Let’s get down to business. About 15-30% of Canadians suffer from chronic constipation1, predisposing them to various colorectal health issues, hemorrhoids, rectal prolapse, fecal incontinence, and causing physical duress and emotional stress. Additionally, it’s estimated that about 5% of the general population suffers from persistent diarrhea (not including individuals with digestive disorders or other chronic conditions). Also, about 22% of individuals with diabetes experience frequent diarrhea.2 It is estimated that chronic diarrhea costs US businesses more than $350 million annually from work loss.3
Why is regularity so important? Regular bowel movements help remove toxins from our bodies while fibre aids in the removal of dead cells and “bad” bacteria. Also, gut flora have been linked to everything from acne to asthma to obesity to cholesterol levels. Gut microbiomes that contain healthy, inflammation-reducing “good” bacteria have been shown to help reduce the risk of cancer, heart disease and infection. What is the key to healthy gut flora? A healthy and highly diversified diet.4
Along with inadequate fibre and water intake, chronic stress is a major contributor to constipation. Stress activates your sympathetic nervous system and puts your body in “fight or flight” mode, which diverts blood flow from your digestive tract and suppresses stool formation. Interestingly, stress and anxiety are also implicated in diarrhea and irritable bowel syndrome. It’s not totally clear how stress, anxiety, and irritable bowel syndrome are related -- or which one comes first -- but studies show they often happen together.
Although constipation is medically defined as having fewer than three bowel movements per week, it is often better characterized by the difficulty of defecating rather than the frequency. What’s regular and healthy for one individual will differ from another; however, if your diet is nutritious and balanced, you should expect to produce about 5-7 ounces of stool each day, and to have a bowel movement more often than three times per week.
Foods that may cause constipation include cheese
and red meat. Certain supplements such as iron and calcium can also cause constipation, as can certain pain killers. If you suffer from constipation, don’t be shy, talk to your doctor.
In this article we look at a few important poop issues and their potential causes and treatments.
SMALL, HARD, DRY STOOL:
If your stool is small, hard, and dry, it probably doesn’t contain enough water. Not only do you need to consume adequate water to mitigate this, you also need to get enough fibre in your diet. There are two types of fibre and they both play an important role in bowel health. Soluble fibre absorbs water and helps create softer stools that are easier to pass whereas insoluble fibre increases stool bulk and speeds up transit time.
- Soluble Fibre
Soluble fibre absorbs water in the body and forms a gel that helps lubricate and soften the stool by bringing water into it. Soluble fibre also binds to cholesterol particles in the body and eliminates the cholesterol when you have a bowel movement. A diet high in soluble fibre serves not only to improve bowel health, it may also help reduce blood cholesterol levels and lower your risk of heart disease. Soluble fibre also prolongs stomach emptying so that sugar is released and absorbed more slowly, helping control blood sugar levels. Great food sources of soluble fibre include oatmeal, oat bran, psyllium, barley, apples, blueberries, flax seeds, avocado, cooked Brussels sprouts, and sweet potato.
- Insoluble Fibre
This type of fibre doesn’t dissolve in water and is not broken down in the body. Insoluble fibre provides fecal bulk, putting pressure on the walls of the column to help stimulate bowel movement and speed up transit time. Great food sources of insoluble fibre include vegetables, fruits eaten with edible seeds and skin, wheat bran, and brown rice. Both types of fibre are important to healthy bowel movements.
Acute diarrhea is generally defined as the abrupt onset of 3 or more loose stools in one day; if this occurs for longer than 14 days, it is considered chronic or persistent diarrhea. Acute diarrhea is often a result of an infection, acute illness, or food reaction or allergy. Persistent diarrhea, however, may be indicative of other issues including bacterial overgrowth, pancreatic exocrine insufficiency, anorectal dysfunction, Celiac disease, inadequate breakdown of nutrients in the small intestine, pancreatic insufficiency, and poor diet. Other triggers for diarrhea include coffee, alcohol, dairy, and fructose.
BRIGHT RED BLOOD IN YOUR STOOL:
If you are or have been constipated, bright red blood in your stool may be due to hemorrhoids. However, red blood in the stool could also be indicative of a more serious medical issue such as lower gastrointestinal (GI) bleeding or cancer.
Floating stools are often an indication of high fat content, which may be indicative of fat malabsorption. Increased gas in your stool will also cause it to float, as will a gastrointestinal infection.
DARK MAROON COLOURED BLOOD IN YOUR STOOL OR BLACK STOOLS:
Dark red or maroon coloured blood in your stool or black, tarry stools (melena) could be indicative of an upper GI tract bleed or an ulcer.
LIGHT, CLAY-COLOURED, OR YELLOW STOOL:
A clay coloured stool may indicate a bile duct obstruction. A yellow stool that is greasy or particularly foul-smelling may be indicative of malabsorption of fats.
OK, not actually rainbow-coloured poops, but if you have been eating large amounts of dark, vibrantly-coloured foods (eg. blueberries, beets, kale, or items with food colouring) your stool may reflect it.
If your poop is trying to tell you something, listen up, and talk to your doctor. Sure, bowel health isn’t exactly cocktail party conversation, but the subject shouldn’t be so taboo that you ignore important signs of potentially serious health issues. If you are one of the many Canadians who are concerned about their bowel health, monitor your bowel movements so that you can identify and manage issues before they become serious medical problems. If you are digitally-inclined, you may even want to try a bowel movement tracking app, such as Poop Diary, Bowel Mover Pro or PoopMD!
1https://www.badgut.org/information-centre/a-z-digestive-topics/constipation/. 2http://www.healthline.com/health/diabetes/diabetes-and-diarrhea#overview1. 3https://www.uptodate.com/contents/approach-to-the-adult-with-chronic-diarrhea-in-resource-rich-settings. 4http://www.cnn.com/2016/09/25/health/fecal-bacteria-obesity/index.html.