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Let’s talk about POO

Posted on October 24th, 2007 by Alison Read 29 Comments - Add Your Own »

toilet.jpgNo one likes to talk about poo. POO is TABOO!

Since being diagnosed with celiac disease and becoming a mother of children with food allergies, I feel I have become somewhat of a poo analyst (hmmm… business cards?) It’s just that after you clear the stuff you are sensitive to out of your system, you are very aware of any changes in your stool. When people come to me for advice, I often ask about it (poo), because there is a lot to be learned from it (again, poo).

One thing is for sure — people don’t know what a normal stool is, and often people assume that having constipation or loose stools is normal because they have lived with it for so long.

I did some research and it turns out that there is a way to classify poo – with the Bristol Stool Chart, which categorizes stools into 7 types.

What is your stool type?

Type 1 = Separate hard lumps, like nuts (hard to pass)
Type 2 = Sausage-shaped, but lumpy
Type 3 = Like a sausage but with cracks on its surface
Type 4 = Like a sausage or snake, smooth and soft
Type 5 = Soft blobs with clear-cut edges (passes easily)
Type 6 = Fluffy pieces with ragged edges, a mushy stool
Type 7 = Water, no solid pieces, entirely liquid

Healthy stools are usually considered to be those falling into categories 3 or 4, the ones that are the most comfortable to pass. Now, if you are really interested in this, and need more clarification on the stool types, and no one is looking, go check out the visual of the Bristol Stool Chart.

The relationship between stool health and food sensitivities

It is interesting to note that celiac disease can present with either constipation or diarrhea as a symptom, and sometimes a person can even alternate between both. Most people with celiac disease or gluten intolerance say that if they inadvertently get gluten, their stool will change for the worse.

With food allergies, it is common to have diarrhea as a symptom. The first time I knew my daughter had an allergy to avocado, she had diarrhea that began about 2 hours after eating it, and continued for 2 weeks! A pediatric nurse told me that the reason the diarrhea was green and smelly was because the food was going through the digestive system too quickly and the result was that bile (which is green) was being excreted. My daughter’s unusual avocado allergy was later confirmed with a skin test.

When my daughter was older, I removed dairy from her diet because eating it caused her to have large, smelly, soft, greenish stools (accompanied also by rashes). Her stools improved, but she sometimes complained of tummy aches and her stools were still not “right.” I had a suspicion that it could be soy, since she had started eating more of it (most dairy alternatives are soy-based). I have recently removed all soy from her diet and sure enough, her stools are now in the healthy range (which can also be characterized, in my opinion, by a clean wipe). No more tummy aches and improved behavior too. Her dairy and soy intolerance were confirmed by a stool test.

Why does this matter?

There are certainly times when a person’s stool may be out of the healthy range and it is not celiac disease or a food intolerance or allergy (eating a lot of certain types of fruit, for example, or a case of food poisoning). But if a person is consistently out of the healthy range, it may be an indication that something else is going on — an immune system response perhaps. In that case, there may be other damage occurring in the body and it is important to remove the offending food from the diet. Please see your doctor for testing and advice.

Whew — after writing all that, I’m pooped!

Related reading:

Symptoms of celiac disease
Allergy vs. Intolerance
Corn and my baby

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  1. you forgot to mention my own criteria: color and smell and mucus.
    That how I describe the no-nos:
    – neon green mucus (think bits of green apple jello that came from nowhere). this is usually the most unmistakable sign of food allergy. And an urgent call.
    – anything green as in grass green, apple green
    – anything mucus, as in bits of jello (could be orange, yellow). those colors would appear in a newborn breastfed baby (as early as 3 weeks old for mine) who has food allergies/intolerences.
    – anything RED, DARK RED, or “black powder” should be carefully recorded and mentioned to the doctor, as this is usually a sign of bleeding.

    and as for the smell, it’s difficult to describe, but I’d say that my son’s gluten poops stink something very close to a drunkard’vomit. Which make sense, as the food is not digested, so it stays “acid”. As a rule of thumb, breastfed babies poops smell close to nothing, and not breatfed babies shouldnt have stinkies you can smell two rooms away.

  2. Sophie,
    Thanks for the additional description — unfortunately, I know exactly what you are talking about!

  3. I was surprised not to see a description of steatorrhea, which is a situation where fat floats on the surface of the water of the toilet and the whole stool is frothy and extremely smelly. Most offensive. That was the key that finally sent me to the MD and a diagnosis of celiac disease.

    I don’t know why celiac is underlined in red on my screen, but I’m not sure of the correct spelling for steatorrhea or is it steatorhea? – no, that does not look right. Anyway, it is not a commonly used word and probably not in the computer’s spell check list.

    Thanks for a good article and the Bristol Stool Chart. Having gone to school in Bristol, England, I found it most amusing.

  4. My son is sensative/ intolerant of artificial colors, flavors and salicilates.

    But poop was one of my BIG problems that sent me on the path to finding a solution. It is often one of the first things I ask about.

    Smell– my son’s were always sweet. I was in the family room at SILs one day while she was changing my niece in a nearby room. I could smell the diaper and asked what she was reacting to– her mom was amazed– it was a recation to strawberries– something that causes mucusy, sweet smelling poops in my son.

    Acidic– Depending on the food, the poop was so acidic it would burn his bum BADLY in the 30 seconds it took to lay him down for a change. Have not noticed this since he is potty trained 3 years ago– but that is also probably due to the fact that we follow a pretty strict diet.

    Uncontrolable– Depending on the food and amount, he is pooping before he notices he needs to go to the bathroom.

    Thanks for the chart. That just totally confirmed what the Drs. never believed– my kids poop was not normal!

  5. Joyce,
    I have found that some pediatricians don’t care about poo at all unless there is something totally out of the norm (but these days, what is COMMON is considered NORMAL, even if it’s not). But I believe the proof is in the poop! 🙂

  6. My daughters poop was gritty/grainy. As if she was eating sand castles for lunch. It was hard to clean her when we changed her diaper and had to use handfulls of wipes. Is there ever such a thing as TMI in a Poop Post? 😉

  7. Nicole,
    Did you figure out what is was??

  8. Poo, I am glad that I am not the only one who notices and sometimes panics! My son is 17 months and he has had poo trouble since he was born. For months they consisted of nothing but green water. Sometimes containing little black specs that almost lookes like old paint chips. The rashes were so out of controle that I stoped using wipes. I just put him straight into the bath after a BM. I switched pediatricians because he was also presenting with severe vomiting which had been since birth. I just had no answers. Our new pediatrician tested him for chrones disease and Celiac disease. The celiac test was not fully explained to me but it must have come out positive because we were told that he needed the biopsy test to be sure. My husband and I disagreed on weather or not he should have the test done. I was for it, but my husband thought of it as torture. So we didnt have the test. 6 months later i take baby in for his shots and he has dropped to the 10th percentile on the growth chart. I put my foot down and decide to just go gluten free. My son has been gluten free for almost 3 weeks. He sleeps longer, eats more, and cries less. And for the first time He is having solid poop. My problem is that right before the diet change his stools were so light yellow that they almost looked white. Now that the stools are solid they are still a very light yellow and they almost look like they are made of an off white chalk. The smell is still as bad as before the diet and I dont know if that will ever change, but the color worries me.

  9. P.S.~ for any one battling bad diaper rash I recomend CALMOSEPTINE. I made my doctor give my a prescription of it and the rashes disapear.

  10. Jamie,
    It sounds like your son is making progress! I ended up eliminating dairy and soy from my daughter’s diet before I felt she had normal poo! If is smells bad, you might look at those two very common allergens.

  11. two updates since my first comment.

    – my son had is first normal BM just shy of four. He SCREAMMMMMMMED from the bathroom that “something was hurting his but”. He had never felt any sensation there, beside burns or wet etc.. It’s funny to recall, but at the time, it was a slap in my face, when I was working so hard to potty train him (this would explain that – of course!).

    – my own accidents are now my “cow” episodes.
    I’m not sure if it’s a #5 or #6. but it’s explosive like a viral diarrhea – preceded and followed (10mn) by strong stinky gas. It’s in the bowl in a thick clean pile (just like the photo above) – and you know you’ll have to flush 3 times. But for a child in diaper, it could look like everything and anything…

  12. My almost 3 month old has been having very phelgmy watery poops since he was a month old. They had been green and frothy and sometimes bloody for a while but I’ve eliminated dair. And that helped. But they are still just phelgm and liquid. My doctor says he may just have phelgmy poops but I don’t accept that. Any suggestions on what I should look into?I just don’t think he’s getting the nutrition he needs and I think the phelgm is the reason. There seems to be more when I eat green veggies and I don’t know if they cause more phelgm or help eliminate it. Any ideas would be greatly appreciated.

  13. Mandy,
    I think the most important thing is to trust your own instincts as a mother. My pediatrician was not very interested in poop. I think the reason could be that many babies suffer from food intolerance and therefore have weird poop (and they also probably suffer from colic or irritability, but nobody thinks that is a problem that can be solved!) It is a case of what is common becomes “normal.”
    So, keep investigating what is bothering your baby. Gluten is certainly a big offender, so you might try that next. And don’t worry, you won’t be depriving your baby of any nutrients by cutting out gluten as long as you are eating a healthy and varied diet. I breastfed both my daughters and didn’t eat a speck of gluten!

  14. My story is long…so I will try to cut to the POO of the situation. I have Celiac disease and believe my 2 yr. old does as well. He has had difficulties with consipation since birth. (2 months pre-mature) He is now gluten free and does have a bowl movement daily, however, they are still very large and hard and painful. When he eats gluten he does not go for 7-9 days without medication. He does not eat a lot…in fact I have a hard time getting him to eat much at all. He drinks a lot of water daily and some rice milk. Any one with any advice on what food alergy I may be missing here I would greatly appreciate it. I am trying to potty train him, but because of the pain it is not working very well.

  15. Tammy my story is long as well and I’ve just found out that I have Celiac… for years Dr. prescribed meds wouldn’t move my poop but someone told me about “Natural Calm” found at the health food stores that is a powdered magnesium sweetened with stevia (is not marketed as a laxative but I’d heard of Milk of magnesia sold in stores). It may have calcium too and I don’t know if they have it for children or if safe for little ones but I’d look into it if your 2 yr old still having trouble. It is the only thing that moved my bowels painlessly and cramp free and made it look like anything close to the healthy range listed above. My understanding is that it just pulls water into the bowels. I was told to start with one teaspoon of powder in glass of h20, if no movement next day take 2 tsp and so on until regularity was achieved. I will tell you I traveled once without it by accident and tried several different kinds of capsuled magnesium and they didn’t work at all. Good Luck

  16. I wish I would have known all the info about, gluten, soy & casein 7 years ago. My daughter is now 8 and for the 3 past days she has had a non-smelly, (ok, couldn’t smell it from 3 rooms away) normal color, NOT larger than the toilet, bowel movement. We have been fighting all kinds of doctors, they kept insisting she was stool withholding. Tons of meds, Mineral oil, Miralax, punishment, bribery, the list just goes on! and it just kept getting worse! I found a wonderful doctor who put her on a GFCFSF diet for 5 weeks now!!! Yes, it’s hard, but the change is amazing!!!! She has Aspergers and a lot of Sensory issues, which the diet has helped also! It was so bad she would freak out if the word poop was used! We have to call it #2. I hope this is the answer. We are all POOPED out!!!

  17. Kathy,
    Amazing what diet can do… how people’s lives could be helped! I’m glad it’s working for you!!!

  18. Hi Alison … great post and comments. Our son had toddler’s diarrhea from his first birthday to his second. By his second I was fed up with docs telling me to put him on the BRAT diet. Like that would solve the problem. I write this to help any moms and dads out there who are faced with “issues of poo” similar to those we have experienced.

    My son started having foul smelling diarrhea at age 1, shortly after starting cow’s milk formula. Chronic sinusitis, too. We took him off milk, then soy, all dairy and started him on nut milks. At 1-1/2 he had blood tests and he was positive to dairy, egg, wheat and dog. I kept him off soy just because I am not keen on soy because of the estrogen component and that it often mimics milk and produces a similar reaction in some kids. Still things did not clear up, BUT I was not being vigilant (hidden ingredients in packaged foods). At 2 I was told by an ND to be VIGILANT about dairy, egg and gluten. Went on the Anticandida Diet for 3 months, and voila, his system returned to normal with “clean wipe” diapers 85% of the time. I think excess fructose and sugar do a number on him so we avoid those, too (except for low sugar fruit). I think his system has calmed down…inflammation of the body is another thing worth looking at and avoiding inflammatory foods such as those in the night shade family.

    Anyway, for what it’s worth, there is our story … wanted to throw it into the conversation as I KNOW there are many parents out there wondering if there kid has a problem but not knowing what to do. Foul smelly, sulphur, runny, undigested food-filled diapers are not normal in my book. Don’t buy the “go on a BRAT diet” line (unless recovering from a stomach virus or queasy tummy). All that turns to sugar which then can create more dis-ease. I would say, try cutting back on fructose (sugar in fruit and juices) and other sugars. Then try removing dairy, then soy, then eggs, then gluten. If still no luck, see an allergist. My son reacted to EVERYTHING on the skin prick test so we had to go on to blood testing for more accurate results. Allergist said that his immune system was probably soooo rev’d up that he reacted to all the skin pricks (his back was lit up … I mean all!). Hope that helps someone out there 🙂

  19. Thanks for the comment Lexie – the more personal experiences for desperate moms out there, the better!

  20. My son’s is more of a 5 or 6. We can’t figure out why. He did not test with “allergies” but intolerances to gluten, casein, soy, almond, lemon, and bananas over 2 years ago. We are very vigilant about his diet. He is now 5 1/2 and has regressed in potty training. He poops his pants numerous times a day. (We suspect he doesn’t know he is doing it until it is too late.) I think we need to get his tests re-run.

  21. Joy,
    I’m sorry to hear that. When my daughter’s stools are loose, she has a harder time getting to the bathroom because it comes too fast. It sounds like he has another intolerance. That’s frustrating.

  22. I have learned a lot from your site Alison! Thanks for being brave enough to open topics like this important one.

    I wanted to mention to Joy about my niece who had a lot of problems to the same issues. We thought she was just looking for attention . I remember her being at least 5 years old and still pooping her pants and she suffered for a long time with this. Then later her mom found out after much searching and tests that only one of her kidneys were working and I believe this was the cause. Just something to think about and ask your Doctor. Good luck. P.s I felt so bad afterwards for making her wash her own underwear when she stayed with us. Because like I said we were ignorant and thought she was testing us, wanting attention.

  23. The person above who had the sand castle poop, may like to know that (I run a daycare, so I have a large test group) but whenever we feed the children falafel for lunch, we have those poops from everyone the next day. . .

  24. Finally, I am not the only one concerned about my son’s poop. I also have been dismissed by my pediatrician about my son’s poop since he was born. I switched to another dr right after we found out he had food allergies (which the first dr also made no big deal about). Even after removing all the allergy foods, he still had issues with his poop. Just recently, I started removing corn products and trying to be corn free. We have stopped some of the bad diarrhea and bad rashes. It is hard to eliminate all corn because it is in almost everything we use day to day (sweeteners, preservatives, packaging, etc.). We are making progress, including that now he sleeps at night after a sleepless 2 and a half years. Moms know their kids best. I’m glad everyone is being vigilant and trying to find answers.

  25. My daughter just turned four and we have been struggling with her bowels since birth. She was full term but only 3lbs 7 oz. At 4 years old she is just 23 lbs. She doesn’t eat well, never has infact, we had her on a concentrated dose of formula with still growth issues.
    Her bowels are HUGE and green.
    She is on a laxative (has been since infancy)
    Once she has the big movement she will do nothing for at least three to four days then starts out with green, watery stools that get gritty/sandy.
    She has been tested for Celiacs multiple times each time negative. She has also been tested for a range of conditions in an attempt to explain her lack of growth. We are waiting on genetic and endocrinology tests.
    She has a speech delay.
    as a mom watching your child scream through a BM I am beyond frustrated and heartbroken. At least our new pediatrician agreed to send her to a GI specialist. We see him in two weeks.
    Is it possible the Celiacs test was wrong?

  26. Leanne,
    Celiac tests can be inaccurate, especially in young children. Why don’t you try a gluten-free diet and see if that helps? Or get alternative testing for gluten intolerance/sensitivity, which is more common than celiac disease.

  27. Thank you Alison, I’ll switch her diet. 🙂

  28. My doctor resented told me to quit eating gluten and dairy because he assumed they were what was causing my terrible constipation and stomach bloating. He did not do any tests to figure out if this was correct. For the most part I have been on a gluten/dairy-free diet for about 3 weeks. I have been eating more natural foods and more corn containing foods. Since on the diet my constipation has gone away but I have been having very loose stools and abdominal discomfort. I’ve just started a food diary. Is there any way a doctor can determine food allergies from a stool test? Do you think symptoms are from another food or is it just my body getting used to the new diet?

  29. Hello,
    I am in need of advice. My nearly three month old breastfed son has infrequent stools which began at four weeks old, passing usually every 8 to 13 days. He is in a great deal of pain, and often virtually inconsolable.
    During his first month he stuggled to gain weight and pooped upwards of 15 times per day. At one month old I eliminated dairy, this helped his weight gain. His weekly gains increased to 5 or 6 ounces. His movements were liquid, mucousy, and with few seeds. Now they are completely frothy with no seeds and soak into the diaper.
    His doctor felt he may be constipated and recommend giving him sugar water. After two weeks of sugar water, we felt it wasn’t helping and resorted to glycerin suppositories because of his obvious suffering. With this aid approximately 8 ounces of frothy stool poured out of him and left him with a sore bum.
    Any insight as to what the problem is, or suggestions on how to remedy would be greatly appreciated.