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If it comes out Brown and Yellow then you can stay Mellow

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As a Doctor of Chinese Medicine, I am no stranger to talking about “poop” and “pee”.  It’s a normal function of the body and the variations of its presentation can give you deep insights into your health and digestion.  For both excretions, the color, size, shape, and smells mean different things.

Let’s take a closer look at your poop or stools specifically.  First:

Did You Know?

  • It’s normal to poop anywhere from 3 times a day to once every 3 days depending on if this has been a long time habit either way and the stools are well formed.
  • If your stool smells pretty funky and strong, you may be ingesting too many animal proteins.
  • Healthy poop sinks slowly and starts as half floating and half sunken.
  • Excess mucus in the stool could be a sign you need to get tested for food allergies and start to avoid those foods.

Stool Color and What it Means:

The normal color of stool should be a medium to darker brown color.  So what if your poop is green?  Or red?  Or black?  What does it mean if it has some white stringy stuff trailing through it?  I will attempt to answer some of those questions.

Green:

No need to panic if this is happening occasionally.  Most likely this is normal with a reasonable explanation.  Sometimes it is green because you had some green foods or a mix of vitamins or supplements- even if they’re not green.

There can be many reasons: The first and most obvious is eating green foods which is of course super good for you and helps form healthy poops because of the fiber content. Green, leafy vegetables contain chlorophyll, which can color the stool green.  Iron supplements or foods that are rich in iron can also give it a green tinge.

Aside from the actual pigments you take in, bile, which is a natural substance that is secreted in the first part of the small intestine to help you break down fats, is green too.  Usually, when food is digested and passed through the large intestine, it turns into a darker brown color.  However, if the poop is still green by the time it is excreted, it may have gone through the large intestine too fast to be changed in color and may come out more as diarrhea. This is often called “rapid transit” or “decreased colonic transit time”.  Take your time and chew foods well.

In breast-fed infants, green poop is normal, especially right after delivery. In older children, the reason could be food-related as described above, or from eating or sucking on colored non-food items such as crayons.

Yellow:

If your stool is yellow, it may be a sign that certain fats or protein and glutens in your diet are not getting properly digested. Tell your doctor and rule out malabsorption disorders (like celiac disease).  It may also be you’ve just been eating too many fatty foods so cut back.

Light White-ish or Pale:

Are you having any abdominal pains or does digestion feel sluggish?  These colors can be indicative of a lack of bile. Perhaps a bile duct is obstructed, or maybe you’ve taken too much bismuth subsalicylate (Kaopectate, aka Pepto-Bismol) or some other anti-diarrheal medication? If this persists, bring this up with your doctor.

Red or Rainbow:

Most likely this is normal unless you feel any pain or a sensation of “bearing down”.  Foods with dark purple or coloring, like Kool-Aid, popsicles, and gelatin (Jell-O), can result in rainbow-colored poop.  Certain high pigment foods (like beets and other things with artificial red coloring) can make your poop look alarmingly bloody colored though this is totally normal. Real blood, however, can be a sign of a problem. When you wipe with toilet paper and see blood, this may be a sign of hemorrhoids.  The medical term for blood in the stool is “hematochezia.” The brighter the blood is, the lower it may be coming from in the gastrointestinal tract (colon) and rectum. A physician should always investigate blood in the stool to rule out potentially serious conditions.  

Black:

Black stools can range from being normal to being a very serious condition.  If they are tar-like in consistency and have a foul odor, this can be the result of eating certain foods, taking iron supplements, or possibly from internal bleeding. If the black color is from blood, it is known as “melena.” The dark color indicates that the blood has been in the body for some time and comes from higher up in the gastrointestinal tract (esophagus, stomach, small intestine).

Note: A black stool caused by food, supplements, medication, or minerals is known as “false melena.”  Foods that are dark blue or black may also cause blackness. Substances that can cause false melena are:

  • Black licorice
  • Blueberries
  • Iron supplements
  • Lead
  • Bismuth (Pepto-Bismol)

Consult a physician immediately if the black color cannot be attributed to a benign cause such as an iron supplement or food.

Stool Smells and What They Mean:

Isn’t poop supposed to smell bad?  Well, it generally smells a bit bitter and not great but if it ever starts to smell like rotten eggs, take note. Changes in diet are the most common culprit for changes in stool odor, but if this smell continues for a few days along with cramping and diarrhea, then let your doctor know.

If you get foul-smelling poop from eating something that didn’t sit well with you, no need to worry – just wait it out and eat more cleanly.  However, if the smell is accompanied by changes in the color of the stool, pain, fever or chills, or weight loss, it could mean something serious and you may wish to consult a doctor.  Antibiotics, medicines, and excess multivitamins can also upset the natural flora of your gut so be sure to supplement with quality probiotics, especially after a round of antibiotics.

If this is a chronic issue, then you may wish to take steps to find out the underlying cause.  Foul-smelling stool can also be caused by malabsorption issues, such as lactose intolerance, celiac disease, food allergies, or inflammatory bowel disease.

Bristol Stool Chart Explained:

This chart was developed by a team of gastroenterologists at the University of Bristol and is widely used as a general measurement by healthcare professionals to evaluate the consistency or form of stools.

Some general guidelines for understanding this chart:

  • Stools at the lower numbers on the scale are hard to pass and often require a lot of straining. If you are constipated, you will be passing type 1 or 2 stools when you pass them at all.  In Chinese Medicine, this can be caused from blocked energy of the liver and/ or from not taking in enough fiber and liquids.  The liver plays a huge role in digestion and needs lots of dark leafy greens and iron rich foods to function properly.
  • Those suffering from diarrhea will pass type 6, 7, or 8 on a frequent basis. Those at the loose or liquid end of the spectrum may seem to pass through your digestive system too easily, causing an urgency to defecate as well.  In Chinese Medicine, sometimes you need to supplement the digestive system with more digestive fire.  Needling certain acupoints to address the kidneys and spleen can be very helpful with additional moxabustion (herbal infrared) and herbal medicine.  If the stools smell foul and feel incomplete or burning, then we may need to take the excess heat and damp out of the digestive system.  Everyone is different.  See your acupuncturist to help you determine your needs.
  • Types 3 and 4 are ideal since they are easy to pass without being too watery.

There is a direct correlation between the shape of the stool and the amount of time it has spent in the colon. Therefore, the Bristol scale can be used to detect patterns or changes in bowel habits. However, it’s important to remember that this scale is intended to provide a general, not exact, measurement of fecal form and consistency.

The Bristol Stool Scale classifies feces into seven types, based on their appearance as seen in the toilet water. They are distinguished as follows:

  • Type 1: Feces come out in separate, hard lumps, similar to nuts. Type 1 has spent the longest amount of time in the colon and is generally difficult to pass. When feces sit in the colon for too long, it can cause constipation. This condition is usually caused by a lack of fluids, lack of friendly bacteria, stress, excess mucus, and not enough good fiber, though it can also be a sign of other conditions.
  • Type 2: Lumpy and sausage-like in appearance.
  • Type 3: Comes out looking similar to a sausage but with cracks in the surface.
  • Type 4: Feces are smooth and soft in the form of a sausage or snake.
  • Type 5: Feces form soft blobs with clear-cut edges that are easily passed through the system.
  • Type 6: Fluffy pieces with ragged edges. These are considered mushy stools.
  • Type 7: Entirely liquid and watery with no solid pieces. This type of stool has spent the least time in the colon. Diarrhea is usually caused by a bacterial or virus infection from food or water. It can also be caused by anxiety, food allergy, drugs, or other problems in the colon. This type is a sign that something is wrong, and the body is trying to cleanse itself.
  • Type 8: This type was not included in the original Bristol Stool Scale, but was added later by Dr. Group. It is foul-smelling and mucus-like with bubbles (sprayed out). This may indicate excessive intake of alcohol and/or recreational drugs.
Diarrhea

Abnormal Stools:

According to HealthLine, you should seek immediate medical attention if you have any of the following changes in bowel habits:

  • blood in your stool
  • increased mucus in your stool
  • watery, diarrhea-like stools for over 24 hours
  • pus in your stool
  • severe abdominal pain

And you should make plans to see the doctor if:

  • You haven’t pooped in more than three days
  • You can’t pass gas
  • You have mild, persistent abdominal pain
  • You have lost the ability to control your bowels and have sudden urges to have a bowel movement
  • You’re losing weight for no apparent reason
  • You have thin, ribbon-like stools for longer than a few days

Disclaimer: As with any online advice, this article is not meant to replace a consultation with a professional doctor, and if you are concerned about your bowel movements or your stools in general, then my advice would always be to make an appointment with a doctor as soon as you can.