Parents of infants and pets readily share stories about their young charges' bathroom habits without hesitation. They chuckle at descriptions of disgusting diaper blowouts, swap Everyone Poops At nightfall, gather your pup’s droppings and contemplate their consistency, then unleash frustrations in web-based feline communities over a kitten defying authority by relieving itself beyond the litter tray. However, the biological processes involved in excretion are far more intricate than simply visiting the restroom.
Get acquainted with our specialists: Dr. Xiao Jing "Iris" Wang serves as an assistant professor and practicing gastroenterologist at the Mayo Clinic located in Rochester, Minnesota. Additionally, we have Dr. Scott A. Jackson, who works as a microbiologist for the federal agency known as the National Institute of Standards and Technology (NIST). Lastly, meet Dr. Felice Schnoll-Sussman, the director overseeing the Jay Monahan Center for Gastrointestinal Health within Weill Cornell Medicine.
We frequently feel uncomfortable discussing our bowel movements. Let's face it; it's high time we break this awkward silence! A successful trip to the bathroom can be nearly as gratifying as enjoying a delicious meal, whereas an unpleasant one—or worse, not having one at all—can really dampen your spirits.
Moreover, the output from our digestive system can reveal significant insights into our general well-being. Consequently, let’s delve into—and find answers for!—questions centered around human adult feces.
What truly occurs during defecation?
"Many individuals recognize that when we consume food, our body extracts the necessary nutrients with the remainder being discarded as waste," explains Xiao Jing (Iris) Wang, M.D., who is an assistant professor and general gastroenterologist at the Mayo Clinic in Rochester, Minnesota. "However, there's far more complexity involved!" She has also authored a children’s book on this topic. Boo Can’t Poo! —the story of a constipated ghost.) “Different portions of your gastrointestinal tract are receiving input from and giving input to the brain all the time, in a complex back-and-forth. The bowels even have their own nervous system that can function independently.”
Once you finish eating, the food along with digestive fluids travels from your stomach to your small intestine. Here, water and nutrients pass through the walls of your intestines into your blood stream. Whatever is not absorbed moves into the large intestine, where additional water and electrolytes are extracted. The leftover material forms feces, also known as stool, which waits in your rectum until you're prepared for defecation.
“The presence of stool in the rectum sends a signal to the brain that says, ‘I have to go! Tell the rest of the person it’s time to find a bathroom!’ ” explains Dr. Wang, adding that it also asks the brain to hold off until you get there. When you finally get seated, your pelvic floor coordinates with the brain and the puborectalis muscle to relax the a*** sphincter and let it open—and then, as Dr. Wang dramatically puts it, “Ta-da!”
How long does it take food to pass through the system? How often is “regular”?
The duration "transit time" differs from individual to individual, spanning anywhere between 12 hours and multiple days as food moves from mouth to anus (apologies again). As Dr. Scott A. Jackson, a microbiologist working with the U.S. government’s National Institute of Standards and Technology (NIST), explains: “Should you wish to get familiar with your personal transit time, simply consume some beets; their vivid color makes them unmistakable once they exit.” Understanding what is normal for you allows you to recognize any substantial deviations easily.
What do unusual colors or textures indicate?
Most shades of poop (such as yellow, cream, or green) typically aren’t cause for concern. However, if your stools appear vividly red (without beet consumption), dark maroon, or black, take notice. These hues might indicate internal bleeding. "Blood in the stool isn't always severe; it could simply stem from an issue like a hemorrhoid," explains Felice Schnoll-Sussman, M.D., who directs the Jay Monahan Center for Gastrointestinal Health at Weill Cornell Medicine. "Nevertheless, it can also point to a more critical condition."
Vivid red stools often suggest bleeding within the lower gastrointestinal tract; since the blood doesn't travel much distance, it retains its bright hue. On the other hand, dark-colored stools—referred to as melena—or those appearing maroon typically signify that the blood has combined with digestive acids originating from the upper part of the gastrointestinal system. The underlying reasons can differ widely: this might point towards issues such as a broken vessel in the stomach or esophagus, conditions related to inflammation of the intestines, peptic ulcers, or even malignancies. However, they may also result from factors including intake of iron pills, medications like Pepto-Bismol, consumption of items containing activated charcoal, or eating significant quantities of foods such as blood sausages or black licorice. In summary: consult your healthcare provider immediately.
Do changes occur in digestive function as people get older?
Sure. As we age, along with changes in hormones, our colon also slows down. Similar to how skin loses elasticity over time, the colon might become less toned. This decreased firmness can lengthen the distance waste has to travel," explains Dr. Wang. "Additionally, many elderly individuals do not consume enough fluids, possibly due to concerns about reaching the restroom promptly, which can lead to constipation." In such cases, when hardened feces block the weakened anal sphincter, small amounts of loose stools occasionally leak out, mimicking diarrhea symptoms; however, these occurrences actually stem from constipation issues.
How about stress—does that affect pooping?
It seems so. For different individuals, stress may result in either constipation or diarrhea. The specific reaction depends on which parts of your digestive tract are more susceptible to stress. As explained by Dr. Wang, "Our sympathetic nervous system triggers a fight-or-flight response, something humans needed back when they had to escape predators like bears and lions." In such scenarios, digestion isn’t necessary; instead, energy should divert to muscle activity and heightened awareness. Consequently, this leads the colon to slow down and tighten up the sphincter muscles. Additionally, during tense moments, many people subconsciously clamp their bodies. These factors often contribute to constipation in certain cases. However, it’s crucial to understand that under pressure, stress hormones might speed up the function of the small intestines as well. Such acceleration could provoke irritation and enhance permeability within the gut, potentially causing loose stools or even diarrhea in affected persons, according to her observations.
At what point should I consult a physician?
Dr. Schnoll-Sussman states, "You're the most reliable historian when it comes to your bowel movements. Develop the practice of examining them post-defecation; any alterations should lead to a discussion with your physician." Should your typical solid waste transform into looser consistency without prior changes, or if your usual infrequent trips to the bathroom become frequent occurrences, these shifts warrant attention. According to her, unusually thin stool might indicate an obstruction within the colon hindering regular passage through it. Furthermore, noticing reddish, dark maroon, or black excrement mandates immediate consultation. She adds humorously, "Don’t hesitate to snap a photo and forward it to your healthcare provider—there's absolutely no shame in sharing images of feces as we physicians find this quite routine!"
Regardless of circumstances, avoid dismissing your worries. "Whenever we wish to evade something, we might attempt to rationalize it—" Oh, my stool is red because I ate beets a few days back. , or I've been dealing with diarrhea because of the tacos I ate last month. Remember, a doctor’s objective goes beyond just identifying issues; it includes reassuring patients when everything is fine," explains Dr. Schnoll-Sussman. "But without awareness, we cannot accomplish either task. As I often mention, 'There should be no shame in seeking help.' If something isn't right, we'll address it."
Come on, do I really need a colonoscopy?
It is currently advised that individuals aged 45 and older initiate routine screenings, assuming they do not have a personal background involving colorectal cancer, polyps, or inflammatory bowel disease, nor a familial record of colorectal cancer—in such cases, screening would be recommended at an earlier age. No matter what medical past you possess, consult with your healthcare provider regarding the most suitable schedule for these tests based on both your overall health condition and genetic predisposition. Screening methods include conventional colonoscopies (occurring once per decade), computed tomography-based virtual colonoscopies (annually through imaging scans), stool DNA examinations (to be conducted yearly or biennially), and annual fecal immunochemical testing. In addition, during the previous summer, the Food and Drug Administration sanctioned a novel blood examination capable of detecting signs of colon cancer; research suggested that this diagnostic tool has been effective in identifying over eighty-seven percent of early-phase tumors. Ensure thorough discussion with your physician concerning all potential procedures available to you, particularly when concerns related to undergoing standard invasive techniques like colonoscopy may prevent adherence to necessary preventive measures.
As mentioned earlier, traditional colonoscopies remain the benchmark. "Think of it as part of an initiation ritual," advises Dr. Schnoll-Sussman, noting that patients receive sedation throughout the process and only spend about a single day on this. Patients often fret over whether the preparatory phase will be more daunting than anticipated; however, she clarifies, "It doesn’t involve much cramping. You’ll frequently visit the restroom and might become irritable—that’s pretty much everything." She warns though: "The key is ensuring thorough preparation since inadequate readiness can make things difficult for your physician akin to navigating treacherous weather conditions. The success of a top-notch colonoscopy hinges upon meticulous adherence to presurgical guidelines by the patient."
What are the most recent developments regarding colon cancer statistics?
The positive update is that the incidence of colorectal cancer diagnoses has declined steadily since the middle of 1980, largely due to an increase in individuals undergoing screening exams such as colonoscopies and fecal tests, stopping tobacco use, and being mindful of additional risk elements. This trend is quite encouraging.
However, the unfortunate truth is this: For individuals below 55 years old, the incidence of colon cancer has risen steadily since the middle of the 1990s. According to Dr. Wang, "From 2000 to 2017, these figures climbed approximately 1.7% annually," with projections indicating they will keep rising until at least 2030. This upward trend holds substantial weight—during the latter half of the '90s, colorectal cancer ranked as the fourth primary cause of mortality among women under 50; today, it stands as the second most common culprit. Consequently, in 2018, the American Cancer Society revised its guidelines recommending initial colonoscopy screenings be conducted starting at age 45 instead of 50. In addition, multiple federal health organizations updated their advice along similar lines back in 2021.
What caused the abrupt rise? According to Dr. Wang, "I am unable to provide an exact reason for this trend. We believe it involves a combination of dietary habits, environmental factors, and lifestyles, yet we lack solid statistical support. Research indicates that consuming large amounts of processed meats and sugar-sweetened beverages alongside insufficient consumption of fruits, vegetables, and fibers may contribute to early-onset colorectal cancer."
However, there might be additional aspects involved. "We should also take into account alterations in the so-called nutritious foods we consume," like fruits and vegetables, she explains. "Agricultural methods have evolved, the composition of our water supplies has shifted, and numerous unknown elements have varied too. These modifications likely affect what our systems encounter daily, particularly impacting the microbial communities within our colons."
I prefer not to dwell on the bacteria in my colon. Do I really have to?
But it’s good! Having a balance of bacteria in your colon is essential for health. Your “gut microbiome” is the ecosystem in your intestines; the Cleveland Clinic calls it “a microscopic world within the world of your larger body.” Poetic! Thousands of microorganisms— bacteria, viruses, fungi, parasites—teem there, helping keep the body’s systems in balance.
“It’s like the ‘three sisters’ in farming,” says Dr. Wang, referring to the idea in Indigenous American agriculture of three different crops in a shared space (corn, beans, and squash) nourishing and protecting one another in different ways, supplying a balanced diet for their cultivators, and fortifying the health of the soil they grow in. “To keep going with the metaphor, though, weeds and bad bugs can come in and deplete the ground of nutrients,” she says. All this can drive inflammation.
However, even with all the discussion surrounding gut bacteria, she points out, "We still have a great deal to discover regarding how our diet and lifestyle influence various bodily systems, including the digestive and immune systems."
When will we have more information?
According to NIST’s Jackson, "The last two decades have focused on identifying connections between the microbiome and various health and disease states." We're now reaching a turning point. There is substantial evidence suggesting that equilibrium within the gut microbiome may influence conditions such as cancer, mental illnesses, asthma, Alzheimer’s, obesity, heart health, Type 2 diabetes, among others. As Jackson notes, "In the near future, during your yearly physical examination, doctors will likely gather not only blood and urine samples but also stool specimens to evaluate the state of your gut microbiome."
The aim is for sufficient knowledge to be gathered about the microbiome so that fecal bacteria can be utilized to treat particular diseases. "There's a great deal of promising research," according to Jackson.
To put it briefly, feces is now getting its time in the spotlight, and we'll all benefit from this by becoming healthier.
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