Your poop - The crystal ball of health - (6/29/2021)

By Dr. Ron Gasbarro

Mr. Loo walked laboriously into the pharmacy, stooped over as if he was drained of energy. He shuffled over to the pharmacist and asked, "Where is the Number 2 aisle?" "You mean Aisle 2," replied the pharmacist. "Why, it's right over there beyond Aisle 3." Mr. Loo then grunted and began to rub his tummy. "No, I mean the stuff to go Number 2 because I can't." Can't what?' asked the pharmacist. "I can't go Number 2!" Mr. Loo growled. "OK, that's in Aisle 6," directed the pharmacist. "Oh, that makes sense," Mr. Loo said acerbically as he hobbled off but not before launching a gassy, sulfurous salvo that may soon evacuate the store. 

As we see, constipation is no garden party for either the constipated or those who breathe the same air. Yet, it is worse for Mr. Loo. Constipation means that one's intestinal tract is not working to clean out the solid wastes left behind by the foods we eat. In fact, the color, texture, and timing of our stool can give us a good picture of our overall health. Many people do not like to peer into the toilet bowl after they defecate. But occasionally, it is a good idea to get a sense of one's poop for health reasons. Oh, where to begin?

How about color? Normally, your fecal palette should be in the brown (chocolate to mocha) range. Why? When your digestive tract is functioning normally, a yellow-orange substance called bilirubin is formed in the liver. Bilirubin contains dead red blood cells and other wastes. The bilirubin combines with the yellow bile from your liver to create a cocoa-colored stool. Some people report green poop. What gives? Put down your sandwich and hear this. If you are a vegan, it probably means you ate a ton of greens lately. These plants are made mostly of indigestible cellulose. So, what goes in is the same as what comes out. The same with corn – but you've probably noticed that. Bloody or black tarry stools are a signal to call the doctor. A very pale or even white stool can signal hepatitis. Here, the liver is not pumping out bilirubin – a possible medical emergency.  

Texture is crucial. Stools should be soft, fluffy, and easily passable. (Enjoy the go, as the Charmin commercial urges). Yet, we all have the odd bout of diarrhea or constipation. Typically, constipation is caused by the foods we eat – or don't eat. For example, mac 'n cheese is great. But without fiber to carry it through the intestines, the result is like pouring concrete down a storm drain. Diarrhea is a soupy mess caused by medications, stress, or foods, such as most of what is on Chi-Chi's menu. The danger of chronic diarrhea is dehydration, particularly in young children and older adults. If an over-the-counter medication does not plug up your butt, seek help. 

Smell is everything. Meat and dairy are harder to digest. Therefore, they stay in the colon and putrefy as they mosey along. People who eat copious fruits and vegetables have stools so sweet, you'll ask why Kim Kardashian didn't bottle the scent as her signature perfume (well, almost). The timing of defecation varies. It could be so regular that you can set your watch by it. Other people go once every 2 days. The frequency is whatever feels right for you and is based on your food and water intake. Only do not make it a habit to sit on the pot while you catch up on your reading of 19th-century Russian novels. Painful hemorrhoids can ensue from the straining, throwing your behind out of kilter. 

The pharmacist strongly stresses the need of a regular colonoscopy. While what comes out can tell you a lot, what is going on in the deep dark folds of your colon is not so apparent. Let your healthcare provider peek inside. You could live longer because of it. 

Ron Gasbarro, PharmD, is a recovering pharmacist and writer-in-residence at Rx-Press.


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