Anonymous:

I have been trying to go to the bathroom daily and when I do it comes out like pebbles. Sometimes I sit on the toilet and nothing comes out. This has been going on for about 3 months now. What is going on here?


Dr. Stool:

Changes in bowel habits can occur for one of two reasons- 1) a drastic change in your diet/lifestyle or 2) development of a gastrointestinal disorder. Pebble poo reflects a lack of stool cohesion caused by a deficiency in dietary fiber. Fiber lends bulk to stool but is also the glue that causes poo to stick together and emerge as a single log. Any persistent change in bowel habits (say, for weeks or months) should prompt a visit to your doctor. Dietary modification is usually the first step towards restoring stool normalcy, but some pebble pooers may require a colonoscopy or other testing to rule out colon cancer (thankfully, this is usually NOT the problem).




Anonymous:

The problem I have with my stool movement is that I have no control - when i feel the need to go, it goes. Can you give me advice what can be done about this?


Dr. Stool:

It sounds like you are struggling with fecal incontinence, a common problem in which stool inadvertently escapes from the rectum. There are two main factors that can contribute to this problem: 1) liquid stool and 2) weak or uncoordinated anal sphincter muscles. Anything that liquefies the stool (infection, medications, etc) can contribute to incontinence. Usually, this occurs in tandem with some weakness of the anal sphincter, the muscle responsible for keeping the gates closed until a socially acceptable moment. Weakness of this muscle is normally seen in women who have suffered trauma to the pelvic area during their childbearing years. Treatment of fecal incontinence consists of solidifying stool with fiber and medications and special strengthening exercises of the anal sphincter through a process called biofeedback. Severe cases require surgery to repair the damaged sphincter muscle.




Anonymous:

What would be the average time for poo formation and expulsion? Meaning, to be able to relate what you have eaten with what you defecate. In the morning poo can you see yesterdays breakfast and lunch, or also dinner?


Dr. Stool:

The normal gastrointestinal transit time varies from person to person and is also affected by diet. The average individual, however, can expect to see meal remnants (Deja Poo) in their stool 30-40 hours after ingestion. There are special x-ray tests which can determine your 'transit time' by following a radiolabelled meal as it travels through your intestines. This test may be useful if you are suffering from severe constipation or other gastrointestinal problems such as abdominal pain and bloating. If you REALLY want to know how you measure up, a poor man's transit test can be performed by seeing how long after consumption it takes poorly digested foods such as corn to show up in the toilet bowl.




Anonymous:

What's the deal with the Never-ending wiping poo?


Dr. Stool:

The "never-ending wiping poo" can be caused by one of several factors. First, the stickier the poo, the more you will have to wipe. Usually by the time stool makes it to your rectum it is somewhat dessicated by the colon's avid absorption of water. However, if your stool passes quickly through the colon there will be less time for absorption and your stool may have a more gel-like consistency. This can occur for many reasons, including things you consume in your diet that may not be getting digested (dairy, gluten, etc). Second, there may be something in your rectal area that gets soiled with stool- the most common being large external hemorrhoids. Finally, the presence of something called a perianal fistula can also cause this phenomenon. A fistual is simply an abnormal conduit, in this case, between your intestines and your skin that causes stool to continuously drain. Thankfully, dietary factors and hemorrhoids are much more common.




Anonymous:

What volume of faeces would you say an average, American male (170 pound) would generate over his lifetime?


Dr. Stool:

150 grams of stool/day x 365 days/year x 75 years = 4106 kilograms (9033 lbs) of stool. About 5 tons!




Anonymous:

I am a vegetarian, very active and have a healthy diet. Is it normal to have loose stool so often or could there be a bigger problem?


Dr. Stool:

Loose stools have many causes (see "Soft Serve"). If the stools are only loose intermittently you may want to make sure you are not eating something that your body cannot digest. The most common causes are lactose intolerance, artifical sweeteners (ie, sorbitol), and fructose (sodas). If there is no obvious dietary culprit, you should consider getting checked for certain gastrointestinal diseases like celiac disease, which is a food intolerance to gluten-containing products.




Anonymous:

Why is it that you can spend several minutes in the bathroom after you have finished your business, attending to other bathroom needs, without noticing any particular odor, but your wife can start to enter and either turns right around or runs directly to the cabinet for the air freshener?


Dr. Stool:

This, my friend, is one of the great mysteries of poo. Keeping track of our bowel movements is an important aspect of our everyday lives (why else would we be programmed to take that quick glance into the toilet after having a bowel movement?). Surely, detection of poo's aroma would seem to be advantageous from an evolutionary perspective- serious ailments such as bleeding and infection can often manifest by changes in smell. Regardless, one should acknowledge the universal smelly nature of poo and give a quick courtesy flush half-way through a bowel movement.




Anonymous:

Why is my butthole so sore after my massive dumps?


Dr. Stool:

Three possibilites (see "Monster Poo," "Ring of Fire" and "Chinese Star"): First, is that the girth of the stool causes your anal sphincter to stretch and, on occasion, forms small tears in the muscle; something called an anal fissure. Second, is that you have irritation cause by the ingestion (and eventual excretion) of spicy foods. Hemorrhoidal inflammation is the third possibility.




Anonymous:

I have been 'irregular' now for some time. I have tried high fiber diets, plenty of exercise, 'Fibercon' but still have a constipated existance. Got any suggestions?


Dr. Stool:

Sorry to hear about your losing battle with constipation. While it may be a surprise to some, just increasing your fiber intake can actually make some constipation worse. Sure, it "bulks" up the stool, but unless you consume enough water, your stool may actually become harder and more difficult to pass

I would make sure to drink 6-8 glasses of water a day in addition to your high fiber diet and see if that helps. If not, the next step would be to visit your local GI specialist to discuss other testing and possible use of laxatives (medicines that speed up the movement of the intestines).




Anonymous:

Is it possible for hemorrhoids to impede or affect poo evacuation?


Dr. Stool:

Typically, hemorrhoids do not cause direct blockage to the passage of stool. After all, they are nothing more than swollen veins, which like blood vessels in other parts of the body, are soft and easily compressible. In situations where hemorrhoids become severely inflammed or thrombosed (which is when a clot forms in the hemorrhoid), the passage of stool can become quite painful and thus lead to a conscious decision to refrain from passing stool. In rare cases, patients with extremely large hemorrhoids can experience prolapse of their hemorrhoids outside the anal cavity, thus making the act of having of bowel movement much more difficult.


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