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Potty Talk: Understanding Feces, Stool, and Bowel Movements

By Dr. Victor Marchione, MD ,

Disclaimer: Results are not guaranteed*** and may vary from person to person***.

Bowel movements are a regular and ideally effortless part of life, but we all know this isn’t always the case. Questions about one’s stool are common, whether they be worries about shape or color or just wanting to know why it smells so bad. Hopefully, this article can shed some light on the subject and also help you understand what’s normal, what’s uncommon, and what should be brought to your doctor’s attention.

What Is Stool?

Feces are roughly 75% water and 25% solid waste. The solids are a mixture of dead bacteria and cells, cholesterol, fat, inorganic substances, protein, bile, and indigestible food substances like fiber. The unmistakable scent is from a mixture of chemicals produced by bacteria, such as hydrogen sulfide. The shape and appearance of your stool is partially dependent on how long it remains in the body.

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When freshly made by the body, stool is far less solid than the version we typically see. As stool is stored in the colon, water is drawn away until it becomes something more familiar to our eyes. After a bowel movement, any leftover stool is moved from the rectum back into the colon where water absorption resumes. Over time, this can cause the stool to dry out and become stiff and hard to pass. Conversely, if the stool spends too little time in the colon the result will be watery, flaky, or otherwise non-solid.

How to Classify Your Stool

The Bristol Stool Chart is a handy medical reference that divides stool into seven types depending on its consistency. Knowing a bit about the chart can help inform you on the general condition of your own bowel movements. The chart comes up when determining if someone has constipation or diarrhea. Stool can be classified into the following:

Generally speaking, types one and two are considered signs of constipation, types three and four are considered ideal and types five, six and seven are considered signs of diarrhea. Keep in mind that stool frequency also needs to be taken into account. Not everyone has a bowel movement every day, but you should have a bowel movement at least once every three days. Being “regular” means having a type three or a type four bowel movement at least three times per week with minimal straining.

The Toilet of Many Colors

Stool is normally brown due to the presence of bilirubin (bile), but it can come in a rainbow of different hues, shades and colors. These colors can be the result of something you ate, like a dye-rich food, or due to movement in the gastrointestinal tract:

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The Myth of the Perfect Stool

It is worth noting that there is no such thing as a “perfect” or “ideal” stool. While some types are obviously more problematic than others, it all ultimately comes down to what works for you. Someone who has a type 4 stool every day is not automatically better off than someone who experiences type 3 stool every two days. The important thing is that you are able to pass your stool without strain or pain.

Having said that, there are two traits of your stool that should be watched out for. The first is when your stool is narrow and pencil-thin. Speak to your doctor if you have more than one pencil-thin stool, since this can mean that there is an obstruction somewhere in the lower GI tract. The second is that your stool should not float. Stool is normally denser than water and sinks, so floaters can mean you are not absorbing fat and oil properly. They can also come from excess gas, so floaters aren’t an automatic concern unless you have them frequently.

We all cast a curious glance down at the bowl every now and then and wonder about what we see. Hopefully this little analysis clears up some questions.

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Sources for Today’s Article:
“Bristol stool scale,” Wikipedia web site, https://en.wikipedia.org/wiki/Bristol_stool_scale, last accessed November 25, 2015.
“Feces,” Encyclopedia Britannica Online web site, http://www.britannica.com/science/feces, last accessed November 25, 2015.
Hatfield, H., “The Truth About Poop: Understanding Stool Color, Shape, and Frequency,” WebMD web site, http://www.webmd.com/women/features/digestive-problems, last accessed November 25, 2015.
Picco, M. F., “Stool Color: When to Worry,” Mayo Clinic web site, October 12, 2012; http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080.

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