“Everybody looks at their poop.” ~Oprah Winfrey
Perhaps as a mom who runs a nonprofit for children where poop is an everyday conversation, it's not a big deal for me. But I know it's not like that for most so I'm going to make it easy for you and we are going to talk in numbers. A bit more sophisticated than calling it "number 2" but kind of along those lines. In case you haven't heard of it I'm sharing the Bristol Stool Chart (well they actually call it the "Bristol Stool Form Scale") which was developed by researchers at the Bristol Royal Infirmary, a hospital in Bristol, England, as a visual guide for poop. It's a perfect way to talk about poop without really talking about it. And it's a way to distinguish normal poop from abnormal without getting embarrassed over TMI.
Looking at the chart below, those that have trouble with elimination have type 1 to type 7 poops. Softer poops are better and type 4 to type 6 are all within the range of normal. Poop doesn't have to be formed. they can be mushy. Only type 7, when it looks like water (you know the word) isn't normal.
Sometimes when introducing a food like IQed to your diet which contains whey and the ayurvedic botanicals Turmeric, Amalaki, Haritaki, Gymnema, Green Tea, Guggul, Cocoa, Cinnamon, and Cayenne Pepper that help support the metabolic system, and naturally and gently help with detox, you may notice an increase in type 4 to type 6 poops. One other tip to help with elimination is to make sure you always have enough hydration. A basic tip is to take body weight and divide in half and that would be approximate for a number of ounces of liquid a day. But to make it simpler one children's hospital says 1 eight ounce glass of water for each year.
Bristol Stool Chart (aka "Bristol Stool Form Scale")
Type 1: Separate hard lumps, like nuts
Typical for acute dysbacteriosis. These stools lack a normal amorphous quality because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive, the typical diameter ranges from 1 to 2 cm (0.4–0.8”), and they‘re painful to pass because the lumps are hard and scratchy. There is a high likelihood of anorectal bleeding from mechanical laceration of the anal canal. Typical for post-antibiotic treatments and for people attempting fiber-free (low-carb) diets. Flatulence isn‘t likely because fermentation of fiber isn't taking place.
Type 2: Sausage-like but lumpy
Represents a combination of Type 1 stools impacted into a single mass and lumped together by fiber components and some bacteria. Typical for organic constipation. The diameter is 3 to 4 cm (1.2–1.6”). This type is the most destructive by far because its size is near or exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s bound to cause extreme straining during elimination, and most likely to cause anal canal laceration, hemorrhoidal prolapse, or diverticulosis. To attain this form, the stools must be in the colon for at least several weeks instead of the normal 72 hours. Anorectal pain, hemorrhoidal disease, anal fissures, withholding or delaying of defecation, and a history of chronic constipation are the most likely causes. Minor flatulence is probable. A person experiencing these stools is most likely to suffer from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls. The possibility of obstruction of the small intestine is high because the large intestine is filled to capacity with stools. Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause a hernia, obstruction, or perforation of the small and large intestine alike.
Type 3: Like a sausage but with cracks in the surface
This form has all of the characteristics of Type 2 stools, but the transit time is faster, between one and two weeks. Typical for latent constipation. The diameter is 2 to 3.5 cm (0.8–1.4”). Irritable bowel syndrome is likely. Flatulence is minor, because of dysbacteriosis. The fact that it hasn‘t become as enlarged as Type 2 suggests that the defections are regular. Straining is required. All of the adverse effects typical for Type 2 stools are likely for type 3, especially the rapid deterioration of hemorrhoidal disease.
Type 4: Like a sausage or snake, smooth and soft
This form is normal for someone defecating once daily. The diameter is 1 to 2 cm (0.4–0.8”). The larger diameter suggests a longer transit time or a large amount of dietary fiber in the diet.
Type 5: Soft blobs with clear-cut edges
I consider this form ideal. It is typical for a person who has stools twice or three times daily, after major meals. The diameter is 1 to 1.5 cm (0.4–0.6”).
Type 6: Fluffy pieces with ragged edges, a mushy stool
This form is close to the margins of comfort in several respects. First, it may be difficult to control the urge, especially when you don‘t have immediate access to a bathroom. Second, it is a rather messy affair to manage with toilet paper alone, unless you have access to a flexible shower or bidet. Otherwise, I consider it borderline normal. This kind of stool may suggest a slightly hyperactive colon (fast motility), excess dietary potassium, or sudden dehydration or spike in blood pressure related to stress (both cause the rapid release of water and potassium from blood plasma into the intestinal cavity). It can also indicate a hypersensitive personality prone to stress, too many spices, drinking water with a high mineral content, or the use of osmotic (mineral salts) laxatives.
Type 7: Watery, no solid pieces
This, of course, is diarrhea, a subject outside the scope of this chapter with just one important and notable exception—so-called paradoxical diarrhea. It‘s typical for people (especially young children and infirm or convalescing adults) affected by fecal impaction—a condition that follows or accompanies type 1 stools. During paradoxical diarrhea, the liquid contents of the small intestine (up to 1.5–2 liters/quarts daily) have no place to go but down, because the large intestine is stuffed with impacted stools throughout its entire length. Some water gets absorbed, the rest accumulates in the rectum. The reason this type of diarrhea is called paradoxical is not because its nature isn‘t known or understood, but because being severely constipated and experiencing diarrhea all at once, is, indeed, a paradoxical situation. Unfortunately, it‘s all too common.
Interestingly, the interpretations and explanations of the BSF scale that accompany the original chart differ from my analysis. To this I can only say: thanks for great pictures, but, no thanks for the rest...
Excerpted from Fiber Menace, page 117-120;
Up to 5 times a day can be within the range of normal.. "how often should you move bowels — applies to healthy people with no or minimal anorectal, nerve damage and normal stools, who reliably sense the urge to move their bowels, and complete the act without straining or any noticeable discomfort. If this describes you, technically you should move your bowels after each major meal, particularly the meals that contain plenty of dietary fat, because the act of eating fat stimulates intestinal motility more than any other factor. Here is how this not so well-known fact of human physiology is described in a major textbook for medical students" source
Lisa Geng got her start as a designer, patented inventor, and creator in the fashion, toy, and film industries, but after the early diagnosis of her young children, he entered the world of nonprofit, pilot studies, and advocacy. As the mother of two “late talkers,” she is the founder and president of the nonprofit CHERAB Foundation,c o-author of the acclaimed book, The Late Talker, (St Martin’s Press 2003), and is instrumental in the development of IQed, a whole food nutrition meal replacement. Lisa currently serves as a parent advocate on an AAN board for vaccines, and is a member of CUE through Cochrane US. Lisa is currently working on a second book, The Late Talker Grows Up and serves as a Late Talkers, Silent Voices executive producer. She lives on the Treasure Coast of Florida.