Knowing if our digestion is “normal” or “abnormal” can help us to know whether we need to improve our digestive health. My goal with this column is to help you better understand how to identify abnormal digestion and give you some ideas for what you should do if your digestion needs support.
What is normal for one person might not be normal for another. The following are general expectations of what normal digestion should look and feel like:
■ 1-3 bowel movements per day that are formed and easy to pass
■ Absence of abnormal contents in those BM’s (ie. no mucus, blood or undigested foods)
■ A dark brown color (should not be yellow, black, white or clay in color, but occasionally may be more green or orange, depending on how much green or orange foods consumed)
■ No pain in your digestive tract (the tube that goes all the way from your mouth to your bottom)
■ No pain or discomfort when passing your bowel movement
■ Absence of reflux, heartburn or excessive burping
■ No nausea or vomiting
■ No excessive gas or bloating
One of my favorite tools for discussing the size, shape, color and consistency of bowel movements is the Bristol Stool Chart. This chart defines BM’s on a 1-7 scale with Type 1 being associated with constipation and Type 7 being watery diarrhea. A Type 4 on the Bristol Stool Chart is considered a normal BM. It is well-formed and smooth with a sausage-like shape and is free from cracks, blood, mucus or undigested food.
Here’s a breakdown of the types of bowel movements on this chart:
Type 1: Hard little pebbles. This type is consistent with severe constipation.
Type 2: Lumpy balls or hard chunks like the pebbles from Type 1, but all stuck together. This type is consistent with constipation.
Type 3: A large, hard log with cracks in it. This type can indicate some mild constipation, but can also be considered somewhat normal.
Type 4: A smooth sausage or snake-type shape that is easy to pass. This type is considered normal.
Type 5: Smooth chunks or blobs broken into pieces with clear-cut edges. This type is normal to slightly loose.
Type 6: Soft blobs with soft edges. Sometimes more like mud or pudding. This is consistent with mild diarrhea.
Type 7: Completely liquid. This type is consistent with severe diarrhea.
When the gut becomes imbalanced, our digestive symptoms can become abnormal. Bowel movements can become loose, hard to pass, infrequent or too frequent, and could even be associated with pain, bloating, or abnormal stool contents like mucus or blood.
The absence of pain, blood, mucus, undigested food, urgency, frequency, bloating, foul smells or excess gas is what you should expect when your bowel movements are “normal.” Some variations in these symptoms are likely from person to person, and are still considered normal.
Looking in the toilet and tracking your stool contents and consistency can give you clues that tell you if your gut is on or off track.
When is it important to get a workup to find out what is causing your digestive symptoms?
■ When symptoms aren’t resolving on their own
■ When symptoms persist longer than a day or two
■ When the simple tips offered by your providers aren’t resolving your condition
■ When your digestive symptoms are interfering with your quality of life
Please see your doctor if you have anything new or severe happening with your digestion. The following are more serious symptoms that could indicate that you need help ruling out more serious conditions, such as colon cancer, severe infections, or inflammatory bowel disease.
More serious signs and symptoms include:
■ Unintended weight loss
■ Diarrhea at night
■ Rectal bleeding
■ Unexplained iron deficiency anemia (possibly other nutrient deficiencies such as Vitamin B-12)
■ Unexplained or persistent nausea with or without vomiting
■ Continuous vomiting
■ Difficulty swallowing or frequently choking on your food
■ Persistent abdominal pain that isn’t relieved by passing gas or having a bowel movement
■ Abnormal stool color, especially if it looks like coffee grounds, is bright yellow or is clay-colored or white
■ Digestive changes accompanied by fever and/or chills
If you have experienced or are experiencing any of the above symptoms, talk to your primary care provider right away and get a referral to a gastroenterologist to rule out any urgent underlying causes of these symptoms. If symptoms are sudden or severe, you may need to go to the ER or a walk-in clinic.
Why should we care so much about healthy digestion?
Benefits of balanced digestion: ability to absorb the nutrients from our food, improved energy, balanced mood, clearer skin, healthier hair, stronger nails, less risk of autoimmunity, reduced inflammation, balanced blood sugar, less risk of obesity, balanced hormones, etc.
Risks of imbalanced digestion: lack of absorption of nutrients from our food, increased risk of autoimmune disease and inflammation, more skin infections or inflammation, fatigue, poor sleep, lack of blood sugar balance, imbalanced hormones, increased risk of obesity, discomfort, inconvenience, etc.
So check out your poop to see if it’s within the realm of “normal.” If you are not seeing or experiencing normal bowel movements, consider getting help from doctor for rebalancing your gut.
Next time, I’ll write about what Irritable Bowel Syndrome is and isn’t. Teaser: There are several known and treatable underlying causes of IBS.
Dr. Christine Bowen of Everett is a licensed naturopathic doctor, keynote speaker and has been published in the Townsend Letter. In practice since 2005, Bowen specializes in holistic approaches for digestive health and autoimmunity. Go to www.bothellnaturalhealth.com for more information. Connect with her via Facebook drchristinebowen or Instagram @drchristinebowen.