Is Your Poop Trying to Tell You Something?
Reviewed by Bill Rawls, MD
Medical Director of Vital Plan

“Let’s talk about bowel movements,” said no one ever. Even when talking to your doctor, issues around digestion and what constitutes normal or abnormal can be an uncomfortable topic. But they’re worth paying attention to.

“People should consider their bowel movements more closely — they give you a lot of information about your digestive health,” says Dr. Bill Rawls, M.D., medical director of Vital Plan. For example, research in the journal Gut reports that formed stools and regular bowel movements are strongly associated with a more diverse microbiome, a key marker of gut health.

But no one’s digestion or stools are perfect all the time, and that’s OK. Everyone passes gas — 10 to 20 times per day is the norm. Diarrhea is a common symptom of PMS. And occasional bouts of bloating, stomach pain, loose stools, or constipation are perfectly normal and usually nothing to worry about. That’s especially true if you can trace the problem back to something you ate or did.

In those cases, the fix is easy: simply avoid the triggers in the future. After all, most of us have overindulged during a holiday or given in to the temptation of certain foods or drinks we know don’t sit well with us. You can also overdo it on healthy foods that are known to cause gas and bloating when eaten in excess, like broccoli and Brussels sprouts. Plus, we all get stressed at times or veer off normal sleep and exercise schedules, all of which can trigger or exacerbate digestive issues.

So the real question is, are your stools and your digestive process normal and regular the majority of the time?

Or have abnormal and irregular just become your new normal?

Here’s some help in answering those questions, plus advice for taking control of your digestive health as much as you can.

What Do Normal Bowel Movements Look Like, Anyway?

For one, you should generally feel good. Nothing about the digestive process should impact your quality of life, leave you embarrassed, or keep you from doing the things you want to do.

Otherwise, here are the clues to look for in your bowel movements:

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Color

Healthy, normal stools should be a medium-dark brown, not grey, Dr. Rawls says. “Brown means your body is producing sufficient amounts of bile during digestion.” The absence of bile and grey stools suggests your liver is congested, while green and yellow hues can often be linked to the foods you’re eating. If you notice black poop, and it isn’t connected to food you’ve been eating or supplements you’ve been taking (like licorice, blueberries, or iron), consult with your doctor. Black stools can indicate blood in the GI tract.

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Consistency

You want stools that look mostly smooth and are solidly formed yet soft. Very hard, lumpy, or pellet-like stools can indicate a sluggish colon, and that stool isn’t moving through properly, so too much water is being extracted from the stool. On the other hand, loose or watery stools are generally a reaction to a buildup of bacteria with toxins that damage the mucosal lining of the colon, causing it to leak fluid, Dr. Rawls says.

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Frequency

If you pass stools spontaneously, once or twice per day, without having to strain nor with significant urgency, you’re in good shape. After using the restroom, you should also feel as if you’ve eliminated all waste; you don’t want any lingering sensation of fullness in your rectum.

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Odor

Normal stools actually only have a mild odor. “You shouldn’t have putrefaction; if the smell is running you out of the bathroom, that’s not good,” Dr. Rawls says. “It can happen when people eat a lot of meat, for instance, which may lead to an overgrowth of bacteria that causes stools to smell horrible.”

If you’re not experiencing those hallmarks of healthy number twos on the regular, and instead experience digestive symptoms (constipation, loose stools, bloating, etc.), it’s probably your body’s way of telling you something is not right in your gut or your diet.

Unfortunately, gastrointestinal (GI) issues have become so commonplace that many people come to expect them. “Unless a GI problem is really bad, most people just accept it and live with it,” Dr. Rawls says.

But you don’t need to — there are simple steps you can take to help support a happy, healthy gut and digestion, not only to maintain regularity but also to feel your overall best. (For serious symptoms, such as blood in your stool or severe and persistent GI upset or systemic symptoms, consult your healthcare provider.)

6 Ways to Normalize Digestion

1. Fill Your Diet with Fiber-Rich Foods.

“We’re living in the golden age of food; access to excellent food that can make people extraordinarily healthy is more available now than any other time,” Dr. Rawls says. Ready access to a range of fresh produce is a big part of that. And when it comes to improving digestion, you can’t beat fruit and veggies.

One of the main benefits is their fiber content. Not only has it been shown to help reduce the risk of various diseases, fiber also feeds the gut’s good bacteria, which keeps your GI and other systems healthy, your gut lining strong, and your digestion normal. And that’s especially true of the fiber from fruit and veggies as opposed to fiber in grains, Dr. Rawls says.

Produce contains both soluble and insoluble fiber, which are equally important and work together to move food through the digestive system and waste through your colon. Insoluble fiber — found in high amounts in foods like apples, strawberries, and peas — attracts water and forms a gel-like substance that slows down digestion. Soluble fiber, abundant in broccoli, greens, and asparagus, adds bulk to prevent loose stools.

Yet Americans get only about 15 grams of fiber a day — significantly less than the 25 to 30 grams experts recommend. So, if you’re not meeting that guideline, replace more grains and meats with fruits and veggies. A review in the World Journal of Gastroenterology found that doing so improves stool frequency. Just make sure to gradually up your intake and spread it out over the course of the day, which gives your body time to adapt. (Too much fiber all at once can cause gas and bloating.)

Fruit is your digestive system’s friend for a few other important reasons. “Beyond supporting gut bacteria, the fiber in fruit helps protect you by promoting a normal mucus layer that coats the gut,” Dr. Rawls says. There’s also a lot of water trapped inside the cells of fruit and veggies, which slowly release it during digestion. That not only keeps you well hydrated, it also aids in the digestive process and moves stool through your colon.

2. Eat Slowly

If you inhale your food (like so many of us who eat on the run), chances are you’re getting a big side of air with your meal, which can cause burping or flatus (gas in the stomach or intestines), Dr. Rawls says. Try resting your fork on the plate between bites and taking extra time to chew.

A leisurely, well-chewed meal has other digestive benefits, too. Chewing sends the signal that food is coming, helping to prime your digestive system for action. The act of chewing also starts to break down food before it even reaches your stomach, so there’s less work to do once it arrives.

Eating slowly also gives your brain time to pick up fullness signals, helping to prevent overeating and the bloat and indigestion that can follow. One study even found that when women ate more slowly, they consumed less but were more satisfied than when they were told to eat quickly.

3. Boost Gut Function with Movement

Add gut health to the myriad of reasons to take a hike or walk, swim, or bike ride. Exercise can change the composition of your gut’s microbiome for the better. A study in Medicine & Science in Sports & Exercise demonstrated that when sedentary people exercised three times a week for 6 weeks, they showed increases in the type of bacteria that produce short-chain fatty acids, which help reduce inflammation in the gut.

Some movement is better than none — even a  simple 15-minute stroll after dinner can help your gut do its job better.

4. Go for Bitters to Feel Better

When you eat something bitter (such as dandelion greens, arugula, and radicchio), take aromatic bitters (herbal extracts in an alcohol base), or swallow bitter herbal supplements, bitter taste receptors in your mouth and throughout your digestive tract send the message to your body to start making enzymes that help break down food.

Bitter-tasting foods and herbs aid in smooth, healthy digestion by improving bloating, stomach pains, gas, and other symptoms. That’s likely why bitter plants, herbs and aromatic bitters are widely used in traditional medicine to help support healthy digestion.

If you’re interested in herbal remedies to augment gut health, most herbs are bitter by nature, so they naturally help with digestion by triggering those bitter taste receptors. But they have additional properties that help balance and aid the digestive tract, Dr. Rawls says. A few to look for:

berberine berry tree circle

Berberine

Berberine helps stimulate bile and support good-for-digestion microbes in the gut. It’s been used in ancient medicine as a treatment for diarrhea and to treat other gastrointestinal and inflammatory conditions, plus aid gastrointestinal function.

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Slippery elm bark

Slippery elm bark contains mucilage, a soothing compound that may help keep the lining of the GI tract healthy. It’s also known to help soothe heartburn and upset stomach. A small study in the Journal of Alternative and Complementary Medicine found that two formulas that contained slippery elm bark helped improve constipation, plus stomach pains and other symptoms in people with inflammatory bowel syndrome (IBS).

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Dandelion root and extract

Dandelion root and extract are particularly bitter; it’s recognized as a digestive stimulant and for its mild laxative properties that may help regulate bowel movements.

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Cardamom seeds

Cardamom seeds are rich in phytochemicals that may help soothe the intestinal tract and support healthy gut microbes.

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Fennel

Fennel is known to relax smooth muscles along the GI tract, plus the seeds help encourage the flow of bile needed to adequately break down food.

5. Up Your Supply of Enzymes

Digestive enzymes such as amylase, protease, lipase, lactase, are produced in the pancreas, stomach, small intestines, and mouth. They act sort of like a team of miners, helping to break down food in order to get at the valuable and usable nutrients. Different enzymes help digest different types of food and nutrients — fats and oils, carbohydrates, proteins. You might benefit for increasing your intake of digestive enzymes if you notice reflux, gas, bloating, indigestion, and other digestive issues frequently.

To help support your digestion, Dr. Rawls recommends taking a digestive enzyme supplement for two to three months after upgrading your diet with fiber-rich foods. Be sure to choose one that represents all three enzymatic categories for broad spectrum coverage. Some good enzymes to look for:

    • Lactase. An amylase that breaks down lactose, a sugar in dairy
    • Alpha-d-galactosidase. Another amylase, it targets carbohydrates found in plant foods that can be difficult to digest, particularly legumes and cruciferous vegetables such as cauliflower, cabbage, and broccoli.
    • Papain and bromelain. two fruit-based proteolytic enzymes, found in papaya and pineapple, respectively.

6. Think Twice Before Taking PPIs.

Many people who suffer from acid reflux turn to drugs called proton-pump inhibitors (PPIs), which stop cells in the stomach from producing the hydrochloric acid that bubbles up and causes discomfort. In fact, they’re among the top 10 most widely used drugs in the world.

But popping these pills may come with some serious potential side effects. For one, while the drugs reduce stomach acid, if taken long-term, there can be a rebound effect once you stop taking PPIs, potentially leaving you worse off than you started.

Research has also found that PPI users tend to have a less healthy gut microbiome. And a review of 56 studies published in the World Journal of Gastroenterology found that PPI use is associated with an increased risk of infection with C. difficile, a bacterium that causes severe diarrhea and inflammation in the gut. The thinking: Suppressing acid production makes the stomach less acidic, which may lower your body’s natural defenses against C. diff and other threatening microbes. Consider speaking with your doctor about in you’re interested in possible alternatives to PPIs.

The Takeaway

Pay attention to your stools for warning signs your digestion has gotten off track. While achieving normal stools and digestion can take a bit of trial and error, try to incorporate as many of these gut-supporting tips into your daily routine as possible. Soon, you’ll find that you may develop a new definition of normal – one that’s much more in line with the goal of feeling well.

References
1. Allen JM, Mailing LJ, Niemiro GM, Moore R, Cook MD, White BA, Holscher HD, Woods JA. Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans. Med Sci Sports Exerc. 2018 Apr;50(4):747-757. doi: 10.1249/MSS.0000000000001495
2. Andrade AM, Greene GW, Melanson KJ. Eating slowly led to decreases in energy intake within meals in healthy women. J Am Diet Assoc. 2008 Jul;108(7):1186-91. doi: 10.1016/j.jada.2008.04.026
3. Franke A, Harder H, Orth AK, Zitzmann S, Singer MV. Postprandial walking but not consumption of alcoholic digestifs or espresso accelerates gastric emptying in healthy volunteers. J Gastrointestin Liver Dis. 2008 Mar;17(1):27-31.
4. Hawrelak JA, Myers SP. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med. 2010 Oct;16(10):1065-71. doi: 10.1089/acm.2009.0090
5. Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013;5(4):1417-1435. Published 2013 Apr 22. doi:10.3390/nu5041417
6. Trifan A, Stanciu C, Girleanu I, Stoica OC, Singeap AM, Maxim R, Chiriac SA, Ciobica A, Boiculese L. Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis. World J Gastroenterol. 2017 Sep 21;23(35):6500-6515. doi: 10.3748/wjg.v23.i35.6500
7. Vandeputte, D. et. al. “Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates.” Gut. 2015;0:1 – 6.
8. Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol. 2012;18(48):7378-7383. doi:10.3748/wjg.v18.i48.7378

About the Medical Director
Dr. Bill Rawls
Dr. Rawls is a licensed medical doctor in North Carolina and a leading expert in integrative health. He has extensive training in alternative therapies, and is the Medical Director of Vital Plan, a holistic health and herbal supplement company in Raleigh, NC.
  • Dr. Bill Rawls

    ABOUT BILL RAWLS, M.D.

    Dr. Rawls is a licensed medical doctor in North Carolina and a leading expert in integrative health. He has extensive training in alternative therapies, and is the Medical Director of Vital Plan, a holistic health and herbal supplement company in Raleigh, NC.

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