

Studying Stools

Copyright 2002. Karen DeFelice. last updated 8.25.05

Note: Digestive enzymes may have a significant positive impact on regulating stools and elimination.

The Enzymes for Digestive Health and Nutritional Wealth book discusses how and why in detail.



If you are looking for a Poop Group, somewhere to ask questions about interesting body by-products, you can go here http://groups.yahoo.com/group/enzymesandautism A lot of information can be gathered from just observing stools. Color, texture, consistency, and other 'properties' can give clues to what is happening in digestion. This article is intended to help with stool detective work by parents and is only given as a guide. Visually inspecting stools alone are not diagnostic of anything. Other symptoms and signs are generally present. Please consult a health care professional with further concerns.You will see there is some overlap and what comes out one day may be due to someone that happened on previous days due to transit time in the gut. 1. Dark-colored stools may be seen in platelet function disorders, iron deficiency anemia, cirrhosis, colorectal cancer, disseminated intravascular coagulation, peptic ulcer, or stomach cancer. Liver disease may include a yellow tone to the skin and whites of eyes (jaundice) and brownish urine. 2. Black or tarry stools (Melena) - the passage of black, tarry and foul-smelling stools; can be an indication of digested blood in the stool. Other causes are, iron deficiency anemia, cirrhosis, colorectal cancer, disseminated intravascular coagulation, peptic ulcer, or stomach cancer. In advanced cirrhosis (liver disease), the abdomen becomes distended with fluid and ruptured blood vessels in the stomach and esophagus cause bleeding. The person may vomit blood or pass black stools. Very dark stools, for example, may indicate an ulcerative lesion in the higher digestive tract.



Note: The ingestion of black licorice, lead, iron pills, Pepto-Bismol, or blueberries can all cause black stools or false melena. Stools should be tested for the presence of hidden blood. 3. Blood in the stool (Hematochezia) - the passage of red, or maroon- colored stools. Red or "frank" blood in the stool could be caused by hemorrhoids. Bloody stools can also be seen in amebiasis, anal fissures, or colorectal cancer. Bright red bleeding with bowel movements may be due to hemorrhoids; however, other conditions such as colonic polyps or tumors, diverticulosis, and abnormal small vessels called AVMs also may cause bleeding. Unusually, the bleeding is coming from the upper intestine or stomach. Bleeding such as you describe usually is evaluated by colonoscopy. Blood, as seen in the stool, can originate anywhere along the intestinal tract. A black stool usually means that the blood is coming from the upper part of the GI tract. At least 6 Tablespoons (or 200 milliliters) of blood must have been lost in order to cause passage of melena. Maroon-colored stools or bright red blood usually suggest that the blood is coming from large bowel or rectum. However, sometimes can be caused by massive upper GI tract bleeding. Some upper GI causes of bloody stools can also cause vomiting blood such as in peptic ulcer disease. The color of the stool can suggest the location of the bleeding however this is not reliable. A definitive diagnosis will require radiographic and/or endoscopic investigation. Black color –

- bleeding ulcer

- gastritis

- esophageal varices

- a tear in the esophagus from violent vomiting



Maroon color –

- all the causes of black color stool

- diverticular bleeding

- vascular malformation

- intestinal infection (such as bacterial enterocolitis)

- inflammatory bowel disease

- tumor

- colon polyps or colon cancer



Bright red color -

- all the causes of black or maroon color stool

- hemorrhoids

- anal fissures ("cracks" in the anal area) 4. Gray stools, pale stools, putty or clay colored stools may be seen in hepatitis, gallbladder disorders, or malabsorption conditions. Bile salts in the stool excreted by the liver give it a normal brown color. Obstruction to bile flow out of the liver (you may see the word "cholestasis"), or liver infections like viral hepatitis (A, B, C, etc.), may produce clay colored stools. Possible causes for clay colored stool result from problems in the biliary system (the drainage system of the gallbladder, liver, and pancreas): Malabsorption problems can cause undigested fat in the stool (steatorrhea) which is characterized by foul smelling, light yellow to gray, greasy or frothy stools. This may also be caused by low bile output. 5. Green stools may be bacteria, or a green or blue food eaten. Green, blue, or yellow artificial colorings too. 6. Orange stools may be due to certain medications. Beta-carotene (a form of vitamin A) may cause orange stools as a side effect so check any sources of vitamins or supplements, as well as intake of foods high in beta-carotene (carrots, sweet potatoes, etc.). Another possibility is if the stool is more pale-orange, it might indicate lack of bile salt (which gives stool a brownish color). Other sources are antacids containing aluminum hydroxide, barium from recent barium enema test, and hepatitis. Consider checking some baseline liver tests to evaluate proper liver function. ??Artificial orange or yellow colorings, or other artificial colorings can product orange stools. Hi :) Where on earth did you ever get the idea that bright yelloe stool indicates excessive bile involvement ? . Nothing coud be further from the truth. It's the opposite. It is the addition of bile into the intestinal tract as part of the digestive process that actually turns the stool brown.



Stool starts out green , then turns bright yellow as it goes through the digestive tract. It is bile and bacteria that finally turn it brown. Yellow or green stools can indicate stool is passing through the digestive tract too rapidly not giving it a chance to change colour. Bright yellow stools can also indicate not enough bile / bilary obstruction.

7. Heavy, fat-rich stools can indicate various intestinal and pancreatic disorders, and so forth. Can also be due to malabsorption or insufficient fat breakdown. 8. Diarrhea - The passage of an increased amount of stool. This is frequently considered to be 3 or more stools per day, or excessively watery and unformed stool. Chronic diarrhea occurs when loose or more frequent stools persist for longer than two weeks. Diarrhea causes can be grouped into several general categories. Infections – viruses, bacteria, parasites

Toxins - often referred to as 'food poisoning.' Toxins may be produced in foods as bacteria grow. These toxins are responsible for the associated vomiting and diarrhea.

Malabsorption - lactose intolerance, celiac disease (sprue) or gluten malabsorption, cystic fibrosis, cows milk protein intolerance, intolerance to specific foods (beans, fruit, etc.) There are other less frequently encountered causes of malabsorption.

Inflammatory Diseases of the Bowel – Crohn's disease, ulcerative colitis

Immune deficiency

M edications – antibiotics, laxatives (especially those containing Magnesium), chemotherapy

Other 9. Floating stools

Stools that float are generally associated with some degree of malabsorption of foods or excessive flatus/gas. Floating stool is seen is a variety of different situations, the

majority being diet-related or in association with episodes of diarrhea caused by an acute gastrointestinal infection. A change in dietary habits can lead to an increase in the amount of gas produced by bacteria in the gastrointestinal tract. Similarly, acute gastrointestinal infections can result in increased air/gas content from rapid movement of food through the GI tract. One misconception is that floating stools are caused by an increase in the fat content of the stool. In fact, increased air/gas levels in the stool make it less dense and allow it to float. Another cause of floating stools is malabsorption. More than two weeks of diarrhea with floating stools is often seen in people suffering from malabsorption, a dysfunction in the GI tract that affects the body's ability to digest and absorb fat and other food. Increased levels of nutrients in the stool (those not absorbed by the GI tract) are supplied to the normal bacteria that live in the gut, which in turn produce more gas. This results in more air/gas- rich stool that floats. Dietary changes, diarrhea, and malabsorption can cause floating stools. Most causes are benign and will resolve when the infection ends or the bacteria in the GI tract become accustomed to the changes in your diet. 10. Stinky stools - stools normally have an unpleasant odor, but one that is recognized as fairly common or 'typical'. Stools that have an extremely bad, out- of-the-ordinary odor may be associated with certain medical conditions. Foul-smelling stools also have normal causes, most notably diet. Foul smelling stools may occur in conjunction with floating stools. Extremely foul smelling stools can be due to bacteria overgrowth. Some bacteria produce hydrogen sulfide which has a characteristic rotten egg smell (horrible stench). It can also be the putrifying debris in the gut. Ammonia smelling stools can be attributed to bacteria overgrowth or nitrogen being insufficiently digested or improperly metabolized. When food is insufficiently digested, the non-absorbed food can then become food for harmful bacteria, or just putrefy, in the gut. Either of these leads to toxins being released in the body. Sulfur smell - a few people noted that if they eat more sulfur containing foods and have a yeast problem, the yeast may feed on the sulfur foods and get worse. These cases also say an increase in yeast with sulfur supplements. Other supplements reported to produce a smell when not absorbed and metabolized well are selenium, glutathione, and SAMe. Besides smelly stools, a person many have bad body odor and bad breathe even shortly after taking a shower or brushing teeth. 11. Yeasty stools – "yeasty" stools indicate the presence of yeast, but are not the only indication of yeast. These may appear during either yeast growth or die-off. Possible yeast-looking stools include: cottage-cheese looking stools

frothy stools…like yeast bread rising

yeasty smell to stools

stringy-ness to stools…like cheese strings 12. White specs in stools:

1. Rice (may cannot even digest rice)

2. They've been eating paper

3. or, something else they can't break down. For my daughter this would include any kind of bean, nut, seed, grain, vegetable, popcorn, etc. She initially was ok with rice but later on (about 10 mos.) stopped being able to digest pretty much anything. Eventually found white little seeds from the Mesa Sunrise Waffles. 13. Black specks may be seeds, foods, or from die off of yeast or bacteria. If you start any supplement that might create looser stools, temporary diarrhea, or die-off of yeast or bacteria (like an antibiotic, probiotic, digestive enzymes, antifungal, laxative, etc), you might see dark or black flecks in stool during this 'cleaning out' period. Certain types of adverse bacteria in the colon can produce dark residues and this is getting cleaned out. 14. Severe constipation, or alternative constipation and 'diarrhea' (or loose stools) This could be encopresis.

see Encopresis 15. Adding Fiber: Remember the Water!

Fiber is often recommended to help with constipation. The idea is to add fiber which will absorb more water into the colon and help make stools softer and easier to pass. This applies to over-the-counter sources as well as whole food sources. But you need to remember to drink sufficient or even extra water too in order for this to work. If you are having problems with constipation, consider upping the water intake along with the fiber. This might not need saying but then again it might be one of the overlooked factors. Kd. 16. Mucos in Stools Mucos is produced in the intestinal tract as way to coat and protect the gut lining. Having too much or too little mucos can cause problems. Proteins are digested in the stomach but carbs need to be digested in the intestines. If your child has leaky gut, the intestines will form a layer of mucus in the lining to protect itself from the irritating di and polysaccharides. But it also means that the natural enzymes in the intestines cannot get to the food b/c of the layer of mucus, so it becomes fodor for the yeast, microbes and bad bacteria living there. Because the supplemental enzymes are digesting the food in the stomach, the food is not causing any more problems in the intestines and the need for protective mucus is decreasing. My son had mucus in his stools for about 3 weeks. It is the body clearing itself out and detoxing. The next thing I noticed after the mucus went away was a much more healthy skin tone which I think meant he was finally absorbing the nutrients from his food. You can have mucos for a variety of reasons. However, since you know there was lots of gunk in there, and just started an enzymes/probiotic program with help cleaning out the gunk, the mucus can be sloughing off in this process. The alternating stool consistency can also be part of this process. Allow a couple weeks for the bulk of the cleaning out to happen. I know there is the tendency to analyze things on a minute by minute or hour by hour basis, but the transit through the gut can be a matter of hours, days, or weeks. Allow about a week to evaluate changes in diet, supplements, or meds to see the net results (unless there are drastic healthy problems happening, of course).

The information on vFair.com is for educational purposes only. vFair.com is not engaged in rendering medical advice or professional services. The information provided throughout vFair.com should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have, or suspect you may have a health problem, you should consult your healthcare provider. http://www.clevelandclinic.org/quality/08-20/08-20b.htm

http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm 17. Notes from Another Stool Detective Link to more notes and observation on stools