistency in lactose-tolerant women. Eur J Clin Nutr 2008; 62: 727– 32.
Törnblom H, Van Oudenhove L, Sadik R, Abrahamsson H, Tack J, Simrén M. Colonic transit time and IBS symptoms: what's the link? Am J Gastroenterol 2012; 107: 754– 60.
Heaton KW, O'Donnell L. An office guide to whole-gut transit time. Patients’ recollection of their stool form. J Clin Gastroenterol 1994; 19: 28– 30.