Once you’re no longer in diapers and don’t need someone to wipe your bottom, bowel movements become a private thing. Everyone poops, but few people talk about it, which may lead you to wonder if your experience is normal.
Let’s start with something that is never normal: blood in your stool.
“When you see blood, it’s important that you let your doctor know,” says UNC Health gastroenterologist Annapoorani Veerappan, MD.
While blood can be a sign of something benign, like hemorrhoids or an anal fissure, it’s important to rule out colorectal cancer, which is on the rise in younger people.
You should also talk to your doctor if you have any concerns about your bowel movements and if they’ve changed recently.
In the meantime, Dr. Veerappan offers these signs that your poop is normal—or not.
Color
If your stool is any shade of brown, that’s OK. Variations between lighter or darker brown may happen because of your diet. You may also notice dark green stool, which could be from leafy greens in your diet and some food dyes.
“There are three colors I worry about: black, red and white,” Dr. Veerappan says.
Black stool can indicate old blood. There may be a bleed in the upper part of your gastrointestinal system, and by the time it works its way out, it’s turned black.
Red stool is also a bleeding concern.
“A bright red stool could indicate a bleed on the left side of the colon, while dark red could indicate issues on the right side of the colon,” Dr. Veerappan says. “If you have red stool and feel lightheaded, dizzy or generally unwell, you might have a brisk upper GI bleed, and you need an urgent evaluation.”
Stool gets its typical brownish color from bile, which flows into the small intestine during the digestive process. If the liver doesn’t produce bile or if bile gets stuck in the liver, stool will be light-colored or white. This can be caused by another health issue, such as hepatitis, cirrhosis or gallstones.
Shape and Consistency
In the 1990s, British doctors created the Bristol stool scale, a range of seven different types of stool. This scale can help you explain to your doctor what you’re seeing in the toilet bowl if you’re concerned.
“Stool is supposed to be a sausage-shaped log,” Dr. Veerappan says, noting that type 3 and 4 on the scale are normal. “If you have type 1 (small, hard little pellets) or type 2 (longer lumps), you’re constipated, and types 6 and 7 are looser and watery diarrhea.”
It’s normal to have the occasional bout of constipation or diarrhea. But if either are persistent, or if it hurts to go to the bathroom, talk to your doctor.
Smell
It’s normal for poop to smell bad.
Within your gut, billions of bacteria break down your food, and that process emits gases that can stink.
Smell is only an issue if it goes with a concerning color or shape of stool, Dr. Veerappan says.
Frequency
There’s a pretty wide range of what’s “normal” when it comes to how often you poop. Some people have a bowel movement every day; some people don’t. Some people have multiple bowel movements per day.
“We do want people to have at least three bowel movements a week,” Dr. Veerappan says; anything less than that meets the definition of constipation.
Feel like you have to go after every meal? That’s your gastrocolic reflex at work. It’s a natural response to food entering your stomach; your system wants to find room for it by pushing old food out. It’s generally not a problem unless it’s accompanied by other symptoms like bloating, cramping or diarrhea.
It’s important to know what your normal frequency typically is, so that you can be aware of any changes.
Duration and Urge
Leave your phone outside the bathroom so you don’t sit there and scroll.
“I recommend spending no more than 3 to 5 minutes on the toilet at a time,” Dr. Veerappan says. “If you’ve been sitting there that long, and nothing is happening, then get up, walk around, drink some water. Only sit on the toilet when you have the urge.”
When you sit on the toilet, simply hoping to poop or straining, you’re at increased risk for hemorrhoids, a weakened pelvic floor and rectal prolapse, thanks to gravity and pressure.
If you feel like you have to go all the time, but then nothing comes out, or if you don’t feel the urge to go until it’s too late and you have an accident, you may have pelvic floor dyssynergia, which means that the rectum is not relaxing and contracting at the right times.
“If you’re experiencing any incontinence, tell your doctor,” Dr. Veerappan says. “There is treatment, and we want to help you have a good quality of life.”
Factors That Can Change Your Bowel Movements
A change in diet, exercise habits or medications can change your bowel movements, and so can:
Stress: About to head into a job interview or worried about a meeting with your child’s teacher? Don’t be surprised if you feel the urge to go.
“It’s important to think about the gut-brain connection,” Dr. Veerappan says. “When you’re feeling more stressed, anxious or depressed, that’s going to affect every part of the GI tract. You might feel nauseous, overeat, undereat, have diarrhea, experience belly pain.”
If your stress management skills aren’t keeping those symptoms at bay on a regular basis, talk to your doctor.
Menstrual cycle: The hormones associated with menstruation can disrupt your normal bowel movement habits, but the changes aren’t the same for all women.
“Everyone is different,” Dr. Veerappan says. “You’re more likely to have loose stool when you’re premenstrual or menstrual, but some people have more constipation around their period. It’s important to understand what’s normal or abnormal for you, and then if there are changes that you can’t correlate with your cycle, talk to your doctor.”
Travel: When you travel, your eating, drinking, exercise and sleep habits are often thrown out the window.
“Constipation is notorious when people travel,” Dr. Veerappan says. “Try to remember to drink water and eat things with fiber.”
Tips for Healthy Bowel Movements
The habits that keep you healthy—regular movement, eating a well-balanced diet, a good night’s sleep, stress management—will also keep your bowel movements regular.
You also need to drink lots of water; Dr. Veerappan recommends eight 8-ounce glasses a day and upping your intake to 100 ounces on days you exercise.
It’s also important to prioritize fiber in your diet. Fiber helps to prevent constipation, and most Americans fall short of the recommended daily intake of 25 to 35 grams.
If you find yourself straining, Dr. Veerappan recommends the Squatty Potty, a footstool that changes the angle at which your rectum is positioned over the toilet.
For occasional, mild constipation, try over-the-counter Miralax, which contains fiber and uses the water in your body to move stool through your system.
If constipation is ongoing, or if you’re experiencing any changes in your bowel movements, talk to your doctor.
Have questions about your bowel movements? Talk to your doctor or find one near you.