What Is Normal Poop? | U.S. News

Fashion magazines are often blamed for setting unrealistic standards of beauty for women. We come to aspire to the cover models’ flawless skin, cinched waists and super-wide “thigh space” that are more likely the result of Photoshop or extreme dieting than a healthy eating or exercise regimen. But in my line of work, I encounter another source of unrealistic cosmetic expectations for my patients: the Bristol stool scale.

The Bristol stool scale is a research tool that describes stools on a scale of 1 to 7 using words and pictures. (This is the part of the article where you likely pause for a Google break.) The Bristol scale was originally developed as a descriptive tool; it was never intended to diagnose any medical condition.

Through broad online dissemination, however, the Bristol scale has been co-opted by digestively curious laypeople to feed a misconception – that there is indeed such a thing as a “perfect poo” to which we should all aspire.

At the heart of the Bristol stool scale’s popularity is this little-discussed fact: Lots of people are quite insecure about their poo’s appearance, deeming their “No. 2s” to fall short on any number of aesthetic dimensions.

I get complaints about pencil-thin poos and fat, “fluffy” poos; “swirly” poos and poos that disappear in a cloud of brown smoke on flushing; poos on the looser side, “concrete” poo; poos that come out in multiple pieces instead of one long perfect “banana” shape; and poos that are studded with remnants of foods recently eaten or pigmented with their colors.

I have learned that people have quite high expectations of their poo and tremendous fear about what it might mean when their poos don’t fall within the prettiest numerical range on the Bristol scale.

But before you embark on your own futile pursuit of poo perfection, I urge you to consider my following threefold poo philosophy, backed by years of working in a gastroenterology practice:

1. Few things that come out of the human body – if any – are aesthetically pleasing. When I was pregnant, I attended a childbirth preparation class. One of the most enlightening and beneficial components of the curriculum was a slideshow of just-born babies with all manner of “normal” appearances: from cone-shaped heads and white pimply faces to bodies coated in dark downy fur and faces splotched with purple marks.

The takeaway: A newborn immediately emerging from inside their mother may not appear perfect by Hollywood baby standards – or frankly, even cute – but that doesn’t make it abnormal.

So too with poo. A poo can take on a variety of appearances and still be considered normal. For example, a poop can be a range of colors – from light brown and dark brown, to magenta or green from certain veggies or blue from artificially-colored foods and beverages.

Chronically skinny poos generally reflect ano-rectal muscle straining rather than anything about your digestion. And a stool’s texture is often indicative of how much time it spent moving through your colon and can reflect the balance of fiber in your recent diet: loosey goosey and shredded wheaty suggest lots of roughage (insoluble fiber) or a faster transit time, whereas formed, pastier “Play Dough” stools result from more starches and soluble fibers and a slower transit time.

Overtly hard stools often reflect inadequate dietary fiber, imbalanced forms of dietary fiber from low-carb or keto diets, or extremely slow transit time. Many women experience alterations in their bowel habits and in their stool’s appearance throughout their menstrual cycle, which is also a normal phenomenon.

2. Corn adds character. As do beet pigments, quinoa grains and sesame seeds, for that matter. Fiber is by definition indigestible to humans. This means that plant fibers – from corn kernels and tomato skins to celery strings and seed coats – should show up in the stool.

Seeing plant fiber in the stool does not imply that you’re malabsorbing nutrients, nor that you lack sufficient digestive enzymes. Remember: Humans aren’t supposed to possess any digestive enzymes for fiber!

Rather than fret about the fibers and pigments that add color and texture to an otherwise mundane poo, enjoy them as reminders of that delicious meal in your recent past, or observe them as a fun “tracking” exercise to estimate how long it took for your meal to make it from “entrance to exit.”

3. If your pooping isn’t problematic, then your poo isn’t problematic. Forget about its shape. Or size. Or how it compares to other poos you’ve spotted online. The best way to judge the quality of your poo is by how it contributes to your health-related quality of life.

Specifically, ask yourself:

If you answered yes to all of these questions, then who cares whether your poo looks pretty? As my gastroenterologist colleague often tells patients about their poo: “If it comes out like it’s always come out and you feel good, there’s no problem.”

If you answered no to any of these questions, you may consider a change in your diet and an evaluation by your doctor.

Although no one’s poo is going to win any beauty contests, there are a few instances in which a poo’s appearance does raise red flags that something is amiss.

The following developments should not be dismissed, and warrant a discussion with your doctor: