The Scoop on Poop
The Scoop on Poop
Pooping is a natural bodily process, something we all have been doing everyday since we were born. In our culture, poop is a forbidden subject. Poop is simply not discussed in polite conversation among well bred people. Poop and references to it populate our expressions of anger and frustration, swear words, slang, and street talk, but rarely civilized discourse or literature.
Parents discover that one of the "joys" of parenthood is that they are forced to deal with poop, not only with diapers but when potty training their toddlers. We do not expand on the subject of poop. "Good job! No! Do not touch it. It is dirty." Once our kids are toilet trained, we are all very happy to leave the subject forever.
However, now we are sick and we need to get help. Now we discover that the enormous and varied English vocabulary leaves us at a loss for words when we need to talk about our poop with a doctor. The formal terms: "defecation of excrement," "problems with evacuation of feces," or "loose stools" are inadequate.
We are embarrassed to use food analogies and besides using food terms for poop seems gross. What can we do?
The Bristol Stool Scale
The Bristol Stool Scale to the rescue. Developed by Dr. Ken Heaton at the University of Bristol, as a classification method for his research and first published in 1997, the Bristol Stool Scale has become a clinical communication aid. Enter "Bristol Stool Scale" in the Wikipedia search box and up comes an illustrated chart of the 7 types of poop as classified by Dr. Heaton. The Bristol Stool Scale gives us a vehicle for a descriptive poop "show and tell" at our next medical appointment.
The seven types of stool on the Bristol Stool Scale progress from hard to liquid:
- Type 1: Separate hard lumps, like nuts and hard to pass
- Type 2: Sausage-shaped, but lumpy somewhat hard to pass
- Type 3: Like a sausage but with cracks on its surface
- Type 4: Like a sausage or snake, smooth and soft, easy to pass
- Type 5: Soft blobs with clear cut edges and passed easily
- Type 6: Fluffy pieces with ragged edges, a mushy stool pass a little too easily
- Type 7: Watery, no solid pieces. Entirely liquid, shoots right out
Reference: Lewis SJ, Heaton KW (1997). "Stool form scale as a useful guide to intestinal transit time". Scand. J. Gastroenterol. 32 (9): 920–4. doi:10.3109/00365529709011203
Since knowledge about defecation, this solitary, secretive and undiscussed activity, is hard to come by, the Bristol Stool Scale provides some important insights for us as to what is a normal poop. The scale shows that the ideal poop falls naturally in the middle of the scale. The Bristol Stool Scale is a handy objective measure. It shows us that Types 1 and 2 indicate constipation. The ideal poop, in the middle of the scale, is represented by types 3 and 4. Type 4 (referred to as T-4) are the first class stools as they are compact but easy to defecate. Type 5 is tending towards diarrhea. We do not need any explanation for types 6 and 7 which are clearly diarrhea. We all see types 6 and 7 in the middle and end stages of a colonoscopy preparation process.
You might want to add a Bristol Type coding to your event log. Some of us think that seven categories are not enough. It seems a little strange to say, "Doctor, I had some T- 5.625's this week" (meaning some soft blobs, some mushy but I had to dash to make it to the toilet). However, in the absence of anything else, the Bristol Stool Scale is the best communication method that we have. Happy T-4's to you!
Your Own Stool Scale
Diarrhea (D) and constipation (C) are both indicators of digestive imbalance. The terms are used so frequently on the group http://www.health.groups.yahoo.com/group/BTVC-SCD that we often use just the letter C or D. Knowing our own poop patterns is important and something to note in our food and event logs.
The probiotic, saccharomyces boulardii (usually called "s. boulardii") is usually helpful with diarrhea. While this probiotic is not on the approved list in the BTVC book, Elaine did approve of s. boulardii shortly before she died.
The folks on the BTVC group on Yahoo http://www.health.groups.yahoo.com/group/btvc-scd generally recommend that you take the capsules on an empty stomach. Start slowly with a half a capsule and not more than one at first. Then, if that is tolerated, in a few days, slowly add more capsules until you begin to notice a difference in your stool. Do not increase the dose too fast or you will get die-off.
Some find s. boulardii is more effective if they take all the pills together in the morning instead of spreading them out over the day for more impact even though the instructions may direct 1 to 3 capsules, three times a day.
In the meantime, take care of yourself. Take daily epsom baths to help detox, seeFlare Ups, get lots of rest, take it very, very easy. Make sure you are hydrated with lots of broth and gelatin.
S. boulardii is a non-colonizing yeast that is beneficial to the digestive tract. It is also very helpful in combating and preventing candida, a yeast that is a problem for many whether on SCD or not.
Saccharomyces boulardii that does not contain SCD prohibited ingredients may have to be ordered on line. Nutricology Brand, GI ProHealth and Kirkman Brand are okay. Since any company can change its formulation, always check the ingredients before buying, especially the inactive ingredients, even on brands that you have trusted in the past. Jarrow Brand and Florastor s. boulardii both have inactive ingredients that are SCD prohibited.
Question - My stool comes out in a soft tube and coils up in the bowl. However, when I flush, most of it turns to powder as it flows around the bowl and down the drain. There are no signs of blood. What does this mean?
Answer - It means that you have more healing to do. The fact that there is no blood is a good sign and means that some healing has taken place. In time, the stools that come out formed will remain formed during flushing.
For Your Information
Ultimately the hope is the SCD diet can correct gut imbalance and make the gut ecology a healthier one. Elaine wrote (not in the BTVC book) that, contrary to what one might expect, raw fruits and vegetables tend to exacerbate constipation.
Constipated people are lacking in gut bacteria. See Probiotics for details. It is the bacteria in the stool, both dead and alive, which absorbs water and allows a smooth passage of the stool out of the intestinal tract. Without sufficient probiotics absorbing water, the stool gets very dry and hard to pass.
Here some of the successful remedies posted by veteran SCDers. It is not intended to be medical advice:
An old but very effective constipation remedy is to have a glass of warm water with a tablespoon of fresh lemon juice or squeeze half a lemon taken first thing in the morning before eating.
Elaine's formula for constipation relief
Get Welch's Prune nectar or other juice without added sugar. Simmer down until one half the volume and refrigerate. At breakfast, take 6 tablespoons of the above mixed with the one half cup of plain Tropicana Orange Juice (not the one with calcium added) or one half cup of fresh orange juice added to weak hot legal tea.
Note that normally one would dilute all juices so that they were 50% water. However, in this case, the juice is diluted by the tea.
For some, a beet a day keeps constipation away. Wash and peel. Cook in a crock pot with a little water for a couple of hours or steam or bake a bunch of beets. Have one a day. Diced in salads or soups, sliced and warmed in butter with salt or whatever suits you. Http://www.Pecanbread.com has several beet recipes for those dealing with constipation. By the way, beets can make the stool appear darker, even red. That is okay.
Magnesium and high levels of vitamin c and 1 beet a day.
Plain True Calm is SCD allowed. Also used is the Now brand of magnesium citrate powder. A pretty high dose is only 1 teaspoon. Do not exceed this dosage or it can cause diarrhea.
C. posted - I use "Now's Magnesium Citrate" 100% Pure Powder. It has no additives of any kind. I have talked with the company and gave them a big list of SCD Illegals (ingredients not permitted) and I have been reassured by the company that it is safe from all the illegals on my list: glutens, grains, casein, lactose, corn, soy, starches, MSG, yeast, gums, oilgofrutose, alcohol sugars, seaweed, maltodextrin, carob and pectin.
On the back of the bottle it says the Now brand of magnesium citrate is free from: sugar, salt, starch, yeast, wheat, gluten, corn, soy, milk, eggs, shellfish or preservatives.
It is a pure powder that you measure out yourself in a preferred liquid. I use it in water, before bed. (1 tsp. is 630 mg.) If you decide to use this product start out slow with maybe 1/4 teaspoon. Then try 1/2 teaspoon. Slowly work yourself up to what your body needs. Too much magnesium citrate can cause diarrhea and if it does, just back down to a lower dose. I have used this as a way to help me to poop when I am constipated because it can soften things up a bit. If diarrhea occurs, just back down to a lower dose. This is the only brand that I have found that has no additives to it. It has a real sour tart taste to it, which I like. It actually taste pretty good in plain water or S. Pellegrino. Anyway, it works well for me. I hope it works out for you too.
The color of our stool is affected by the foods we eat. For example, beets or tomato sauce can give stools a reddish tinge. Butternut squash can give it a tanner color. This is normal.
However, if what you see in the toilet bowl is clearly blood, pay attention. Bloody stools are an important symptom. Your body is signaling to you to reconsider what you are eating. You should note any signs of bleeding in your food and event log.
A Few Drops of Blood
A few drops of blood in your stools are a warning signal that you have eaten something that is beyond the tolerance level of your body at this time, despite the fact that it may be allowable on the SCD diet. Also, did you inadvertently have something not allowed on the SCD diet? Recheck all the ingredients on supplements. Did you eat in a restaurant recently or food that someone else prepared?
The problem may be from eating too much of something that you thought you were tolerating well in the past but now is not. Digestive healing and the SCD process requires patience and perseverance. Digestive healing is often two steps forward and one step back.
This is where your food and event log comes in handy. Often the problem is eating too much fruit. Even though fruit is technically a monosaccharide and allowable on the SCD diet, fructose can be a problem for many people. We enjoy the taste of fruit and it is easy to eat too much of it. Other places to look in your diet is consuming too much yogurt, honey, nuts or cheese. Are the bananas you are consuming completely ripe?
Drop back to a more basic diet of safe foods: roasted meats, poultry and fish and steamed vegetables like zucchini until all blood signs completely disappear. Stay with or return to all foods being cooked, peeled and seeded. After any signs of any bleeding have been absent for a few weeks, slowly, one at a time, reintroduce other foods. We suggest putting fruit and fruit juices at the end of the line.
More Than a Few Drops of Blood
This is always discouraging as well as frightening but not very uncommon, especially after a cold or a bout of antibiotic treatments. It also may be that you are continually consuming foods that your system cannot tolerate. We recommend "rebooting" your digestive system.
It is important to be proactive even though you feel discouraged and tired. Stay steady and win.
Drop back to the full introductory protocol (Intro). Make the chicken soup as described on page 89 (May 2010 edition of BTVC) and consume it for two days. Then, slowly reintroduce other foods. Be very conservative. Stay with roasted meats, poultry and fish with steamed vegetables for as long as it takes. Stay with cooked, peeled and seeded. Focus on your healing, not on the menus of others.
Wait until your stool is normal for a few weeks and then slowly reintroduce other foods. Avoid fruit and nuts until other foods are tolerated. Be sure to thoroughly chew your food (mashed down to a paste) before swallowing.
If bleeding persists, consult your doctor. Query the moderators on the BTVC Yahoo group as they may have some suggestions for your specific situation.
Some believe that a source of some of our digestive ills is that our bodies have not changed much since the caveman but the food supply and the way we live have. The caveman had no furniture. He squatted to poop. It is only in the past few hundred years that the Western world used toilets that were based on the concept of a chair (with a hole in it).
Today, outside of the Western developed world, most of the world still squats. In Asia, for example, the plumbing fixtures or toilet structures are usually a lot lower to the ground than the toilets in Europe or America.
Some have found that elimination is easier and better with squatting. When using a Western toilet, they have simulated squatting by using telephone books or step stools to raise their feet about seven inches or more from the floor.
The theory of the benefits of squatting is based on our anatomy. When we stand or sit, the anorectal angle, a bend in the lower rectum, helps us to control defecation. The puborectalls muscle acts like a tense sling tightening at the bend. When we squat, the anorectal angle is in the straightest possible position and the puborectalls muscle is in the most relaxed state. The opening is as then large as possible to facilitate a complete elimination.
An entrepreneurial family has developed a group of products that are better suited and easier to take care of than using old phone books. They call their product a "squatty potty." This device fits in front of the contours of the toilet and has a platform for placing one's feet seven (or nine for the advanced) inches off the floor. Visit http://www.squattypotty.com to see their video including a demonstration on a TV show and learn more details.
You will have a big laugh at squatty potty and then you might just order one. Those with tendencies to constipation or large stools find this device helpful. The authors at SCDWiki.com have no connection to the squatty potty company.
The Process of Poop
This website discusses the process of making poop, including a discussion of color http://lifespa.com/2013/01/the-perfect-poop/. It is from the point of view of Ayurveda, not SCD, and those on SCD which might disagree with the once a day goal; however, we include this reference as some might find the process of interest.
Color of Poop
The color of poop may be affected by the foods we ate and that is okay.