Did You Know #2 : What Your Poop’s colour tells about Your Health

Even the everyday observation of something so trivial as our poop can give some great insights into what’s going on inside the body. Curious? We tell you how!

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Stool color indicates health and disease.

The normal poop can look anything from yellowish brown to dark tan, depending on a number of factors, including the composition of the food you eat, the amount of water (and alcohol) you drink and the type of work you do. Then how to assess the color for abnormality? Here’s a list of red flags you should know –

A) Black/blackish stools
The less serious reason for this is excessive iron intake in diet or medicine. Black stools are especially common in people taking the classical “red iron pills” (Ferrous sulphate/ fumarate) supplied in government hospitals. This is frequently accompanied by constipation.
The seriously harmful reason is bleeding in the gut. The black color comes from coagulated blood mixed with stools, which denotes that the source of bleeding is in the upper part of the bowels, distant from the anus. The causes of such bleed are numerous. Most common ones are listed below (accompanying signs and symptoms in brackets) –
1. Peptic ulcers ( vomiting, upper abdominal pain, history of hyperacidity, heartburns)
2. Ingesting sharp stuff like glass etc., by mistake. (Black stool that later turns red, pain)
3. Enteric fevers like dengue or typhoid can sometimes cause upper gut bleeding turning stools black. ( fever, skeletal pains, vomitting, diarrhoea, etc.)
4. Consuming excess of irritant purgatives (Croton seeds, Plumbago root etc.) or any gastrointestinal irritants.
5. Bleeding esophageal varices (pain of throat/chest, difficulty swallowing, vomitting)
6. Carcinoma of the stomach (rapid loss of weight, sudden change in dietary preferences, uneasy feeling in the stomach, history of peptic ulcers etc.)

The actual differential diagnosis is a physician’s job only. So, if you aren’t taking a lot of iron and have fever / heartburns / abdominal pain / “lump” feeling in the belly / vomitting alongwith black stools, its time to see the doctor.

B) Yellow stools
Stools get the yellow tints due to stercobilin, a pigment formed as a by-product of the liver metabolism. Its production is increased in all types of hepatitis and several biliary disorders. Yellow stools due to liver disease is mostly accompanied by jaundice. This is specially an alarm sign in alcoholics, in whom it indicates an excessively strained liver. However, it can sometimes be a normal sign in children; for example, in natural neonatal jaundice which resolves automatically in a couple of days.

C) White-Clay colored Stool
This occurs when the bile doesn’t reach the guts sufficiently due to some reason, most commonly due to obstruction by gall stones. If this condition is accompanied by jaundice (yellowing of eyes, nails, skin etc.), pain or tenderness in the upper/ upper-right part of your belly or dark discoloration below the navel, you need to see a doctor immediately.
Exception – Certain bulk laxatives like kaolin can impart such color to stools. If you are taking one, stop it and reobserve. If the color and pain persist, see the doctor.

D) Green colored stools
This, combined with pain in the lower belly, is an indication of bowel inflammation, most commonly by protozoal infection. A visit to the Doc is in order here too.
Exception – Greenish stool after a meal rich in green leafy vegetables is perfectly normal, as the chlorophyll pigment in these veggies is excreted as it is, when excess.

E) Reddish stained stool
The first culprit that needs to be excluded is beetroot. Just as with the leafy veggies, the red pigment in beetroot makes the poop reddish. Also, if one is taking the drug rifampicin, chances are that your stools, along with your urine turn reddish. These are no alarm indicators and can be neglected very safely.

Then comes the real nemesis, blood in stool. Blood stained stool can indicate a very wide number of conditions in your guts’ lower part, ranging from simple anal fissures to even rectal cancer. Panicked? Don’t be! There’s a saying in the medical field – if you make a rare diagnosis, you are rarely correct. Almost 99% times, it’s one of the simpler reasons. How to be more sure still? Here’s a small indicative differentiation list –
(Note – This is just for your knowledge. DO NOT use this to diagnose yourself. Clinical diagnosis is the doctor’s job, not yours.)

1. Anal fissures – present mostly with constipation, cause intense ‘cutting’ pain while passing motions and some minutes afterwards. Stools generally have a linear streak of blood on the side of the fissure.

2. Bleeding piles (haemorrhoids) – cause profuse bleeding, generally after passing motions. This condition is many a times painless, or with moderate burning pain for a few hours after defaecation.

3. Ano-rectal fistula/abscess – The bleed is mostly minimal or even absent. Pus may be found on microscopic examination, or rarely by naked eyes in the stools.

4. Bacterial infections of gastrointestinal tract – can cause lower GI bleeding. They are mostly preceded with moderate to high grade fever and abdominal pain.

5. Ulcerative Colitis – Carries the usual signs and symptoms of colitis in addition to bleeding per rectum, but is much higher on the severity scale.

6. Carcinoma of rectum – accompanied by constipation caused by obstruction, rapid weight loss, “lumpy” feeling in lower bowels and other symptoms of space occupying lesions.

Having had this diagnosis primer, its time to have a flash card for your ready reference.
So here it is!

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Stool color chart

Save it, print it, pin it, share it, do whatever you like. The next time your tummy sends an alarm signal down a lower end, you are ready to read it and respond!
Have a good time.

Stay healthy, stay happy!

About the Author – Dr. Harshad Rajandekar is an Integrative Medicine Practitioner specializing in Ayurvedic medicine and Yoga, running a private practice at Nasik, India.
He also gives consultations and public lectures on Ayurvedic dietetics and nutrition.

Disclaimer – This article is written solely for patient awareness purposes, and NOT meant to be used as alternative or replacement to clinical therapy, or as medical education.

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