Poop. Number two. BM. Stool. Whatever you call your number two, you should be familiar with your “normal” so when things start to not come out quite right, you’ll know when to call the doctor. Did you know paying attention to your bowel movements is a great way to keep an eye on your health? March is Colorectal Cancer Awareness Month so pay attention the next time you sit down for a number two. Check out our infographic, Oh Poop!, to learn more about your number two!
Make your number two your number one priority by reading this Q and A with Colorectal Surgeon Jennifer Davids, MD.
Does “regular” mean different things for different people?
Many of us use the term regular when it comes to bowel movements. As a colon and rectal surgeon, I am often asking my patients questions about their bowel movements because regular doesn’t tell me much. Most consider it to mean that the bowel movements follow a certain pattern with respect to frequency and consistency. There is a wide range of bowel movement patterns that I would consider normal, ranging from a few bowel movements per day to once every few days. Dietary intake (specifically, the amount of dietary fiber or roughage), the amount of fluids consumed, some medical conditions and medications, and even genetics all contribute to the frequency and consistency of stools.
How about men versus women?
Some women do experience changes in their bowel movements around the time of their period (sometimes looser stool or more cramping), but otherwise, there aren’t significant differences.
How about the shape and size of stool?
Ideally, stool should be soft and formed. Bowel movements should pass easily with minimal to no straining or pushing, and it should be painless to pass. You should feel well emptied after a bowel movement and not feel like there’s a lot left behind. Stool should be relatively easy to wipe and not exceptionally thick or pasty. Infrequent passage of hard stools that have a cracked surface, accompanied by straining, suggests constipation.
Bowel movements should only take a couple minutes to pass, and hard stool that takes a lot of effort to pass should be avoided, as this can worsen common anorectal problems such as hemorrhoids, which bulge more from straining and sitting on the toilet for long periods of time. Put down the crossword puzzles in the bathroom!
What does “irregular” bowel movements look like? What are some of the culprits behind it?
Being irregular suggests that there isn’t an established pattern to the stools, or that there has been a change from the usual pattern. Stools are sometimes hard, sometimes loose or everywhere in between with no predictable pattern. Typical causes include:
- Diets that are low in fiber
- Poor fluid intake
- Food sensitivities
- Lactose or other dietary intolerances
- Traveling (usually from interruptions in food, hydration and toileting routines)
In other cases, irregular stools could be a sign of a medical condition, including one below, that needs further attention from your doctor:
- Infectious diarrhea
- Inflammatory bowel disease (Crohn’s or ulcerative colitis)
- Celiac disease
- Irritable bowel syndrome
- Colorectal cancer
At what point should a person be concerned and contact a doctor?
If any of the following occur, then a trip to the doctor is a good idea.
- Any significant change in the texture, consistency or frequency of the stools without any apparent reason
- Straining, difficulty passing stools
- Rectal pressure
- Pain with bowel movements
- Blood with bowel movements, even if it’s on the toilet paper or on the stool
- Stools that appear black may contain blood from higher up along the digestive tract
- Abdominal pain, cramping and unintentional weight loss
Make sure to get a colonoscopy to be screened for colorectal cancer, even if you have no symptoms! Colorectal cancer is common, yet preventable. The American Cancer Society recommends screening starting at 45 years of age for healthy individuals with no family history of polyps or colorectal cancer. Colonoscopy may be needed sooner if you have a family history or are experiencing symptoms. Ask your physician about when you should be screened.