It is not an issue that people like to talk about, but it is still important for health and well-being: the bowel movement. But looking closely at the big business is worthwhile. Even though changes in color and consistency of the stool are often due to the diet and are completely harmless, they can sometimes provide evidence of disease during bowel movements. We have summarized for you an overview of the possible meaning of color, consistency and smell of the stool and explain how chair changes can occur.
What does chair consist of?
Stool arises when digesting food in the intestine. It consists mainly of undigested food components such as fiber and water in variable proportions.
In addition, in healthy people bacteria of the normal intestinal flora, rejected cells of the intestinal mucosa digestive secretions and mucus in the stool are included.
Defecation: How often is normal?
The frequency of bowel movements varies from person to person. Facial rates from three times a day to three times a week are considered normal. If the defecation is less frequent than three times a week, it is called constipation.
On the other hand, frequent bowel movements are not necessarily pathological: only if more than three times a day a soft, unformed stool is discontinued, is diarrhea defined.
Chair amount dependent on diet
The normal daily amount of stool is 100 to 200 grams per day. With low-fiber diet or reduced food intake such as during fasting, the amount is lower, with high fiber intake - such as vegetarians - stool amounts up to 1, 000 grams may be normal.
However, an increased amount of stools in normal diets may also indicate a digestive disorder, such as a disease of the pancreas. A warning sign is also here if the stink stinks conspicuously and greasy at the same time.
Why does chair have different colors?
The characteristic middle brown color of the stool is caused by a degradation product of the red blood pigment hemoglobin: When red blood cells in the spleen are broken down, the bile pigment bilirubin is produced, which enters the intestine with the bile and then turns the stool brown.
So it is understandable that diseases of the biliary tract can cause a change in stool color. But various foods, medications, infections, metabolic disorders or bleeding can also affect the color of the stool.
What does the color say about the bowel movement?
Normally the chair should have a light brown to dark brown color. Color changes may be diet-related, but in some cases indicate disease.
The following overview can help you to classify different stool discolorations correctly:
- deep brown / black: A very dark to black stool may indicate bleeding in the stomach or small intestine and is then called the tarrene (melena). The color is caused by degradation processes of the blood in contact with gastric acid or intestinal bacteria. However, certain foods such as beetroot, spinach, blueberries and dark chocolate, as well as charcoal tablets and iron supplements can cause black staining of the stool.
- gray / clay / cream: If the stool is strikingly bright, it may be due to a disease of the biliary tract or liver. Other warning symptoms include nausea, vomiting, upper abdominal pain or colic and brown urine. In any case, light stool should be clarified by a doctor.
- white: The X-ray contrast medium barium sulfate ("barium swallow") is used for radiological imaging of the gastrointestinal tract. It is excreted undigested again and leads to a white color of the stool.
- ocher: Ocher stool may occur in an abnormal fat loss (steatorrhea). Typically, this so-called fat stool is voluminous, greasy, glossy and malodorous. The cause is usually a disorder of fat digestion or fat absorption in the intestine, which can occur in various diseases of the digestive system and metabolism. A medical examination of fatty stools is therefore required.
- Green: Greenish stools may occur when eating chlorophyll-containing foods such as spinach, kale or lettuce. Green diarrhea, on the other hand, is an indication of an intestinal infection.
- yellow: foods such as carrots, squash or eggs can discolor the stool yellowish. However, in connection with diarrhea, a yellow stool color indicates an intestinal infection.
- red: A uniform reddish color of the stool can be caused by the consumption of beetroot, cranberries or red food coloring. However, if it is blended blood, a doctor's visit is essential.
How should the consistency of bowel movement be?
Normally, stool is a soft but shaped mass that is easy to excrete.
Deviations are often due to diet and behavior: So a low-fiber diet, low drinking and lack of exercise can promote hard stool and constipation. Constipation, in turn, leads to hardened stool, as more water is absorbed from the stool during a longer residence time in the colon.
Bristol Chair Shapes Scale: Classification of stool consistency
At the University of the English city of Bristol, in 1900, a table was drawn up to classify the shape and consistency of the chair. The so-called Bristol chair shape scale includes seven types of chairs:
- Type 1: hard beads, difficult to excrete
- Type 2: firm, sausage-shaped lumps
- Type 3: sausage-like, with a cracked surface
- Type 4: sausage-like, with a smooth surface
- Type 5: smooth, soft lumps, easy to excrete
- Type 6: mushy with soft lumps
- Type 7: thin, watery, without solids
Type 3 and 4 are considered "ideal chairs", but type 5 can also be found in healthy people. Type 1 and 2 are often associated with constipation, whereas type 6 and 7 occur in diarrhea.
If the stool is shaped in a pin shape or band-like way, this can indicate narrowing in the intestine. Possible causes may be adhesions, intestinal polyps and, in rare cases, colon cancer. Therefore, if you have a thin chair, you should see a doctor as soon as possible.
Blood in the stool? Absolutely to the doctor!
Blood in the stool is an alarm sign and should always be clarified by a doctor. Although the cause is harmless in many cases, serious illnesses can also be behind bloody stools. Possible causes of blood in the stool include:
- Anal fissure: When tears on the anus, which can occur, for example, in chronic constipation, is usually found bright red blood on toilet paper or stored on the chair. Typical are pain and burning during bowel movements.
- Hemorrhoids: If the bowel movement burns and the anus itches after defecation, this may indicate hemorrhoidal disease. In addition, enlarged hemorrhoids often manifest themselves as pale red bleeding during bowel movements. On the other hand, pain is atypical.
- Intestinal infection: Various diarrhea pathogens such as salmonella, shigella, campylobacter jejuni, amoeba or EHEC can cause bloody diarrhea.
- Inflammation of the intestines: Inflammation in the intestine, as in ulcerative colitis, can cause blood in the stool or bloody diarrhea.
- Diverticulum: Protusions of the intestinal mucosa (diverticula) are harmless in themselves, but can inflame or bleed and thus lead to blood in the stool.
- Tumors in the gut: Benign (polyps) or malignant (colon cancer) growths in the gut or anus can cause bloody stools.
What to do with chair changes?
If you notice changes in bowel movements, you should first consider whether this could be due to the diet. Unusual foods and a different daily rhythm - such as on vacation - can change the appearance, smell, consistency and frequency of bowel movements.
Persistent, nutrition-independent changes and sudden fecal incontinence, however, are a reason for a visit to the doctor.
After a thorough questioning and physical examination, the doctor will usually make a palpation of the rectum. A blood test and a stool sample can provide evidence of inflammation, infection or hemorrhage.
Subsequently, the doctor will decide whether a colonoscopy is required for further clarification.
Defecation at the newborn child
The baby's first stool is called mypeonium (meconium) and is typically green to gray. Normally, the first bowel movement after birth takes place within the first 48 hours.
Usually, the baby already forms a nutritional chair from the second to the fourth day of life - mixed with meconium it is called a transitional stool. The subsequent pure breast milk chair is usually yellow to orange and has a creamy texture.