The Bowl Truth

YOUR STOOLS CAN REVEAL A LOT ABOUT YOUR HEALTH, IF YOU LEARN TO READ THEM.

LET'S FACE IT: DIGESTION HAPPENS. Few of us, however, are able to talk about the end result without embarrassment. It's too bad we're not more willing to pay attention to our stools, because they may be just as useful in diagnosing our health as taking our temperature or our blood pressure. "People can tell a measure of their health by their bowel movement," says Ted Loftness, M.D., an internist in Litchfield, Minn. "Nothing is so overrated as sex and so underrated as a good bowel movement."

From your stool you may be able to get clues about your diet, your gastrointestinal health, and even whether your stress, anger, or anxiety levels are too high.

HOW FOOD BECOMES STOOL From the moment food enters your mouth, your body embarks on a campaign to turn it into a soupy mush called chyme. Chewing, saliva, peristalsis (the involuntary contractions of gastrointestinal muscles), bacteria, hydrochloric acid, digestive enzymes, bile, and other secretions all work to give each meal the consistency of split pea soup. While your digestive

cells are absorbing sugars, starches, fats, vitamins, minerals, and other nutrients, waste products continue traveling down the line. In the colon, all the leftovers are combined, packed together, and partially dehydrated. What remain--our feces--consist of water, indigestible fiber, undigested food (such as corn and small seeds), sloughed-off dead cells, living and dead bacteria, intestinal secretions, and bile. (The worn-out red blood cells in bile give excrement its distinctive brown color.)

If all goes as it should, you'll end up with a healthy bowel movement. Although digestive idiosyncrasies, variations in intestinal bacteria, and other variables can produce different standards for a healthy stool, in general it should be brown to light brown; formed but not hard; cylindrical, not flattened; fairly bulky and full-bodied, not compacted; somewhat textured but not too messy; and very easy to pass. And it shouldn't smell--much. "You're passing methane and bacterial, degraded foodstuffs, so there's always going to be an odor," says Patrick Donovan, N.D., a naturopath in Seattle. "But it shouldn't be a very strong, pungent odor."

Experts disagree on two other stool characteristics: the number of pieces and their buoyancy. Each bowel movement preferably should be in one piece, about the shape and size of a banana and tapered at the end, according to Melanie Ferreira, a nutritionist and instructor at the Natural Gourmet Institute for Food and Health in New York City. Others, however, object. "Stools don't have to be well-formed logs," Donovan says. "They can disperse in the toilet water; they can break down."

As for "floating versus sinking," one school argues that stools should float. Ferreira says buoyancy is a sign that the body has absorbed the minerals in the food and that these nutrients are not contained in the waste. Another camp believes healthy bowel movements should touch bottom because of their bulk and fiber content. Loftness is not impressed with either argument: "Most stools will sink," he says. "Whether it floats or sinks really doesn't seem to make any difference."

An occasional deviation from this total picture is usually considered okay; chronic deviations (or any featuring blood) are not, and should be checked with a doctor. For a list of specific characteristics that may point to health problems, see our chart below.

     If Your Stool Looks...   It Could Mean...

   BLACK, TARRY, AND STICKY   Bleeding in your upper digestive
                              tract. The black color comes from
                              digested blood cells.

            VERY DARK BROWN   You drank red wine last night or
                              have too much salt or not enough
                              vegetables in your diet.

     GLOWING RED OR MAGENTA   You've eaten a lot of reddish foods
                              such as beets.

                LIGHT GREEN   You're consuming too much sugar, or
                              too many fruits and vegetables with
                              not enough grains or salt.

       PALE OR CLAY-COLORED   Minimal amounts of bile are being
                              excreted, perhaps because of problems
                              with the gallbladder or liver.

    BLOODY OR MUCUS-COVERED   Hemorrhoids, an overgrowth of certain
                              bacteria in your gastrointestinal
                              tract, colitis (inflammation of the
                              colon), Crohn's disease (also known as
                              inflammatory bowel disease), or colon
                              cancer. Red blood usually means the
                              ailment is located near the end of
                              your digestive tract, whereas black
                              blood signals partially digested blood
                              coming from an ailment higher up the
                              tract. Seek medical advice promptly.

 PENCIL-THIN AND RIBBONLIKE   A polyp or growth in your colon that
                              narrows the passage for stool.

   LARGE AND FLOATING, WITH   Malabsorption--your digestive system
GREASY FILM ON TOILET WATER   isn't getting the full nutritional use
                              of food.

LOOSE AND WATERY, SOMETIMES   Diarrhea. Possible causes are food ,
 WITH UNDIGESTED FOODSTUFFS   poisoning lactose intolerance,
                              antibiotics, antacids, dietary
                              changes, travel, anxiety, stress,
                              inflammatory bowel disease, or
                              irritable bowel syndrome.

 SMALL, HARD, ROUND PELLETS   Constipation--even if you're
                              defecating frequently. Possible causes
                              are eating too much dry food,
                              including protein, and not enough
                              vegetables and raw foods; laxative
                              abuse; worries; or irritable bowel
                              syndrome.

       ALTERNATING BOUTS OF   Irritable bowel syndrome. This chronic
  DIARRHEA AND CONSTIPATION   condition can be aggravated by red
                              meat, spices, sugar, alcohol, lack of
                              fiber, allergy-causing foods,
                              irregular hours, and chaotic
                              relationships.

        REALLY BAD-SMELLING   An imbalance of intestinal bacteria or
                              eating too much animal protein, which
                              can putrefy in your digestive tract.