The Scoop on Poop: More than Constipation

In Female Pelvic Pain, Male Pelvic Pain by pelv_admin3 Comments

Everybody poops!


I hope that everyone reading this blog accepts this reality.  At PHRC, we spend a lot of time talking to our patients about the importance of proper pooping. Often, this discussion is uncomfortable. I get it. No one is keen to bond with their bowel movements. Poop has a bad reputation, which is unfortunate because it can tell you so much about your health! So before you flush, it may be beneficial to actually look at your poop. I repeat: Look at your poop!


First, let’s consider how poop moves through your body. Your poop goes on quite the arduous journey, like Frodo but without the ring (although many would compare the rectum to Mordor). Let’s not forget that before it ended up in the toilet, feces was food! So after you gulped down that burrito, it hung out in the stomach, where acids broke it down. Other organs — such as the gall bladder, pancreas, and liver — pitch in to help this process. Nutrients get absorbed as the once monstrous burrito moves through the small intestine until it reaches the cecum, which will then grant access to the colon. At this point your carne asada is no more and is slowly becoming a formed ball of waste as it moves up your ascending colon to the transverse and down the descending colon into the sigmoid. At this point, it reaches the rectum. Your brain, in turn, gets a signal that the fecal matter is ready to make its first and only appearance. It is a fascinating process of transformation, much like a caterpillar to a butterfly!


For visual learners, this comic depicts the process quite well:




So, what should happy, healthy stool look like? You may be thinking, “doesn’t it all look the same?” Well, I am here to tell you that not all poop is created equal! According to the Bristol Stool Chart (literally, a chart of poop) there are seven different types of feces. Ideally, you should be Type 3 or 4. If you are more type 1 or 2 it is a sign of constipation, and you may need more water or fiber in your diet. If you are type 5, 6 or 7, you may have an infection or an issue with absorption in the intestines, as type 7 is considered true diarrhea.


Chumpitazi, B. P., Self, M. M., Czyzewski, D. I., Cejka, S., Swank, P. R., & Shulman, R. J. (2016). Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, 28(3), 443–448.


Now, let’s talk about color. Your poop gets its color from bile, the substance that digests fat.Poop should be a nice milk-chocolate brown color. If this is news to you, then pay close attention. Since bile is secreted by the liver and stored in the gallbladder, discolored stool can be a sign of issues with those organs; however, your diet can affect your stool’s hue as well. For example, if you eat a ton of beets, don’t be surprised if your poop is red. However, if your stool is black or has a “tar-like” appearance, that can be a sign of bleeding somewhere in the gut and you should consult a physician to rule out an ulcer or some other medical condition. Now, if you look in the toilet and see something pale green/yellow, that can be a sign of gallbladder issues, but it can also be a sign that you are eating plenty of leafy greens. So if you started a new diet and are eating more veggies, don’t be alarmed to see a rainbow in the toilet (pot of gold not guaranteed). For more information, this helpful chart shows stool  color variations and their potential causes.


What about floaters? Should your poop sink? If your toilet bowl looks like the bay during Fleet Week, that can be a sign of digestive issues. Floating stools can be a sign that your poop is high in fat, which may indicate problems with your liver or gallbladder. Alternately,  it could mean that you should eat less McDonald’s so that your toilet can look more like the Titanic or a successful game of Battleship.


If you made it this far, it means you weren’t entirely grossed out! It also means you learned something and will hopefully be willing to take a gander the next time you go! If you want to learn even more about your fecal matter, there are some tests  that let you take a closer look  at your poop. There are even some people who get fecal transplants to help improve their gut health! So it turns out poop is pretty cool.


  1. Thanks so much! I am going to share this with my pediatric patients.

  2. Thanks Rachel. I have been looking at my POOP for quite a while! So your color/substance chart was quite helpful and also answered some questions I had. I have been keeping track on a daily basis of my medications and BMs for years so I can assess what is happening.

  3. Rachel Gelman, Appreciation for really being thoughtful and also for deciding on a certain marvelous study on constipation. Thank you so much

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