Is Your Poop Healthy? The Bristol Stool Chart Shows What It Should Look Like
This scale can help you tell what's normal—and what's definitely not.
When it comes to pooping, your bathroom strategy is most likely to get in and get out—but it's a good thing to take a look every now and again to see what's going on in the toilet. The size, texture, and color of your poop can tell you a lot about what's going on in your body. And it will vary depending on lots of factors.
"It is important to check because it can help you identify a problem: digestion problems, structural diseases, motility disorders, or an adverse reaction or side effect to a medication," Christine Lee, MD, a gastroenterologist at Cleveland Clinic, tells Health. "In general, the earlier a problem is discovered or identified, the better the outcome."
If you don’t want to spend too long inspecting what’s in the toilet, there’s a super handy visual tool called the Bristol Stool Chart (also known as the Meyers Scale, Bristol Stool Form Scale, or BSF scale) to help you check everything is as it should be. It was developed in 1997 by a team of researchers, led by the late Ken Heaton, MD, an expert in bowel function and nutrition, at the Bristol Royal Infirmary in England, UK.
If something doesn’t look quite right, the Bristol Stool Chart can help you figure out what may be going on.
What exactly is the Bristol Stool Chart?
The Bristol Stool Chart details seven types of poop, ranging from constipation (Type 1) to diarrhea (Type 7). Basically, it helps patients and doctors identify abnormal poop without having to get too embarrassed about personal details. “Patients can better communicate to their doctors the appearance of their bowel movements," says Dr. Lee.
Besides being used in the doctor's office, it can be a super helpful chart to use day-to-day to check that things are OK within your digestive tract and body. The goal? Type 4.
"A diet rich in fiber tends to have more formed, brown stools, most commonly seen in Bristol Stool Chart Type 4," says Dr. Lee. If your diet’s low in fiber and water, you might find your poops more consistently look like Types 1 through 3, she adds.
But it’s not just diet that changes how your poop looks. Here are a few other factors that can change what you see in the toilet bowl.
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Your poop can tell you if you're drinking enough water.
"If you are dehydrated, the large intestine and colon work like dehydrators, pulling water from stools and repurposing it for the body’s use, causing really hard stools," says Dr. Lee. If your poop looks like Type 1 or Type 2 on the chart, you might need to up your H2O intake.
To ensure you’re drinking enough water, follow the CDC’s recommendations: carry a water bottle for easy access to water when you’re out and about and add a wedge of lime or lemon to your water to improve the taste.
How much you're exercising (or moving in general) can also play a big role in what your poop looks like.
"Exercise improves muscle strength, motility, and a healthy stool appearance,” says Dr. Lee. “A sedentary lifestyle greatly exacerbates constipation.”
Remember, your body needs more hydration when you’re physically active, so make sure you’re drinking plenty of water.
Tons of meds can mess with what your poop looks like.
"Bismuth subsalicylate (the active ingredient in many upset stomach medications) can change the color of your stools to black, as can iron supplements," says Dr. Lee.
Blood pressure medications can cause constipation, while some prescription meds for gout or diabetes can cause the opposite problem, she adds.
According to the International Foundation for Gastrointestinal Disorders, other meds that can cause constipation include antidepressants, antacids containing aluminum and calcium, which are commonly used to neutralize stomach acid, diuretics (these help the kidneys remove fluid from the blood), and opiates (prescribed for pain relief).
If you have any concerns about your meds affecting your stools, let your doc know.
Antibiotics can really do a number on your gut, and therefore your poop as well.
"Antibiotics can kill bad and good bacteria. Losing your good gut bacteria can drastically alter your stool consistency and frequency and even leave you vulnerable to pathogen invasions such as C. difficile," says Dr. Lee.
Always use antibiotics correctly—and seek medical attention should you develop diarrhea post-antibiotics, which could signal a C. diff infection, she says.
In most cases, antibiotics only cause a mild case of short-term diarrhea, and normal poop habits resume after treatment ends, says Harvard Medical School. But now and then, an antibiotic gets rid of so many of the “good” bacteria in the bowel that the “bad” bacteria are given free reign to cause trouble. In the case of C. difficile, it can produce chemicals that damage the wall of the bowel and lead to colitis, a type of bowel inflammation. Symptoms of this include abdominal pain, cramps, fever, and diarrhea.
If you develop diarrhea after taking antibiotics, make sure you seek medical attention, Dr. Lee says.
Another possible cause of frequent diarrhea is an autoimmune disease, such as celiac, lupus, thyroiditis, or an inflammatory bowel disease like Crohn’s or ulcerative colitis, says Dr. Lee.
Digestive problems are common in lupus, says the Lupus Foundation of America, and it’s not always diarrhea. Sometimes, people with lupus experience constipation, which is often due to the failure of the muscles to properly move waste through the intestines. Digestive issues may also be caused by meds, such as non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
If you're super stressed, your poop may show it. "Stress levels can greatly affect the appearance of your stools, to either loose diarrhea or the other extreme, severe constipation," says Dr. Lee.
According to a 2014 study published in the Expert Review of Gastroenterology & Hepatology, psychological stress can cause bowel dysmotility, a condition that affects the muscles of the digestive system and can result in either constipation or diarrhea.
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What if your poop is a different color?
In addition to looking like an optimal Type 4 on the Bristol Stool Chart, healthy poop is also a shade of brown (or sometimes green).
But plenty of factors can change your poop color. Pale or clay-colored stools might be a sign of a problem with your liver or pancreas. Black or red stools may suggest gastrointestinal bleeding, says Dr. Lee.
Even the foods you eat could be to blame. “Blueberries may turn the color of your stools to deep blue, and a diet rich in beta carotene (carrots, pumpkin, squash, etc.) may turn your stool orange,” Dr. Lee says. Candies or drinks with food coloring could change your poop color too, she adds.
In general, if your poop looks off and it isn't just a one-time thing, Dr. Lee recommends making an appointment with your primary care doctor to get things figured out.
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