Pooing – What is Normal?

When your digestive system is healthy and operating as intended, you should be experiencing regular bowel movements – what regular means varies from person to person but can range from daily to three times per week – and you should be free of any disconcerting conditions like diarrhoea, gas, abdominal pain, and bloating.  If you are pooing less than three times a week or less than is usual you may be constipated. 

A healthy, properly functioning gut has a good balance of gut bacteria to aid digestion, produce vitamins and support immune function – and all of this contributes to the formation of healthy stools, the consistency and colour of which are the hallmarks of what might be referred to as a ‘normal poo’.  

Constipation is a disconcerting condition in which the body deviates from producing healthy stools, and bowel movements become more infrequent or difficult to pass – meaning there is also a deviation from how many poos a day is normal.  

We refer to constipation as a ‘stubborn stool’ as opposed to a ‘healthy stool’, because this reflects the sensation of trying to pass poo that has become hard, dry and uncomfortable. But why exactly does this happen? 

The movement of stools slows down
During normal, healthy bowel movements, the muscles in the intestines contract in a rhythmic motion as a means of moving waste through the digestive tract.  

During constipation, however, these contractions – and, as a result, the digestive system itself – slow down, which means that stools end up spending a longer period of time in the colon than is usual or ideal.

Increase in water absorption
When stools spend longer in the colon, that provides more time for the body to continue absorbing water from the stools. The end result is hard, dry poo – or ‘stubborn stools’ – that are more difficult to pass than healthy stools that have the optimal water content.  

Try not to strain when you poo 

Furthermore, straining to pass dry, hard stools can put additional pressure on blood vessels in the anus, which can sometimes result in the development of haemorrhoids (also known as piles). This is when the blood vessels become swollen around the rectum, forming painful lumps either inside or outside the anus.  

Feeling of not having fully emptied the bowel 

When experiencing constipation, it is common to have the sensation of not having been able to completely ‘empty’ your bowels when you go to the toilet. This is the result of stubborn stools being dry and difficult to move out of the colon, and therefore often becoming difficult – or even impossible – to be passed in their entirety. The resulting sensation can be very uncomfortable, both physically and mentally. 

There are a number of potential causes of constipation that can include a sub-optimal diet, low activity levels, mental strain or being on a course of certain medications.  

Dehydration 

Given that a  stool typically contains around 75% water, it should come as no surprise that dehydration is one of the main causes of constipation. A dehydrated body results in increased water resorption in the bowel removing the necessary moisture to make poo soft and easy to pass, resulting in a stubborn stool. 

Low fibre intake 

Fibre is a nutritional substance that is difficult for the body to digest. Instead, it bulks out your poo – making it easier for your stools to absorb water, which in turn makes them easier to pass.  

Lack of exercise 

Regular exercise stimulates the muscles in the intestines, which helps to keep the digestive system moving food and waste through the intestines at the correct speed – meaning that poo spends less time in the body, making it less likely to lose moisture and become a stubborn stool. 

Changes in toilet routine 

Not being able to go to the toilet at the usual times can throw your digestive system off – so on occasions where you are on holiday, for example, you might find that you are more prone to constipation because of the impact it has on how frequently your bowel movements occur.  

Certain medications 

Some medicines – especially opioid pain medications, but also some antidepressants, antispasmodics, diuretics and iron supplements – can have the unwelcome side effect of constipation. This can be difficult when the medication is being taken for a chronic condition, in which case it may be beneficial to seek advice from a healthcare professional.

Medical conditions 

Some medical conditions, such as irritable bowel syndrome (IBS) for example, can lead to a higher likelihood of constipation due to their negative impact on the regularity of bowel movements.  

‘Normal’ bowel movement frequency varies from person to person, but generally falls within a range of three times a day to three times per week. If you are having fewer than three bowel movements a week, you may want to start considering whether you might be experiencing constipation. 

That being said, there are a number of other factors to be taken into consideration alongside consistency. Let’s take a look at some of the characteristics that make up a normal poo.  

Frequency 

Daily: many people will simply have one bowel movement at around the same time each day.  

Alternate days: some might be on a less frequent routine, with a bowel movement every other day, or as infrequently as three times per week. As long as the stools are well-formed and the person is experiencing no discomfort, this is still considered within the normal range. 

More frequently: others may go more than once a day without experiencing any bowel issues, and this is fine too.  

The key is consistency – so that whatever is ‘normal’ for a certain individual continues to conform to their regular routine, as long as they are producing what would be considered healthy stools.  

What is a healthy stool? 

Healthy stools are usually soft, well-formed and easy to pass. They should be neither too hard nor too loose, and if compared to the Bristol stool chart should ideally closely resemble types 3 and 4, which are considered the healthiest and are characterised by being sausage shaped and smooth or with cracks on the surface. 

What does a healthy stool feel like?  

A healthy stool should pass without excessive straining or pain, and after you’ve finished you should have the sensation of having completely emptied your bowels.  

What does a healthy stool look like?  

The colour of a normal poo should be medium to dark brown. This is the result of a pigment called bilirubin, which is formed when red blood cells break down.  

What does a healthy stool smell like?  

Even the healthiest stool is never going to smell great, because there is a certain amount of bacteria in your poo that will inevitably cause an unpleasant odour. However, any change during which the odour becomes particularly unbearable might be an indication that you are not passing an ideally healthy stool.  

If you have noticed that your bowel movements have become irregular or you suspect you may have a stubborn stool, there are a number of measures you can take to try and relieve your symptoms.  

On the occasions when that isn’t enough, however, there are some over-the-counter medications that are available to help. Movicol^® , for example, is a gentle, effective form of constipation relief that works by drawing water into stubborn stools so that they become softer and easier to pass.  

If there are significant or persistent changes in your bowel habits, be sure to check with your healthcare professional for advice and to address any potential root causes.  

Movicol^® Ease Powder for oral solution contains macrogol. For constipation. Always read the label.