Diary / Wellness / Sep 26, 2022

The Ultimate Guide to The Health of Your Poop

Written by: Dr. Will Cole

You can’t have optimal health without a healthy gut. But how do you know if your gut is healthy? You don’t have to be diagnosed with a specific condition to know when something is off with your gut. In fact, your next trip to the bathroom can tell you a lot about how healthy your gut actually is.

Everything from the shape of our poop, the consistency, and how often we poop in a day is an indicator of what is going on inside of us. Our stomach and colon make up what is known as the microbiome, a collection of bacteria and fungi that either fuel health or disease based on the ratio of good to bad bacteria that is present.

When there is an imbalance it can lead to inflammation and gut dysfunction that can express itself through our poop. For example, one study found that there were significantly lower amounts of the beneficial bacteria (Prevotella) and increased levels of the bad bacteria (Firmicutes) in patients who struggle with constipation.

As a functional medicine practitioner, I have seen and talked about it all with my patients around the world. Let’s not shy away from this subject. After all, everyone poops (or at least should)!

What Is A Healthy Poop?

People who have healthy bowel movements are generally pretty regular in the amount of bowel movements they have each day and the time at which they use the restroom.

Frequency: While it depends on your diet (how much you are eating, for example) you should be pooping on average between 2-3 times per day.

Consistency: But across the board your poop should be soft enough and long enough to form a curled-up “snake” like shape in the toilet.

Color: Your poop should be a standard brown color. Bilirubin is the pigment compound that is formed during the breakdown of red blood cells in the body and is responsible for that classic shade of poop-brown.

Length of time: Passing stool shouldn’t be a major event. You shouldn’t be spending more than a few minutes actually pushing out your poop, not including time wiping, etc. Anything longer than a few minutes could be a sign of constipation and underlying gut dysfunction.

What is my poop saying about my health?

Since poop is such an important aspect to your health, the Bristol Stool Scale was developed to better explain why different types of poop look a certain way. It is broken up into seven types and makes poop health easier for everyone to understand.

  • Type 1: Little hard rabbit-like pellets indicate severe constipation and shouldn’t ever happen.

  • Type 2: A super hard, lumpy log shape is another sign of constipation but a more mild case.

  • Type 3: A log with just a few cracks that is quick and easy to push out is considered a normal poop.

  • Type 4: This is where the snake shape comes in and is the gold-standard for a healthy poop.

  • Type 5: You start to tread into diarrhea territory if you are easily passing small, soft separate blobs of poop.

  • Type 6: One type of diarrhea is when your poop is super soft but still intact almost like pudding or yogurt in consistency.

  • Type 7: This is full-blown diarrhea when you have no solid pieces and comes out watery and extremely quick. Ever heard of the term “explosive diarrhea”? Yeah, that’s referring to this type.

You also want to consider the color as anything besides brown can be an indicator of some more severe problems.

  • Black: This sometimes happens if you are taking certain supplements or medications so don't be alarmed if this happens if you start taking something new. But it's still important to check with your doctor because it could be a sign of upper intestinal tract bleeding.

  • Green: Most of the time green poop occurs if you ate something that was in that color family.

  • White/Cream: This could mean a few different things whether that is the presence of too much fat from your diet, you aren't absorbing enough nutrients, or in extreme cases a blocked bile duct.

  • Red: If you ever experience blood in your stool you should speak with your doctor right away as it can be a sign of hemorrhoids or intestinal bleeding.

How To Encourage Healthy Poop

1. Lean into probiotics Like we said above, if your microbiome is imbalanced, it is going to be reflected in your poop. Make sure you are getting enough good gut bacteria through probiotic-rich foods and supplements. Sauerkraut, kimchi, and kefir are delicious options. You can also add in a probiotic supplement if you want that extra support. I am a fan of rotating probiotics and probiotic foods to promote microbiome diversity and preventing a monoculture or overgrowth.

2. Try magnesium If you are struggling with constipation a magnesium supplement can be a great addition to your day since certain forms of magnesium have an intensive laxative effect. Magnesium oxide and magnesium citrate can be found in powdered form that can easily be added to water or smoothies.

3. Eat more fiber and resistant starch There are two types of fiber, soluble which dissolves in water and insoluble that doesn’t dissolve. Insoluble fiber is important for a healthy poop because it encourages the movement of material through your digestive system. It also keeps it at a softer consistency, making it easier to pass to help with constipation. And even if you struggle with diarrhea, fiber adds bulk and weight to your poop so it isn’t as loose. Some of my favorite clean, whole-food sources of fiber include artichokes, avocados, almonds, and chia seeds.

Another consideration to support gut health is something called resistant starch. Considered a third type of fiber, resistant starch provides the benefits of both insoluble and soluble fibers. It's called “resistant” because it resists digestion, providing ample food for your gut microbiome, promoting bacterial diversity and healthy digestion. Some sources of resistant starch include green bananas and plantains, cooked and cooled potatoes and potato starch. Our gut bacteria ferment fiber and resistant starch to make short-chain fatty acids. One of the short-chain fatty acids is butyrate. Butyrate has been shown in the scientific literature to support a healthy, balanced digestive system and a healthy microbiome. This is one of the reasons why I advocate a diverse, mostly plant-based keto diet in my book Ketotarian.

4. Ask your doctor about a comprehensive stool test A multiple-day collection provides a more complete look at the microbiome and can uncover fungal, bacterial, or parasitic overgrowth, as well as beneficial bacteria levels. This information will help you know your level of gut dysfunction to better determine how to start truly healing from the inside out. We run these labs for people around the world from our telehealth functional medicine center.

5. Uncover food sensitivities Everyone’s biochemistry and immune system are different, meaning the foods that work best for one person, could contribute to inflammation and gut dysfunction in another. While there are common gut irritating foods like gluten, grains, and dairy, everything else isn’t so black and white. An elimination diet is my favorite tool for discovering your individual food triggers. By eliminating certain foods most likely to cause irritation and then slowly reintroducing them one-by-one it will show you clearly which foods cause gut distress and shouldn’t be included in your diet moving forward. That is, unless you want to make an extra trip or two to the bathroom! I go over tailored elimination diet protocols in my book, The Inflammation Spectrum.

Diary / Wellness / Sep 26, 2022

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