Bowel Movements, Health, and Cancer Risk

With nearly thirty percent of southwest Florida residents being over age 65, bowel movements are probably a frequent (even if secretive) topic of conversation in many homes. That makes sense since the majority of colorectal cancers occur in people over age 50. March is National Colorectal Cancer Awareness Month, which means we’re going to talk about poop—that is, bowel movements. Paying attention to changes in your stool may just save your life.

Just so we’re clear on terminology: Bowel movements go by a few names, not all of them scientific: poop, bowels, fecal matter, and — well, you can guess the last one. We’ll use these names interchangeably in this article. When we talk about bowel movement (BM) or “moving your bowels,” that refers to the physiological process of defecation or “evacuating the bowels.” Peristalsis refers to the muscle contractions that take place in the colon (large intestine) to move the bowels out of the body.

Why Talk about Your Poop?

When the smooth rhythm of the muscles of the digestive tract is disrupted, either moving too quickly or too slowly, we experience digestive distress. For some of us, this distress can be frequent and painful, creating a major disruption in our lifestyle. Checking out your poop can give you early warning of a health problem including colon cancer. It can also warn you of a number of health conditions that needs immediate medical attention.

What’s Poop Got to Do with Health?

The composition of what you deposit into the toilet has important implications for many aspects of your health. The clues found in fecal matter can be an indication of how well your body is—or isn’t—doing in fighting infection. Changes in bowels can indicate if you are at risk for many disease including, but not limited to:

Celiac Disease
Colitis
Colon Cancer
Hemorrhoids
Hepatitis
Inflammatory Bowel Disease
Nutrient Malabsorption Disorders
Pancreatitis
other types of infection

Six Features of Stool and What It Means

There are several key features of stool that indicate how well the gastrointestinal tract (GI) is functioning. The five primary features of poop that you should pay attention to are:

odor
size
color
shape
frequency
consistency

Normal Healthy Poop Looks Like…

The Bristol Stool Chart is the go-to resource for identifying poop that may be indicative of a health problem.

Normal poop is anything that doesn’t cause you to take notice of what’s in the toilet during your trip to the bathroom.

For a simplified example, let’s use the five key features listed above to describe what normal fecal matter can look like:

Odor: Not offensively odorous
Size: May be small or large
Color: Light-to-medium brown range
Shape: Varies — Normal poop is not hard to push out, nor runny
Frequency: Average is 3 per week
Consistency: Loose or slightly formed, not perfectly round, not hard, not soft

Here are a few other tips for checking the features of your bowel movement when you don’t have the Bristol Stool Chart in hand:

Abnormal stools

any stools that require straining and/or you feel pressure from stools passing through the anal canal.
may be small or large size-wise, depending on fiber consumption from your diet, and how frequently you evacuate the bowels.

Normal stools

can be loose or slightly formed (Such as BSF type 5)
are not perfectly round
require zero effort and zero straining for elimination
pass through the anal canal without any perception of pressure
occur about 3 times per week

IMPORTANT: Don’t compare your poop to anyone else’s poop!

Normal stools for one person may be abnormal for another. The degree of normality is determined by the anatomy of the anal canal, diet, and lifestyle habits.

IMPORTANT: What goes in your body, usually shows-up in your poop.

Many substances that you consume can cause changes in the frequency, features, and difficulty of defecation. This includes food. For example, beets typically give a reddish tinge to fecal matter. Other substances that can cause changes in bowel movements* include, but are not limited to:

vitamins
minerals
herbs
hydration level
over-the-counter medication
prescription medication
recreational drugs
protein powder
amount of fiber in your diet
athletic performance supplements
exercise intensity and frequency
exposure to toxins including nicotine
hormonal changes
quality of sleep
stress
travel

* If dietary changes or a medication/product you use are likely to produce changes of any kind in your stool, then this information will usually be indicated by your doctor or on the product label. If you aren’t sure, ask a doctor or pharmacist.

A Good “Stool Rule”

If, while you go, it doesn’t feel right or smells putrid … if, after you “go,” you are compelled to take a look in the toilet to make an observation, that is a good indication something isn’t right with your bowels. It may be time to see the doctor.

If you can’t explain away abnormal stool production by the information provided above, seek medical attention.

When Does a Bowel Movement Require Medical Attention?

Immediate medical attention is necessary for following changes in stool color:

Stool that is hard to pass, requires straining, or you experience abdominal pain.
Stool is black and has consistency like wet tar may indicate infection or GI bleeding.
Bright red stool can indicate stool and/or bleeding in the GI tract or anus.
White, pale, or grey stool could indicate problems with the liver, bile ducts, or pancreas.
Yellow stool could indicate infection or gallbladder problems.
Mucus in the stool can indicate inflammation, infection, or even cancer.

5 Colorectal Cancer Screening Symptoms

The following are questions you can ask yourself as a preliminary step in determining if changes in your stool are a sign of colorectal cancer:

1. Have you seen a change in your bowel movements?

Examples: intermittent or constant diarrhea, constipation, change in the consistency or color of your stool, change in shape of stool (more narrow)

2. Do you have persistent abdominal discomfort?

Examples: cramps, gas, or pain and/or feeling full even if you have not eaten, bloated, or feeling like your bowel is not completely empty. Nausea and/or vomiting

3. Do you have rectal bleeding?

Is there blood in your stool? The blood can be bright red, or the stool may be black and tarry or brick red.

4. Do you feel weak or fatigued?

Fatigue not explained by other causes. This may be accompanied by anemia or a low red blood cell count.

5. Do you have unexplained weight loss?

Unexplained weight loss means losing weight for no known reason, having nausea, or are vomiting without other signs of illness that could be the cause.

You can use this Colon Symptom Tracker to monitor changes in bowels.

Talk to Your Doctor

Screening by your doctor is essential to catching colon cancer early. It is now more common to see colon cancer in people under age 35, though mid-life is still the average age of diagnosis. Colon cancer also is more common in men than women, but both need to be screened.

To learn more about Colon Cancer Diagnosis and Treatment contact our physician at Hillandale Primary Care to schedule your screening and assess your risk.

One last thing… make sure you’re pooping the proper way:

How do You Go Poop?

It may sound hilarious or just strange, but a lot of people are pooping the wrong way! Research shows that the position you take when you’ve got to evacuate your bowels has health implications for the organs of the GI tract. So much so, sitting to poop may be a contributing factor in the development diseases of the colon.

Look at it this way: Before potty training, we humans squat down to poop in diapers—we didn’t sit on the floor or in a chair. Sitting on a toilet, research shows, is not the same as squatting down.

The modern toilet places the thighs at a 90-degree angle to the abdomen, whereas squatting has a much deeper angle that gives more motility to the intestinal muscles and organs.

Evacuating the bowels is much easier on the body in the squatting versus seated position. Toilet position is especially important for the elderly, the disabled, and individuals with compromised mobility. Watch this video to learn from the doctors of gastroenterology who advocate for changes in toilet position.

Resources

MedLine Plus: Bowel Movements

Cleveland Clinic : “Stool Changes and What they Mean”

Colon Cancer Coalition Resources

Mayo Clinic: “Stool Color: When to Worry”

Johnson, R.L., S. Foster, Low Dog, T. and Kiefer, D. National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants.(2012) Washington, D.C.: National Geographic.

Pizzorno, Joseph E. Textbook of Natural Medicine, 4thEd. (2013) St. Louis, MO Elsevier.

American Cancer Society: Colon Cancer Diagnosis and Treatment