On the topic of bowel habits there is a lot of variation between different people. What is normal for one person is not normal for another. Most important, is if there is a definite change in your bowel habits, which lasts for more than 2 to 3 weeks, and for which there is no obvious cause. If this happens you should make an appointment with your GP.
Perhaps you usually open your bowels (have a ‘poo’) once every 2 days and then suddenly you are going a few times daily and the motion is loose. You need to consider whether you have made any recent changes to your diet such as eating more fruit and vegetables? Next is to think about whether there have been new medications e.g. antibiotics, which could be responsible for this change. If there has been no obvious cause, your doctor may ask you to provide a stool sample, to check for possible infection. If there is still no obvious reason for the change, it may be necessary to be referred to the hospital for tests, such as a colonoscopy, to rule out the possibility of bowel cancer. In most cases this will not be found, but it is essential to rule it out.
Ideally, your motions should neither be soft and paste-like nor hard and in small pieces (like pellets), and you should not need to strain to open your bowels. If the motions are greasy and hard to flush away, this can be a sign that you are not digesting your food properly. In some people it may be a clue for coeliac disease, where gluten in the diet is not tolerated, or for problems with the pancreas or liver. If you notice this please tell your GP or nurse. Seeing some undigested food in the stools is less of a problem – often higher fibre foods, such as sweetcorn, may pass through you undigested.
If you notice blood, this can be a cause for concern and should not be ignored. Once again, it is wise to speak with a doctor. There may often be a simple explanation, such as haemorrhoids, but blood in the motion, or dripping into the toilet when you have your bowels opened, may be a sign of cancer. Even if there is only blood on the tissue when you wipe yourself, it is worth mentioning this. More rarely, a very black motion, appearing like tar, is likely to contain blood from high up e.g. in the stomach or small intestine, and it is urgent to get this checked out as it can be a sign of a bleeding ulcer.
A very black motion, perhaps also with abdominal pain or vomiting, it is safest to get an ambulance and have it checked out urgently. However, if you have recently started iron tablets, you may notice that the motion turns grey in colour and if you are otherwise well, this is not something to worry about.
You do not need to have a bowel motion every day. Some people only open their bowels every few days and again what is most important is what is normal for you and also whether you are comfortable or feel bloated. If you are prone to constipation, it can help to drink plenty of water, to increase the fibre in your diet e.g. having oat bran, ground flax seeds or psyllium husk or simply having more vegetables, nuts and seeds and also try to exercise regularly. Sitting on the lavatory with your feet on a shoe box or small pile of books, so that the knees are bent and raised and leaning slightly forward can help to reduce the need to strain.
In contrast, if you are worried about needing to find a lavatory when you are in a public place because you have a tendency to need to hurry to have your bowels opened, it is often possible to get a special card to carry in your wallet. Various charities, such as ‘Bladder and Bowel Uk’ can issue a ‘just can’t wait’ card. If you show this at the reception desk or counter in many shops or businesses or trains, they should be aware to allow you quick access to their toilets.
To summarise, you do not need to frequently check on your bowels, but it is wise to be aware of what is normal for you and to notice if there are any changes or especially any blood. If you are concerned, do not be embarrassed to mention it to your doctor. They are very used to these discussions. Above all, do not wait too long to get this checked out. If there is bowel cancer, early diagnosis can mean a better than 90% chance of a cure.
Author Dr Jackie Rose, a Nutritional Therapist heads up the Nutrition Clinic at Private GP Extra. Dr Rose is an experienced GP (recently retired from practice) who specialises in nutrition and has co-written a Healthy Eating Cook Book. Find out more here https://www.privategpextra.com/nutrition-private-gp-extra/
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