We all poo, yet most of us find it too embarrassing to talk about. But paying close attention to the size, smell, colour and texture of your poo can reveal a lot about how healthy you are.
Growing evidence suggests that the health of your gut – home to trillions of microbes of bacteria – has the ability to influence many aspects of your physical and mental health, including how your immune system functions.
‘It’s important to normalise talking about poo, because issues with it can indicate a problem in the digestive tract. If it’s something serious, it’s crucial to catch it early,’ says Dr Rhianna McClymont, Lead GP at Livi.
Here’s a guide on how to tell if your poo is healthy, the key signs to look out for and when to talk to a doctor.
1. Brown, well-formed and easy-to-pass poo
When it comes to your poo, it’s important to know what’s normal for you. A poo that’s brown in colour, well-formed and easy to pass is considered healthy, explains Dr McClymont. The Bristol Stool Chart is a good reference and illustrates what your stools should look like.
How often should you poo? ‘This differs for everyone. Lots of people will pass one stool every day, but others may pass 2 a day or one every 2 days. The key is to consider what’s “normal” for you,’ says Dr McClymont.
‘If the frequency of your poo suddenly changes, and you become constipated or start passing multiple stools a day when you usually only pass one, it’s best to talk to a doctor,’ she says.
2. Hard poo (pellet-like)
Hard, pellet-like poo can indicate constipation, explains Dr McClymont. You’re likely to be constipated if you haven’t had a poo at least 3 times in the past week and you’re in pain or straining when you go to the toilet. You may also feel bloated, sick or have a stomach ache. Common causes include lack of fibre, dehydration, inactivity, medication, stress, anxiety or depression.
Drinking plenty of water and eating enough fibre is important, says Dr McClymont. Movement and gentle exercise can help to keep your bowel moving too.
3. Loose or watery poo
‘Loose poo or diarrhoea may be caused by a gut infection, food intolerances, certain medications, an overactive thyroid, or a disease of the intestine like Crohn’s disease. Certain foods can be culprits too, like alcohol, caffeine and spicy or oily foods,’ says Dr McClymont. Stress and anxiety can also cause diarrhoea, due to the powerful connection between your gut and brain.
One of the main symptoms of irritable bowel syndrome (IBS), which affects 10 to 15% of people worldwide, is loose stools. ‘Many people find that their IBS symptoms worsen when they go through periods of significant stress,’ explains Dr McClymont.
‘Treating loose poo will depend on the individual trigger, but as a general rule it’s important to stay hydrated, eat plenty of fibre and avoid foods you’ve identified as irritants to your digestive system,’ she says.
4. Bright-red blood in poo
Noticing bright-red blood in your poo might be alarming, but blood in poo is more common than you might think. It can be caused by anal fissures, haemorrhoids, IBD or diverticulitis (a digestive condition that affects the large intestine).
It can also be a sign of bowel cancer. According to Dr McClymont, the red-flag indicators of IBD or bowel cancer include:
- Persistent abdominal pain
- Bleeding from the back passage – particularly if this blood is ‘mixed’ with the poo
- Unexplained weight loss
- A new change to your normal bowel pattern
- A mass in your abdomen or rectum
5. Black poo (tar-like)
Taking iron tablets to treat iron deficiency is a common cause for darker poo, as well as eating foods like black liquorice. But it can also be a symptom of a bleeding ulcer or stomach cancer.
‘Black and tarry stools can indicate a problem like bleeding in the digestive tract,’ says Dr McClymont. ‘It’s important to speak to a doctor if you notice this in your poo as you may need further tests.’
6. Oily poo
If your poo appears oily, floats and is difficult to flush, it may mean that you’re not adequately absorbing nutrients from your food or making bile or enzymes to digest food effectively. Other common symptoms of malabsorption include gas, abdominal cramps, diarrhoea, weight loss and indigestion.
‘There are a number of reasons for this,’ explains Dr McClymont. ‘If this happens with your poo, it’s best to chat with a GP.’
7. Mucus in poo
Mucus in the poo can sometimes indicate an infection or underlying disorder like Crohn’s or ulcerative colitis, which are both forms of inflammatory bowel disease (IBD), says Dr McClymont. A tear or open sore near the anus (anal fissure), ulcers, IBS and food allergies may also increase mucus production.
‘If mucus is present in your poo and you have a change in your bowel pattern, abdominal pain or blood in the stool, bring this up with a doctor,’ says Dr McClymont.
8. Colourful poo
Stools can be any shade from brown to purple. ‘Certain foods can change the colour of your poo,’ says Dr McClymont.
‘Beetroot, for instance, can cause a red-pink tinge, which might be quite concerning at first glance. A diet very rich in spinach and leafy greens may also result in greener coloured poo.’
9. Pale or clay-coloured poo
Bile is produced in the liver and gives poo its brown colour, so if your poo is pale it could be a sign that the liver isn’t producing enough bile or the flow could be blocked. ‘If you spot this, talk to a doctor as it’s likely to need further investigation,’ says Dr McClymont.
10. Noticeably smellier poo
If your poo smells worse than usual, it could indicate anything from constipation to an infection or food intolerance. It could also be caused by a recent change to your diet.
‘If you’re worried or the smelly poo is accompanied by other things like abdominal pain, fever or blood in your poo, bring it up with a doctor,’ says Dr McClymont.
Still feeling awkward?
If you’re feeling embarrassed about speaking to a doctor about your bowel movements, Dr McClymont recommends using the Bristol Stool Chart, which can help explain the consistency of your poo and whether it’s changed from ‘your normal’.
A doctor may do a blood test and rectal examination and ask you to provide a small sample of poo. ‘It’s perfectly normal to give a stool sample and a common thing for a GP to ask a patient to do,’ says Dr McClymont. ‘This is then sent on to a laboratory for analysis.’
If you’re concerned about your poo or bowel movements, book a meeting with a doctor to help identify the cause and decide on necessary treatment.
This article has been medically approved by Dr Rhianna McClymont, Lead GP at Livi.