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What’s a Healthy Bowel Movement? Check Out the Bristol Stool Chart

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Talking about bodily functions doesn't generally make for polite conversation. Judging by the stunning array of constipation medications available at the drugstore, maybe we do need to talk about healthy bowel movements. (I was looking for ipecac syrup, which they no longer carry, to keep in our emergency medical kit.)

What's a Healthy Bowel Movement? Using the Bristol Stool Chart to identify a healthy bowel movement. Five tips for better bowel movements, bowel health.

So, what constitutes a healthy bowel movement?

Believe it or not, some scientists in England (Bristol, to be precise), came up with a  chart to describe the range of typical bowel movements. This is called the Bristol Stool Chart (or as we like to call it, the Poop Chart).

The following is a summary of the chart based on information from www.gutsense.org. I encourage you to visit their site if you want more details or have specific concerns, or to speak with a qualified health care professional.

Type 1:  Separate hard lumps, like nuts

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.

Typical for post-antibiotic treatments and for people attempting fiber-free, meat and fat heavy (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.  Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause 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 disbacteriosis. The fact that it hasn’t became as enlarged as Type 2 suggests that the defecations 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

The authors of www.gutsense.org 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”).

*Note – many other sites list 4 and 5 as preferred shapes.

Type 6:  Fluffy pieces with ragged edges, a mushy stool

These kind of stools 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. 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.

We  are bombarded with advertisements for FIBER! FIBER! FIBER! – like a fiber pill or glass of fiber drink – but is a large amount of fiber the real solution we're looking for?

Based on personal experience, I'd have to say, “no”. I've read some articles that say that large amounts of fiber can actually make bowel problems worse, depending on your situation (such as #2 poop problems from the chart).

We need to look at the colon as not only a part of your digestive system, but part of the body as a whole. Did you know that an under active thyroid can contribute to constipation? And that the gastrocolic reflex (the urge to poop) typically weakens as we age?

I (unfortunately) found this information out first hand when my thyroid became sluggish. The good news is that by changing my diet, I am now happily in the 4-5 range. Here are some of the changes I've made during the last year or so that have helped me.

7 Tips for Healthy Bowel Movements

1)  Eat plenty of coconut oil and other high quality saturated fats.

Fats are our bodies natural lubricants. They provide a feeling of satiation so you are less likely to overeat. Nutiva coconut oil, organic butter and ghee are my personal favorites.

2)  Eat plenty of veggies, including green and leafies, and moderate amounts of fruit

I've been eating less fruit lately since I am cutting back on carbs, but I do make sure to get plenty of plant material each day. Plants provide a good ratio of fiber to water that is generally easy on the digestive system.  Many plants are high in soluble fiber, which swells and bulks up the stool for easy transit, and insoluble fiber, which acts somewhat like a “broom” to “sweep” the colon clear.

3)  Stay hydrated

I'm not fanatical about how much water I drink. I think the eight glasses a day recommendation seems a little over the top, unless you're in a situation where you're sweating heavily. Realistically, would our ancestors have consumed that much fresh water daily? I think it's unlikely.

That said, I think most of us have a higher toxin load from our environments, so we want to keep things moving through our systems. Don't skimp on the water.

4)  Eat and drink plenty of probiotic foods and beverages

As we age, our bodies naturally produce less digestive enzymes.  Our digestive systems slow down (and sometimes even stop – not good).

Live culture foods and drinks like sauerkraut, kimchi, fermented salsas and chutneys, kombucha, kefir, and kvass all help “jump start” your digestive system and often contribute to the healing of many digestive ailments.

Don't know what some of those foods are or want to learn how to make them at home? Visit the Live Culture Foods Section of the recipe page.

Want to learn a lot more? Check out Enzyme Nutrition and/or Enzymes & Enzyme Therapy : How to Jump-Start Your Way to Lifelong Good Health.

5) Avoid highly processed foods

When the boys were younger, we did a little homeschool science experiment where we took samples of different foods and subjected them to “digestive forces”. We soaked them in vinegar, “smushed” them in a plastic bag, and finally forced them through on old nylon stocking.

The foods we examined were a piece of meat, a piece of apple, some celery, some oatmeal, and saltine crackers. When we got to the saltine crackers, they basically coated the inside of the stocking like glue.

The same thing happens in your guts. Highly processed foods lack “bulk” in the form of soluble and insoluble fiber. They are also typically quite dry, so they can be easily compressed in your guts, forming hard, dense bowel movements.

6) Try squatting

Squatting is the natural position for making a bowel movement, because it helps your guts to line up correctly to pass stool more easily. This can be accomplished with lower toilets, or through the use of a simple step like the Squatty Potty®, pictured below.

7) Try Adding Magnesium

Many people suffer from constipation due to magnesium deficiency. According to WebMD, “Dietary sources of magnesium include legumes, whole grains, vegetables (especially broccoli, squash, and green leafy vegetables), seeds, and nuts (especially almonds). Other sources include dairy products, meats, chocolate, and coffee. Water with a high mineral content, or “hard” water, is also a source of magnesium.”

Natural Vitality Natural Calm Magnesium Beverage mix in raspberry lemon flavor is an easy way to take extra magnesium. A glass before bedtime may also help you get a more restful night's sleep and reduce nighttime leg cramps.

So the next time you visit the bathroom, take a peek at what's going on before you flush. If you're not in the 4-5 range, you may want to consider making some changes in your diet.

What's a Healthy Bowel Movement? Using the Bristol Stool Chart to identify a healthy bowel movement. Five tips for better bowel movements, bowel health.

You may also enjoy other posts in the Natural Health series.

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93 Comments

  1. Great chart. I would add one more type that is uncommon but you should keep a look out for. Feces that is foul, oily, food still in it (not corn but softer foods) and though somewhat solid comes out like liquid feces. This denoted a pancrease that is not doing it's job. My daughter has needed to use pancreatic enzymes on and off thorugh out her life because of this pancrease problem. Like I said uncommon but worth telling you doctor if you see it persistantly.
    God bless
    Heather L

    1. Yep, Heather, for anyone who has experienced this kind of poo, it’s foul alright. My son had Cystic Fibrosis, and anyone who has it, and isn’t diagnosed really needs to start taking care of this disease.

  2. Poo! One of my favorite topics 🙂

    I'd love to learn more about the poo of traditional societies – one thing that, as far as I know, that Weston Price never reported. I think we've totally lost track of what is normal. I wonder if flatulence exists when you eat a perfect diet and have good gut flora.

    BTW, I enjoy reading your posts. I have a blog hop. I'd love to share some posts.

  3. gfcfmomofmany – oh my – yes, that would definitely be a cause for concern. Glad you shared this, in case there are others who might run into this problem, and so glad you were able to find help for your daughter.

    Ruth – he was a dentist, not a protologist or gastroenterologist, so I'm guessing he was busy at the other end, but that would be an interesting inquiry. I'd be especially curious about the folks who have minimal plant products in their diets. I suspect some level of gas in "normal", but have noticed personally that I am less gassy and generally less stinky than I used to be before I consumed probiotics regularly.

    1. He was a dentist, however he shifted his interest to nutrition and diet after years of study. He studied different cultures diets and actually does deal with this.

  4. What's bad is when you follow all the advice given and you still suffer with a #2 or #3. I had to give up on that "going once a day" because that's not my body's desire. I sometimes get happy if a stomach bug is going around! (not really, just kidding)

    1. I am in the same boat and I am now going to add a bit more olive oil and walnuts each day to see if it helps.

  5. Paula – have you had your thyroid checked? Does your menstrual cycle have any effect? Once in a while, I still get nailed with a combination of stress and other factors that stops things in their tracks – not pleasant. You can pm me at laurie at commonsensehome dot com if you wish to discuss symptoms. Don't give up hope on a more comfy bottom!

    1. Do you suffer from bowl movements through thyroid problems ? Just i have been suffering for a while now and dont no if it is through my underactive thyroid or not has anyone had this problem?

      1. Bowel movement issues are sometimes associated with an underactive thyroid. (Every person is different.) I do notice that if I eat something close to the standard American diet – heavy on grain products, meat, cheese – lots of low fiber foods – I tend to have much slower bowel movements or even minor constipation. When I make sure to get a more balanced diet, including plenty of veggies and some fruit, and less grain products, it’s typically a 5 and easily passed.

        You might try an more autoimmune friendly diet for a while and see how your body reacts. I did a pretty strict diet when I was dealing with psoriasis and candida overgrowth and it got it under control. There’s more information here – https://commonsensehome.com/anti-candida-anti-psoriasis-diet/

  6. I just came across your blog. I am always in the 5 to 6 range, mostly 6. Always. I have lots of problems at that end and am waiting for a January appointment with a GI doc. I've had a colonoscopy and endoscopy that were normal, but a stool test showed I was was gluten sensitive. I've been eating GF for 3 years with no relief. 🙁

    1. Have you had your Iron levels checked? i had some issues like that till i started taking iron daly, now im a happy girl 😀

      1. I would warn you not to self diagnoise. My mom did that & felt better for a while. But it masked her blood count when
        she was having stomach pains. Turns out she had colon cancer. Always check with your Dr. before self medicating.

    2. Megan I have had colon problems since childhood. a couple years ago having a colonoscopy my dr. did a few biopsies and one came back saying I had celiacs disease. which means gluten free. BUT my dr. felt another test was needed before she put me on such a strict diet. I had blood drawn for genetic testing for celiacs and it came back negative. I am glad my dr. did that and when you said u were doing gf and it wasn’t helping it may not be what is wrong with you.

    3. I am 80 years old and probably say I have been in th1-2 category most of my life, recently I had issue of going 2- 3 days . took OTC to have a movement. then usually latter in day some No. 6 category. The last week I started using Acai berry cleanse, picked up a Kroger. My stool is in the no 4 category all week and the length of stool ranges from 2 foot to 3 foot and about .5 in. in diameter I was worried about that until I read this article. Still a little concerned about there length of the poop. like a snake and a very long snake.

      1. 2-3 feet is quite long. Do you have a very high fiber diet? That’s typically associated with high volume poops.

        The diameter sounds like it’s in a good range to pass easily, and a type 4 should be better than a type 1 or type 2. As long as you are still pooping regularly, and there’s no blood or mucus in the stool, it should be fine. If you do see blood or mucus, start having issues with constipation or pain while having a bowel movement, it would be best to see a healthcare provider.

        1. One other thought – a friend mentioned the possibility of tapeworms. Any chance you could have picked one up? If so, it should be fairly obvious on examining the poop. You can search on “tapeworm in poop human” for some comparison images.

          1. One more note on poop size. I did some hunting around and came across this info in an article called “The Straight Poop” on a raw food website.

            “Your stool’s length should conform to the segment lengths of a clean and healthy colon. Each of the colon’s three distinct anatomical segments—ascending, transverse, descending—is about a foot long. Passed stool tends to break at these segment junctures. So your stool should be at least 1 foot long. A person 6 to 7 feet tall might have colon about 6 feet in length. So that tall person’s stool should be about 2 feet, the length of the descending part of the colon.”

            The author is talking about a high fiber, raw food diet, which would form nice, bulky stool.

  7. Megan – can you tolerate (or have you tried) live culture foods? Many people aren't familiar with them, but they have made a HUGE difference for me. We're exposed to so many things that can upset the flora and fauna of our digestive systems that I feel these foods are critical for health. Please feel free to contact me at laurie at commonsensehome dot com if you'd like to learn more about cultured foods or discuss other options. I'm not a doctor, just and engineer turned my own guinea pig, but I keep asking questions and hopefully finding answers.

    Our digestive systems are sometimes referred to as our "second brains", so if your guts are hurting it impacts the rest of your health, as I'm sure you know.

  8. Thank for your reply, Laurie. I have started using more cultured foods with my daughter. She has cerebral palsy and epilepsy, but meds and the ketogenic diet have not worked. I have been giving her marrow and bone broth (on the recommendation of a Traditional Chinese Medicine doctor), and I started giving her kefir and sauerkraut, both of which she loves. As her gut health improves, so do her seizures.

    I eat pretty much a Weston A. Price diet, but I haven't been as proactive about the cultured foods and getting myself healthy. (I know, I know, gotta take care of myself too! I'm in the trap most moms get into.) I even signed up for the Cheeseslave class on GAPS, but then we moved from Connecticut to Missouri, and I never did it (I have all the videos and info, though).

    So, I know in my heart (and gut!) what the answer is, don't I?! I am very nervous about making my own fermented foods, though. I'm afraid of making anyone sick! (Which I know is silly because I am a fearless cook otherwise!)

    Thank you SO much for your thoughts!

  9. Don't fear fermented food. 🙂 It's strange, but the fermentation process naturally lowers the pH and inhibits the production of pathogens. So, if it ferments, it won't rot. They are mutually exclusive operations, at least early on. Eventually the little fermentation beasties run their course and eat everything they can, and then things start to rot, but meanwhile, you're good to go. I highly recommend the book Wild Fermentation (http://www.amazon.com/Wild-Fermentation-Flavor-Nutrition-Live-Culture/dp/1931498237/ref=sr_1_1?s=books&ie=UTF8&qid=1324227149&sr=1-1)

    The author's a little "out there", but he makes fermenting easy.

    Don't beat yourself up about not doing this or that. Just keep at it, slowly, and make small changes that become habit. Stress can make you just as sick as not eating right.

    You can do this! Our bodies were made to heal, we just need to help them do it.

  10. Hi! Any advise would sure help! My husband has high blood presure it runs in his family and the dr’s have had a hard time regulating it (he is a former marine so he had a high stress job) he has a slightly less stress ful job now but still I know that plays a part. He had a colonoscopy and endoscopy in 2009 because he is on the chart as a #6 but is bloody like the water in the toilet bowl is red bright red 🙁 he goes to a gi doctor soon I’m hoping for some answers. it really worrys me, he says it’s not like that everyday, but the way he talks he’s never had a “snake” and I don’t think that’s normal!

  11. Lauren – no, that is definitely not normal. He really should seek professional help. It sounds like his system is badly out of whack. Quality probiotics and live cultures foods may help, but there’s a good chance that for long term health a diet like GAPS may be required. The suggestions offered in the post above may provide some relief, but he should seek professional advice to rule out more serious conditions.

  12. Ya he has appointments made for different doctors but was hoping to find some relief as the appoinments aren’t for a few months yet, I had him take a fiber pill the doc recommended a fiber supplement and I figured he would take a pill much easier an better then the mix in powder he tried it for a week and a half and said the bleeding has gotten worse 🙁

    1. Lauren – is there any way to get an appointment sooner? That sounds very serious. At the risk of TMI, is there a chance that the blood could be from hemorrhoids or anal fissures? While uncomfortable, those conditions are generally less serious than internal bleeding. If he’s got some sort of surface irritation in the GI tract, especially the rectum or anal area, excess fiber would be the last thing you’d want to add to the diet. A gentle diet to keep things moving that includes items like apples/apple sauce (which have pectin) and chia seeds, would probably be easier on him. Both pectin and chia are hydrophilic, meaning they absorb water. Both of these foods will form somewhat of a soft, gelatinous mass, clumping waste together and helping it move through your system.

      If he’s dealing with something like ulcerative colitis (http://www.umm.edu/altmed/articles/ulcerative-colitis-000166.htm), which he may be, from the symptoms you’ve described, then you need to look at internal treatment. Ted at Earth Clinic comes highly recommended by several friends for self-healing advice. The Earth Clinic ulcerative colitis page is here: http://www.earthclinic.com/CURES/ulcerative_colitis.html

  13. Another suggestion for those with #7. I went to several Doctors and had LOTS of tests without getting a diagnosis or help. A friend suggested NO white flour. Diarrhea stopped in 2-3 days!!!!

  14. Regarding poo or lack thereof:

    Everyone needs to ensure their child seesa good chiropractor at some point before they start school or now. My daughter suffered for months because she was compacted (constipated but could not feel it). Her full intestines were pushing on her bladder making her have to urinate all the time. She was in grade 2 and many doctors examined her, found *nothing* wrong and said it was all in her head.

    For months she suffered because she had to pee every 10 minutes to 1/2 an hour. I thought I was going to go crazy because I had to try and convince this suffering child it was all in her head.

    As it turns out all those doctors were morons.

    A chiropractor *fixed* it in one adjustment!! WOW!

    Doctors are dunces sometimes because they do not trust chiropractors who study the latest in anatomy. If your spinal cord is compacted in any way – you suffer!!

    Subluxasion is the term chiropractors use.

    Doctors are not trained in evolution and how the bones work with the rest of the body. They think some pill will cure but they have been misled.

  15. Tip #6: Get regular exercise. My Mother-in-law calls full body physical activity, everything from walking to jumping rope, “big movements.” This always kinda makes me giggle, but “big movements” are very important for…um…big (healthy) movements.

  16. I recently discovered your blog and am impressed. This is horribly embarrassing to talk about but I think that is the issue. I have chronic constipation and an overly long digestive tract so numbers 1 and 2 are normal and make me miserable. I am sensitive to a lot of grains and feel a lot better if I avoid them but the downside is an aggravation of my other issue. So… is there any natural or herbal remedies that can help convert a person to the higher number results? I eat a lot of leafy greens and try to get extra fiber when possible. Thanks for this discussion.

    1. Annie’s Remedy suggests the following for constipation at http://www.anniesremedy.com/chart_remedy.php?tag=constipation:

      “A spoonful of molasses with 10-15 drops of yellow dock root tincture in a glass of warm water is a better way to increase iron and improve elimination.

      Drinking herbal teas containing gentle laxatives remedies such as dandelion, chicory and chickweed help to keep you regular and prevent constipation.

      Flax seed and psyllium are both safe but efficient intestinal cleansers that provide fiber without all the added sugar and chemicals contained in their commercial counterparts. Be sure to drink enough water when supplementing with fiber.

      The use of harsh purgatives, such as aloe juice and turkey rhubarb should only be used occasionally, when milder herbs and dietary changes have not been effective.”

      I hope you can find something that helps. It sure can make a person uncomfortable.

  17. I just found this page today and am very glad. I have had some poo concerns for over a month now. It’s always a mix of several types but more recently very smelly, mushy, and bits of things in it. Every time now. I normally wouldn’t just say all of this for all to see but I think it’s time to get cracking on fixing this! I have been diagnosed with Hashimoto’s Thyroiditis, have very painful periods, a random pain in my left abdomen that comes and goes, gastroparesis diagnosis from years ago, ulcer 8ish years ago, and in the past few weeks had an ultrasound for that random abdomen pain and they found I had fatty liver disease. I know this must all be connected but I am at wits end some days as to what to do to help! I eat a gluten free and vegan diet (gf because of the autoimmune issues and vegan for ethical reasons). Help! Any thoughts will help me progress! Thank you all!

    1. Do you use digestive enzymes or probiotics? Both can great aid digestion, and probiotics help colonize your body with good bacteria. I have Hashi’s too, and probiotics helped me a lot. (I’ve just started researching enzymes.)

      You may also want to check out the post, “Hashimoto’s Thyroiditis – Common Questions, Misconceptions and Myths“. It has a link to a workshop with a lady who has Hashimoto’s but now lives symptom free through diet and lifestyle changes.

      1. I was using 1 Tbls of a coconut water kefir but it didn’t seem like much difference… I do tend to feel more energized when I drink kombucha but I cannot consume it daily until I have a batch ready. (My fiance’ and I want to start brewing our own to save money). I took a digestive enzyme about a year ago that seemed to almost work too strongly but I am definitely open to finding others to try. I am scheduled to see a functional medicine doc next week and am trying to be open to western ideas on helping to heal my body. Yoga and just breathing seems to go a long way though! I definitely feel diet is a key role. I will check out the Hashi post now! Thank you for your response 🙂

  18. My dad has told often of always having beans on the table at every meal (even breakfast) as a child. Mostly because people were poor and beans were planted and grown, dried and stored. They were plentiful when everything else ran out. He says there was no flatulence problems then!! But as a teen, his buddies and him conjured up this poetic verse to impress their teachers, but amuse themselves because it was all about flatulence!!
    “Speak to me! Oh toothless one!!
    Let me seek out thy sweet lips!!”

    1. Brenda, I am of the generation and so are my adult children, when beans were served quite frequently. In fact my family discussed the other day how we used to make baked bean sandwiches, yum yum. I don’t remember having a flatulence problem when I was young, but my brothers seemed to be able to “toot” on command, and ask each other to name how many and how long. Disgusting to us girls! One of the more prolific poems of my childhood was: Beans, beans, good for your heart, the more you eat, the more you —-. (fill in the blanks)

  19. Great post … addresses a universal yet seldom talked topic.

    One clarification though. I am not sure if the cycle is 72 hours! Isn’t it 14-16hours … but a max of 24hours. anything more could be classified as borderline constipation.

    On the topic of probiotic … nothing remotely comes close to a cup of yogurt or curd. Even better if it is homemade!

  20. My father has major issues with his bowels that have had him hospitalized three times in the past three years. He starts throwing up and can’t stop throwing up, and it is black looking like coffe grinds. This will go on for days till he just gets dehydrated and has to go to the hospital. The doctors say he has major constipation and that when his bowels get full it then fills up his stomach which makes him vomit and it’s fecal matter that is coming up. They pump him full of liquids, give him laxatives, enemas and anything else that will make him go to the bathroom. Now he has to take milk of magnesium every other day and enemas if he doesn’t go the bathroom every three days. I truely believe he has some kind of blockage but the catscans and colonoscamies show nothing. My concern is that I too will have the same issue when I get my dads age cause I have never had “normal” bowels. I go for days, usually maybe every 4-7 days, before having a bowel movement. I have gona as long as 17 days without a bowel movement. I have to tak stool softeners on a regular basis and laxatives when that doesn’t work. My stools are always a 1 or 2 unless I take laxatives then they are a 7. Any suggestions or help with this matter?

    1. If possible I’d suggest you work with a trained natural health practitioner to take a look at your diet and lifestyle. Bowels that are that sluggish are struggling to do their job. In addition to the suggestions in the post, you may also want to consider digestive enzymes (for you and your dad) which help your body to do its job breaking down food. You may also have a food sensitivity that you haven’t recognized, such as gluten or lactose. Food allergies can really throw a monkey wrench in the whole system. I’m not a doctor, just a former engineer with a lot of interest in helping the body to heal itself, but I encourage you to start asking questions and look for help near you, and to try changing your diet to help your body heal.

    2. Your post is now 5 years old. I hope your father is doing well. What the Doctors told to your father that stool is is in the stomach so he has to throw up. It is unlikely. Tell to your Doctor to check about Mesenteric Artery Syndrome.

  21. I think you contradict yourself by saying you think people’s suggestions to eat more fiber to solve this issue isn’t warranted and then turn around and list a top 5 that includes eating more fiber. #2 says eat plenty of veggies and fruit. That is ALL fiber. Fiber IS the solution. The problem is the wrong types of saturated fats, as well as CARAGEENAN and sulfites. By eliminating bad fats, ALL CHEMICALS, especially fast food, and upping the intake of WATER and REAL fiber, not fiber from Metamucil or any of that other synthetic garbage, you will become a lot closer to normal.

    1. Fruits and vegetables also come with a lot of water – not just fiber. What I’m referring to is the products like Metamucil or “magic fiber pills” instead of eating real food.

  22. i have had #1 and #2 for a long time and had been wondering … (i had an illeus close to 50 years ago) and it seem to be getting worse – sometimes its 7 days before i have a bowl movement- so what can i do … drink more water, eat walnuts (i eat lots of them)

    1. Too many nuts could be contributing to slow moving bowels. Nuts don’t have much moisture in them, and tend to pack pretty tight once they are chewed up.

      You may want to try some of the suggestions listed in the post, like more vegetables and fruits, and live culture foods like yogurt, kefir, sauerkraut or kimchi. Enzyme supplements like Garden of Life Omega-Zyme Digestive Enzyme Blend, Caplets, 180-Count Bottle are another option that might help.

  23. While I am comfortably about 5, with 2 visits first thing in the morning and 1 after every meal, and my husband is similar, our 12 year old daughter is more like a 2-3. What concerns me is that her poop is huge and floats – actually causes problems with getting the toilet to flush all the way. I am sure that floating is indicative of something, but can’t remember what. I try to encourage acidophilus daily, but it is hit & miss. I have supplements available to her, but she only takes them when in the mood. The majority of the meals I make for her are healthy, generally 1 egg either lightly sautéed with veggies or fried and a leafy kale & spinach veggie & fruit smoothie with almond milk and flax seed for breakfast, meals prepared by Revolution Foods (supervised by Whole Foods) in school at lunch, and some form of protein with either sautéed veggies or salad with cabbage, broccoli, onions, etc. for dinner. She does eat cheese sticks or granola bars as snacks, or something similar, when she is going through a ‘growth spurt’ (her words). She occasionally eats fast food, maybe once a week, and would live on sweets if given the opportunity, but they are limited to something on Saturday so as to not affect school. She does take daily meds for ADHD & ODD. Any thoughts?

    1. Constipation is one of the less common side effects of many ADHD medications, so that could be the issue. Would it be possible for you to work with a natural health practitioner and possibly wean her off of the medication? There are herbal options with fewer (or no) side effects, or there may be dietary triggers that effect behavior.

  24. A note about water consumption – tap water and bulk water are not as absorbable as what our ancestors had to drink – they are not ‘natural’ waters but are adulterated water and are not very hydrating. I’ve read you absorb less than 20%. Even when drinking ‘good’ water you still need plenty – a minimum of 1/2 ounce per pound and ideally 3/4 to 1 ounce per pound of body weight – especially if you are overweight or have health issues. We do not eat like our ancestors ate either – processed, packed foods do not have the hydrating properties of freshly picked produce. Cat @ http://www.keepitkangen.com

  25. westeran a price was a great man and says how healthy the nz maori were he say the healthiest on the planet.. pre white man they ate poteen green veg and kumra ( sweet potato ) and there diet was the best way to eat but in his book he says eat lots of fruit .. there was no fruit in nz untill the white man came perhaps fruit is part of the poison

  26. Laura, as a nurse, I often have patients, friends and even family with severe halitosis. Sometimes I can detect that if they would evacuate their bowels more frequently, the problem would clear up. Do you or anyone have any studies about that connection?

    1. Donna – how about this?

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093012/

      Slow Transit Constipation Associated With Excess Methane Production and Its Improvement Following Rifaximin Therapy: A Case Report

      “Methane production in the gut is known to be associated with slow gut transit. Previous studies showed that methane production in IBS patients was almost universally associated with constipation and lumpy stools.2,10 In contrast, patients with diarrhea usually have higher excretion of hydrogen in breath both during fasting state and following administration of glucose.11,12 Methane was associated with presence and degree of constipation both subjectively and objectively in a study on 87 IBS patients, 20 (24%) of whom produced methane on lactulose hydrogen breath test.2”

  27. Consistency, frequency, etc. all fine. But the very expensive Metametrix Stool Test showed stuff that has probably been with me since I was born that medical profession has missed all my life…….I would highly recommend it to anybody who may be having other inexplicable health issues that the average practitioner cannot or won’t address. Was started on some Betaine HCL with Pepsin, other GI stuff and more to go. Getting better…….Like my practitioner states – you have to fix the gut before anything else will start to heal……

  28. I found it interesting to read that the urge to poop changes with age. 50+ for me has led to less frequency, typically once every other day. However, when its ready I do get a very strong urge to push. My stools tend to be very hard and lumpy (between 2 and 3 on the scale). The two things that bother me most are that 1) it takes a good 5-10 minutes to have a bowel movement as the stool is quite thick and long and, although I try not to, I do have to strain some while it is coming out; and 2) sometimes the urge to push happens at the most inopportune times when I’m not able to use a toilet right away. This tends to happen at work and it is so difficult sometimes to concentrate on work when I have this intense right there and ready need to poop.

    One thing that I don’t think the article mentions is the relief that one feels after a bowel movement. I’m guessing it has to do with how our bodies react after eliminating waste. Do you have any insight into this question?

    1. If at all possible, do try to poop ASAP, as ignoring urges can lead to other trouble. Maybe some of the ideas suggested in the article can help provide a more comfortable and convenient experience.

      I tend to be a first thing in the morning bathroom user, with BMs during the day if I’m eating more bulky produce, but don’t really notice a significant feeling of relief after taking care of business, except for no more pressure by my bum. If you are going more than 24 hours between BMs, I would think that there would be a more significant pressure build up and reduction.

  29. Thanks for publishing this. For the first part of my life, a bowel movement was something that happened, except when it didn’t, usually because of a lack of privacy or due to travel. Then I changed my diet to vegan and noticed a real change – mostly for the better. That extra plant matter does move things along.

    The descriptions are a little odd to me, as I used to be 2 and 3 with 1s as well, but I didn’t notice pain or much straining – except when I couldn’t go. Now travel doesn’t bother me and my bowel movements are more frequent and are 4 and 5 and something times 6. I’m glad to find out that “the snake” is not necessarily bad.

  30. Nice article. I use psyllium fiber and sometimes the width of my stools is 4cm. They come out in about 30-40 seconds. I go to the bathroom for a movement movement daily.

  31. Hi Laurie, I used to have good bowel movements until I had an appendectomy. Then had candida issues and many other problems. It turns out that appendicitis is the place for great gut bacteria and since mine didn’t have a proper home, I ended up with many gut related issues, IBS, Constipation, candida etc etc and thanks to probiotics through capsules and food, I’m much better now.

    I have a question about that footstool near the potty. I bet that helps with a good squatting position. could you share what it is called and where I can get one please.

  32. As a CNA in a nursing home, poo is one thing I have to know about to keep my residents healthy. I strongly suggest that if you have 5 thru 7 with an extremely foul smell, especially after a bout with gastroenteritis or other G. I. tract illness or antibiotic use, see a health professional and ask about c.diff. Its a spore that is not usually found in the intestines, but it can linger for a long time in the colon and on surfaces. It usually isn’t diagnosed until the situation I described happens, and it is treatable, but also highly contagious. Sorry I couldn’t get it to link. http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html

  33. When i have bowel movements i never look i usually just flush but i looked today I’m type 3

  34. My daily movement is usually after breakfast with an average of 6-7 inches in length with a diameter of 4-5 inches does this seem normal?

    1. If I’m understanding correctly, you’re passing a BM daily that more closely resembles a soda can than a rope. I am not a trained medical professional, but it sounds like you’re dealing with something in the type 2-3 range, which would indicate a chronic constipation issue even though you are pooping daily.

      At that diameter, that’s a sphincter stretcher for sure and may lead to anal canal laceration, hemorrhoids and other issues, as noted in the post (if it hasn’t already). DO NOT ATTEMPT TO ADD A BULK FIBER LAXATIVE! As noted above, additional fiber could be dangerous. If the general recommendations above do not provide relief, please see a trained healthcare professional, as each person is different and there may be secondary issues contributing to your constipation.

      This is a serious matter, because if waste is sitting in your colon too long, it can be reabsorbed into the body, contributing to inflammation and chronic illness over time.

  35. Passing a stool is also helped by a forward-rocking motion much better than just straining the lower bowel for a movement, which can cause problems.

    Just as the seated (rather than squatting) position is less helpful for passing stool, so too is the complete stillness and slackness of the abdomen when just sitting there. It’s too passive and unnatural, so nothing may happen.

    Instead, when you rock *gently* back and forth it often quickly encourages the stool (or several!) to get moving without having to push. You are physically shifting the abdominal organs around the bowel, and you are gently tensioning and releasing your abdominal muscles. It really works!

    1. Good to note, Jono. As we age, the peristalsis muscle contractions that move food through our digestive tract tend to weaken, so anything that can give them a gentle jumpstart may be helpful.

  36. Sorry Guys, got the wrong measurements above, average bowel movements daily is 6 inches in length by one and a half inches diameter, does this sound average?

    1. Again, still not a doctor, but using the chart as a reference, that’s still pushing maximum sphincter capacity – unless you happen to be an exceptionally large individual. Glad that it really wasn’t 6 inches in diameter.

      Study the descriptions of the bowel movements under the chart, and see which one most closely resembles your poop. Generally speaking, 2 or more bowel movements per day are recommended. If you are straining or pooping less than once a day, your system is not doing what it needs to do/getting the food it needs to function properly.

  37. In the text you say: “the maximum opening of the anal canal’s aperture (3.5 cm).” Is this true? I mean, I have poos that can be at least 4.5 cm and they come out without pain…

      1. Ok, thank you for your reply. I use psyllium fiber to make my stools firmer, and then sometimes they can become about 4.5 cm in diameter. Because of the fiber they are not too hard and come out pretty easy with a little pushing. Psyllium is realy the best fiber in the world!!!

  38. Hi I have on the Bristol scale between 3 to 4. Large and wide. I am regular and will have a bowel movement of this size every 2 days and then smaller ones daily. Sometimes a strain and most times very easy . Is this healthy or should I have it checked. I do also have a bariatric bypass. Thank you

    1. If you’re concerned about your bowel movements, it would be best to talk to your health care provider, especially given your bariatric bypass. I’m a researcher, not a healthcare provider, so please keep that in mind.

      Generally speaking, it would seem that your system is a little sluggish. You may want to consider adjusting your diet and see how it affects how you feel and how you poop. I know if I eat too much grain or dairy products, it slows my system down more now that I have reached my mid-40s. More veggies helps keep everything moving right along. Good quality probiotics and/or live cultured food are also a good addition to any diet. Digestive enzymes may also be a help, especially with your reduced stomach area for digestion.

  39. I confess I eat well with a balanced diet but only have the urge to empty my rectum once or twice a week. The type is Type 2, mostly lumpy and hard, the diameter can be up to 6.5 cm (about 2.5 inches) and the length short at about 5 inches. Can be bit of a struggle to pass sometimes, but fortunately no anal fissures or piles.
    The only downside is that flushing can be a problem until the stool has softened – often a day later.
    Does anyone else produce large hard stools and how do you cope ?

    1. Well Peter, judging by the fine array of laxatives available in your average pharmacy, I’d say that your are not alone. Stool softeners (such as this one) may help may your poop more squishy and easy to pass. The thing is, if you’re pooping something roughly the size of a soda can, it seems likely your digestion is a little sluggish – maybe more than a little. While the stool softeners may offer short term relief, long term, you may want to try different diet and supplement options, and see how it affects your bowel movements.

      For instance, I’ve settled into a routine with a high quality probiotic, in combination with life culture foods, to boost the good bacteria in my gut. Also, I find my bowel movements are much more likely to stay in the type 5 range when I eat more vegetables and a modest amount of meat and fruit, but limit grains (even gluten free) and dairy products. Binge on bread and cheese for a couple of days, and bathroom visits are much less pleasant. The paleo/primal style diets are gaining ground not just for weight loss or allergies, but because many people find that they function better getting back to the basics.

      It’s also possible that you may have an allergy or sensitivity that you are not aware of that is slowing down your digestion. You could try an elimination diet, switching to a very simple diet for a week or so, and then slowly reintroducing foods one at a time to see if you notice any difference.

  40. Thanks Laurie for your helpful advice.
    However, I avoid taking laxatives as I hate any side effects and loose bowel movements. Give me a firm movement any-day to a loose one.
    Should I start to develop piles or a fissure with an overly large-diameter hard movement I will think again.

  41. Hello,

    I have only recently noticed a change in my bm. I use to be a normal 4 however over the last week or so Ive been at more of a 6. Its usually somewhat formed sinks but then has several fluffy floaters and passes very easily. There’s no foul odor, doesnt seem fatty, and is every morning like clock work.

    I’ve made several changes in my diet due to high cholesterol. I eat smaller meals 3xs a day with snacks in between. Am avoiding high fat foods, less red meat etc. I’ve also been under a lot of stress the past two weeks which I noted could be part of the cause.
    However ive also increased my water intake considerably and pulled my usual coffee.

    Between the stress and the increased water intake could my body not be absorbing the water fast enough and causing these types of bowel movements?
    I saw g.i. 2 days ago and he didn’t seem to concerned because I was also on my menstrual cycle.

    1. Diet change is likely a factor. If your G.I. doc didn’t seem concerned, you’re probably okay, but you may want to consider some adjustments.

      I am NOT a doctor, so everything here is based on my own experience and research. There’s a few things that come to mind when reviewing your situation.

      1 – When you say you added water and cut coffee, how much water did you add? I know it’s currently in vogue to drink 8 glasses of water per day, but there’s no clear scientific evidence to back that up. (There are, however, a lot of bottle water sellers making a ton of money pushing the idea.) If you eat fruit and veggies (which is sounds like you may be doing since you’re cutting back on meat and fat), they provide a good amount of water, especially when fresh. Too much water can also be hard on your kidneys, slow down your digestion, throw off your electrolyte balance and slow down your metabolism.

      2 – Cholesterol is not the enemy. It performs many protective and critical functions in the body, and is essential for health. 50% of people who die suddenly from heart attacks do not have high cholesterol. If your doctor is concerned about your cholesterol levels, or you need to lower them for your insurance or other reasons, check out the post “15 Home Remedies to Reduce Cholesterol“. Page 2 of that post outlines the function of cholesterol in the body.

      3 – Fat and protein are not the enemy, although if you have a history of kidney stones, less red meat may be helpful. Protein triggers the feeling of fullness in the body faster than fat or carbohydrates, which can help you to eat less.

      4 – You didn’t mention probiotics or prebiotics. These are general helpful to include in the diet, especially as we age. Some prebiotics will also help bulk up stools, which may be helpful with your current condition. The post “My Anti-Candida, Anti-Psoriasis Diet – 9 Steps Towards Healing” may be worth a look. It identifies common problem foods, and suggests probiotic and prebiotic foods, along with some other strategies I’ve adopted to keep my guts in good working order.

      5 – At the risk of TMI, high stress levels sometimes make me poop like a goose (your #6 BMs). I get nervous, my guts get nervous, and everything clears out. It might be worthwhile to try meditation. (EFT) tapping or other stress reduction techniques. I have basic EFT instruction in the post, “Alternative Psoriasis Treatments – BodyTalk and EFT“.

    1. My condolences to your anal sphincter.

      More seriously – it’s largely (pun intended) a matter of what’s “normal” for you. For most people, that would be uncomfortably huge. I’d check hydration levels, ease and frequency of bowel movements (is there impaction and delayed defecation?), diet (too much fiber or not enough, possible food allergies) and other side effects (pain with pooping, bloody stools, hemorrhoids). Are you on medication that has constipation or other bowel movement changes as a known side effect. (Many common meds do.)

      If you are pooping regularly without pain, blood or other signs of stress, it’s probably not a matter of concern. If you have other symptoms or concerns, please work with a trained healthcare provider to address the specifics of your situation. I have no magical internet connected poop diagnostic tools, only general advice.

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