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What’s your poo telling you?

Terri Coles, Reuters

Everything you ever wanted to know about gastrointestinal health

When it comes to ways to keep track of our health, a daily peek in the toilet bowl is probably not what first comes to mind.

But one gastroenterologist says that your bowel movements can be an important clue to the state of your digestive health.

Dr. Anish Sheth — otherwise known as Dr. Stool — and Josh Richman outline all the things you can learn from examining your feces in “What’s Your Poo Telling You?,” a book that uses jokes and trivia as a way to get people comfortable with talking about gastrointestinal health.

A look in the toilet bowl reveals a lot about your gastrointestinal health.

“Of course there’s a humorous side to the subject of poo,” said Sheth, a gastroenterology fellow at Yale University. “But what isn’t as well known is that you can learn about your health by looking in the bowl.”

The book comes with a serious message about the importance of preventing colon cancer, the second deadliest cancer in the United States, Sheth said. People may have some embarrassment when they first pick up the book, he said, but making health the focus of taboo topics makes it easier to discuss them. “I think that’s a safe place.”
The increasing availability of information online is breaking down taboos about previously undiscussed personal health topics, Sheth said.

“Patients are coming to the table with a lot more information about particular conditions or concerns they may have.”

Discussions of bowel health in popular culture also help open up discourse, he said.

Oprah Winfrey recently devoted an episode of her talk show to discussing gastrointestinal health with Dr. Mehmet Oz.

“The Fiber 35 Diet” — a book advocating a high-fiber diet, along with cleansing and detox, for weight loss — hit the New York Times bestsellers list, and a new book called “The ’Regular’ Gourmet Everyday: Sumptuous Recipes for the GastroAmerican Cancer Societyintestinally Challenged,” by author Danielle Svetcov, will soon be released.

And last year, the hospital sitcom Scrubs devoted a song to bowel movements — “Everything Comes Down to Poo” — in a musical episode.


So what can your bowel movements reveal?

A floater is usually the result of too many burritos, but if it comes accompanied by a particularly bad smell and the presence of grease — an indication of fat in the stool — that can be a sign of underlying GI problems, usually related to the liver or pancreas and the body’s ability to digest fat.

Thin stools — The Snake — are probably just a sign that you’re straining too hard and causing your sphincter to contract, but when seen progressively over a longer period of time they might indicate a colonic blockage due to rectal cancer.

Variations in stool colour are expected, but persistent changes can be an indication of a health problem: green stools can indicate a gastrointestinal infection, while white or grey stools may be the result of a bile duct blockage or liver disease.

Most serious of all is what Sheth and Richman term Rambo Poo. The appearance of blood in the stool is often an indication of gastrointestinal bleeding, Sheth said. Blood can be the result of something relatively minor, like hemorrhoids or diverticulosis. But it could also be the result of colon cancer, and the book advises anyone who sees blood in their stool to visit a doctor. Sheth pointed out that many people may not realize that black stool can indicate blood as well. GI bleeding can develop gradually over time, he said, so paying attention to bowel movements can help to catch it — and its cause — early on. (To that end, he and Richman are releasing a second book, “The Poo Log,” this spring.)

But the book is not meant to be alarmist. There is no perfect bowel movement, Sheth said, and regularity can be defined as emptying your bowels anywhere from three times a day to three times a week. The average weight of a day’s worth of stool is 450 grams, which is about a pound, but day-to-day variations are normal based on factors like diet and stress levels.

Serious issues aside, good bowel movements can affect how you feel each day, Sheth said.