Let's face it: Digestion happens. Few of us, however, can talk about the end result without embarrassment. It's too bad; our stools, which yield clues about diet, gastrointestinal health, and stress, anger, and anxiety levels, may be as useful a diagnostic tool as our temperature or blood pressure. “People can tell a measure of their health by their bowel movements,” says Dr. Ted Loftness, an internist in Litchfield, Minnesota. “Nothing is so overrated as sex and so underrated as a good bowel movement.”
From the moment food enters your mouth, your body embarks on a campaign to turn it into a soupy mush called chyme. Chewing, saliva, peristalsis (involuntary contractions of gastrointestinal muscles), bacteria, hydrochloric acid, digestive enzymes, bile, and other secretions work to give each meal the consistency of split pea soup. While your digestive cells absorb sugars, starches, fats, vitamins, minerals, and other nutrients, waste products travel down the line. In the colon, the leftovers are combined, packed together, and partially dehydrated. What remains—our feces—consists of water, indigestible fiber, undigested food (corn, small seeds), sloughed-off dead cells, living and dead bacteria, intestinal secretions, and bile. (Worn-out red blood cells in bile give excrement its distinctive color.)
If all goes well, you'll have a healthy bowel movement. Although digestive idiosyncrasies, variations in intestinal bacteria, and other variables can produce different standards for a healthy stool, it generally should be brown to light brown; formed but not hard; cylindrical, not flattened; fairly bulky and full-bodied, not compacted; somewhat textured but not too messy; and very easy to pass. And it shouldn't smell—much. “You're passing methane and bacterial, degraded foodstuffs, so there's always going to be an odor,” says Patrick Donovan, a Seattle naturopath. “But it shouldn't be a strong, pungent odor.”
Experts disagree on two other characteristics: number of pieces and buoyancy. Each bowel movement should be in one piece, about the shape and size of a banana and tapered at the end, according to Melanie Ferreira, a nutritionist and instructor at the Natural Gourmet Institute for Food and Health in New York City. Donovan disagrees: “Stools don't have to be well-formed logs. They can disperse in the toilet water; they can break down.”
Some experts argue that stools should float; Ferreira says buoyancy is a sign that the body has absorbed the minerals in the food. Others believe healthy bowel movements should touch bottom because of their bulk and fiber content. “Most stools will sink,” says Loftness, who doesn't buy either argument. “Whether it floats or sinks really doesn't seem to make any difference.”
One of the most common gastrointestinal complaints is hard feces and infrequent, difficult elimination—better known as constipation. Chronic constipation may contribute to autoimmune diseases and colon or breast cancer. “The longer stool stays in the colon, the more one reabsorbs the metabolic products [such as estrogen] that have been excreted in the bile,” says Donovan, who treats people with cancer in his naturopathic clinic. “We can see increased risk of breast cancer in women with a history of constipation.”
Experts agree that regularity is important but disagree sharply about frequency. The National Institute for Diabetes, Kidney, and Digestive Diseases says three times a week is normal and healthy for some people. According to Ayurveda, the Indian healing system, once a day provides an ideal, complete evacuation, says Virender Sodhi, M.D., an Ayurvedic doctor and naturopath in Bellevue, Washington. Donovan says a person should have a bowel movement within two to three hours of a major meal—or two to three times a day.
Ferreira thinks once or twice a day is best. She also looks beyond physical health: “The act of digestion and elimination can be seen as a metaphor for our ability to absorb what is useful from our experiences and eliminate what is unnecessary or harmful, or what holds us back. If you have a healthy bowel movement each day, you're letting go of the past and bringing in the new.”
The three basics required for healthy bowel movements are fiber, fluids, and exercise. To improve your digestive system health, try these steps:
- Eat more dietary fiber, found in whole foods, especially grains, vegetables, and fruits. Fiber allows waste to pass through your digestive system smoothly and quickly.
- Drink plenty of fluids (water rather than sugary drinks) to prevent intestinal blockage from excess fiber.
- Exercise daily. Even a walking program, Loftness says, promotes bowel regularity.
- Regularly eat foods known to stimulate digestive enzymes, including brown rice; pungent foods such as garlic, ginger, and onions; and daikon radish.
- Eat fermented foods such as miso (soybean paste), tempeh (soybean cakes), high-quality yogurt, and pickles to replenish beneficial bacteria in your gut.
- Minimize or end your intake of coffee, laxatives, and refined foods, all of which interfere with regular elimination. Antibiotics, birth control pills, and other prescription drugs also can hamper bowel movements. If you're constipated, ask your doctor if you can change or reduce the medications you're taking.
- Pay attention to your food while you eat, says Sodhi. Sit down. Turn off the television. Don't read or listen to the radio. “Look at the food, the aroma, the color.” The relationship this creates between you and the food will improve your digestion, he says.
- Heed the call of nature. Go to the bathroom when you feel the urge to eliminate, not just when it's convenient.
- Reduce stress—which can cause either constipation or diarrhea—through meditation or yoga.
- If you're daring, consider this: Squat on the rim of the toilet in your bare or stocking feet. “Squatting straightens the recto-anal angle and opens it more fully so elimination is much easier,” says yoga practitioner Richard Ravizza, a psychology professor at Pennsylvania State University in Scranton. “You could think of it as straightening a partially kinked garden hose.”
STOOL SIGNS ... COULD MEAN ...
Black, tarry, sticky
Bleeding in your upper digestive tract. The black color comes from digested blood cells.
Very dark brown
You drank red wine last night, or your diet has too much salt or not enough vegetables.
Glowing red or magenta
You've eaten beets or other reddish foods.
You're consuming too much sugar, or too many fruits and vegetables with not enough grains or salt.
Pale or clay-colored
Minimal amounts of bile are being excreted, perhaps because of gallbladder or liver problems.
Bloody or mucus-covered
Hemorrhoids, an overgrowth of certain bacteria in your gastrointestinal tract, colitis (inflammation of the colon), Crohn’s disease (also known as inflammatory bowel disease), or colon cancer. Red blood usually means the ailment is located near the end of your digestive tract; black blood signals partially digested blood coming from an ailment higher up. Seek medical advice promptly.
Pencil-thin and ribbonlike
A polyp or growth in your colon may be narrowing the passage.
Large and floating, with greasy film on toilet water
Malabsorption—your digestive system isn't getting the full nutritional use of food.
Loose and watery, sometimes with undigested foodstuffs
Possible causes of diarrhea: food poisoning, lactose intolerance, antibiotics, antacids, dietary changes, travel, anxiety, stress, inflammatory bowel disease, irritable bowel syndrome.
Small, hard, round pellets
Constipation—even if you're defecating frequently. Possible causes: too much dry food, including protein, and not enough vegetables and raw foods; laxative abuse; worries; irritable bowel syndrome.
Alternating bouts of diarrhea and constipation
Irritable bowel syndrome. This chronic condition can be aggravated by red meat, spices, sugar, alcohol, lack of fiber, allergy-causing foods, irregular hours, and chaotic relationships.
Smells really bad
An imbalance of intestinal bacteria or eating too much animal protein, which can putrefy in your digestive tract.
From Natural Health (April 1999). Subscriptions: $23.90/yr. (9 issues) from Box 7442, Red Oak, IA 51591-0442.