Pay attention to colour

As my patients will tell you, I like hearing about bowel movement.

It may not be a conversation to have over tea, but size, shape, and colour all help to reveal what is going on inside our bodies.

Most people know that going too often or not often enough is not a good thing.

While the former indicates irritation in the gastrointestinal (GI) tract, the latter indicates poor fibre and water intake.

The ideal number of daily bowel movements is three — one for each meal that you have.

After all, the digestive tract is designed, as the name suggests, to digest food and absorb goodness from it. It is not meant to hang on to waste that is ready to be shipped out of your body, just because you do not have time to go.

This said, I am generally happy when a patient has two good bowel movements a day.

Our modern-day diets tend to have less fibre than what our bowels require, so even two is reasonable.

While I have generally been pretty vocal on my desire to know about the frequency and consistency of my patients’ bowel movements (ideally, you are after a couple of long sausages), it is only recently that I have started getting interested in the colour of stool.

EXCELLENT INDICATOR

It turns out that the colour of stool can vary quite drastically and can be an excellent indicator of whether various diseases are present.

Let us start with what is considered normal. Yes, you guessed it: The normal colour of stool is brown, and this is because of what the stool is made up of. It is a mixture of bacteria, water, bile, bilirubin, broken-down red blood celIs, and plant matter that you have not been able to digest, as well as small amounts of protein and fat.

The most worrying stool colour is red, and unless you have been eating beetroot, can be an indication of bleeding in the lower GI tract. Causes include haemorrhoids (piles) or diverticulosis, but it could also be an indication of rectal cancer. While you should always see a doctor in this case, it may be something that is easily treated.

Next, we have green stool. These normally happens when food has travelled through the intestine pretty quickly, such that the bile does not get a chance to be turned into its final brown colour.

You can also pass green stool if you are taking iron supplements or antibiotics, or eating lots of greens.

However, it can also be a sign of Crohn’s disease (a type of inflammation in the intestines).

Yellow stool is the most commonly reported type of strange stool in my practice and can be caused by a gallbladder that is not functioning well (the bile is not being handled as it should). Parasites like giardia can also produce a characteristic yellow stool, but this normally also presents as diarrhoea.

If your stool is clay-coloured, it may have something to do with your liver (low bile output), but the colour change can also be caused by antacids containing aluminium hydroxide.

If you pass white stool, it could be due to mucus in the stool, or inflammation often seen in conditions like IBS (irritable bowel syndrome).

If you pass black stool, you would be looking for bleeding in the upper GI tract (oesophagus, stomach, small intestine). Do not panic, though: You can also get these with iron supplements, heavy meat consumption, and bismuth-containing compounds which some antacids contain.

The writer is a clinical nutritionist and certified by the Nutritional Therapy Council in the UK. Please direct any questions about family nutrition to her on [email protected]