Moment 195: 10 Things Your Poo Says About Your Health: The No.1 Poo & Gut Scientist
What does your poo say about your health? In this episode of The Diary Of A CEO, gastroenterologist Will Bulsiewicz delves into the significance of human stool. He explains how the composition and characteristics of stool provide valuable insights into one's overall gut health and microbiome. Bulsiewicz walks through the Bristol Stool Scale, which categorizes stool types from hard pellets to liquid forms, revealing what each type indicates about digestive function.
The episode highlights the impact of diet on stool quality, with high-fiber plant-based diets promoting ideal stool consistency and gut health, while low-fiber, high-fat diets are linked to constipation. Bulsiewicz also explores how stool color can signal potential issues like bleeding, bile duct obstruction, or fat digestion problems. This episode offers an eye-opening look at an often-overlooked aspect of health: the revealing nature of what's in the bowl.
This is a preview of the Shortform summary of the Jan 10, 2025 episode of the The Diary Of A CEO with Steven Bartlett
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1-Page Summary
The Significance of Human Stool
Stool Composition Reveals Health Insights
Gastroenterologist Will Bulsiewicz emphasizes how stool, composed 60% of bacteria, is a valuable source of information about gut health and the body's microbiome. The types of bacteria present offer insights into one's overall wellbeing, per Bulsiewicz.
Stool Analysis As Informative As Vital Signs
Analyzing stool is considered by Bulsiewicz as informative for assessing digestive health as checking vital signs like pulse rate is for cardiovascular health. Through stool examination, gastroenterologists can better understand and address gut-related conditions.
Bristol Stool Scale
Bristol Stool Types 1 (Hard) to 7 (Liquid)
The Bristol Stool Scale categorizes stool types from 1 (hardened pellets) to 7 (entirely liquid), with Type 4 - soft, formed, sausage-like - considered the healthiest ideal, says Bulsiewicz.
Deviation From Type 4 Indicates Gut Issues
Deviations below Type 4 indicate constipation and slow gut transit, while Types 5-7 suggest diarrhea and fast transit time. Bulsiewicz notes low-fiber diets are often behind Type 1/2 constipation or Type 7 diarrhea stools.
Diet's Impact on Stool and Gut Health
Fiber Promotes Ideal Bristol 4 Stools
Higher fiber intake from plant-based foods like legumes, grains, fruits, and veggies leads to healthier Type 4 Bristol stools, indicating good gut function, per research cited by Bulsiewicz.
Low Fiber Diets Linked to Constipation
In contrast, low-fiber, high-fat diets are associated with constipation and suboptimal stool forms, increasing risk of gut issues.
Stool Color Signals
Red/Black Stool - Potential Cancer/Bleeding
While red stool may signal benign hemorrhoids, Bulsiewicz stresses it should prompt colonoscopy screening for polyps/colon cancer, a leading cancer killer. Black stools suggest slow internal bleeding.
Other Color Indications
Pale or white stool lacking bile pigment may indicate bile duct obstruction. Yellow stool signals potential fat digestion issues like pancreatitis. Diet also influences color temporarily.
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Counterarguments
- While stool composition can provide health insights, it is not the only indicator of health, and other factors such as genetics, lifestyle, and environment also play significant roles in overall wellbeing.
- Stool analysis, although informative, may not always provide a comprehensive assessment of digestive health without considering other diagnostic tools and patient history.
- The Bristol Stool Scale is a useful tool, but it may not encompass all variations of normal stool, as individual differences can affect stool form without indicating health issues.
- Type 4 stool is considered ideal, but some individuals may naturally have stools that slightly deviate from this without experiencing gut issues.
- Fiber intake is generally associated with healthier stools, but too much fiber can also cause issues such as bloating, gas, or discomfort for some individuals.
- The link between low-fiber, high-fat diets and constipation is well-established, but other factors like hydration, exercise, and stress levels also significantly impact bowel movements.
- The presence of red stool warrants medical attention, but not all red stool is indicative of cancer; dietary factors like beetroot consumption can also cause red stool.
- Black stools can indicate internal bleeding, but they can also result from consuming certain foods (like black licorice or blueberries) or medications (like iron supplements).
- Pale or white stools may suggest bile duct obstruction, but they can also be caused by medications or diets high in fat.
- Yellow stools might indicate fat digestion issues, but they can also occur with a rapid transit time through the gut or with the consumption of certain foods.
- Diet's temporary influence on stool color is true, but persistent changes in stool color should be evaluated by a healthcare professional to rule out underlying health issues.
Actionables
- You can track your stool characteristics using a daily journal to identify patterns and potential health issues. Start by creating a simple chart or spreadsheet where you log the type of stool you have each day using the Bristol Stool Scale as a reference. Note any deviations from Type 4 and correlate them with your dietary intake, stress levels, and physical activity to pinpoint triggers for gut issues.
- Experiment with a personalized fiber challenge to improve your stool quality. Gradually increase your fiber intake with a variety of sources such as fruits, vegetables, legumes, and whole grains. Set a goal, like adding an extra serving of fiber-rich food to each meal, and observe how your stool changes over the course of several weeks. This can help you find the right balance for achieving healthier stools.
- Develop a color-coded food diary to monitor the impact of diet on stool color. Use a digital app or a physical diary to record everything you eat and drink, assigning colors to different food groups or ingredients. When you notice unusual stool colors, refer back to your diary to see if there's a correlation with certain foods, which can help you identify if the change is diet-related or if you should seek medical advice.
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The Composition and Significance of Human Stool
Human stool is not merely waste; it's a rich source of information about gut health and more. Gastroenterologist Will Bulsiewicz underscores its significance in medical examinations.
Stool Is 60% Bacteria, Revealing Gut Microbiome Insights
Stool contains a variety of substances but is surprisingly composed mostly of bacteria, at an astonishing 60% of its weight. This composition serves as a gateway to understanding the body’s complex gut microbiome.
Stool Composition Reveals Valuable Health Insights
The presence and balance of bacteria in stool are not trivial; they offer valuable insights into one's health. By examining these bacteria, healthcare professionals can glean important information about the state of an individual’s gut health and overall wellbeing.
Stool Analysis Is as Informative as a Cardiologist Checking Vital Signs
Bulsiewicz suggests that analyzing stool should be considered as informative as when a cardiologist checks vital signs such as pulse and heart rate.
Stool Examination Help ...
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The Composition and Significance of Human Stool
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Clarifications
- The gut microbiome consists of microorganisms like bacteria, fungi, and viruses that reside in the digestive system. It plays a crucial role in various bodily functions, such as digestion, immune system regulation, and even influencing behavior through the gut-brain axis. The composition of the gut microbiome can vary throughout the digestive tract, with the colon hosting a diverse array of microbial species. This microbial community in the gut is essential for maintaining overall health and well-being.
- The bacterial composition of stool refers to the types and amounts of bacteria present in human feces. Stool is primarily made up of bacteria, with approximately 60% of its weight consisting of these microorganisms. This composition provides insights into the gut microbiome, which plays a crucial role in overall health and digestion. Analyzing the bacterial content of stool can help healthcare professionals assess gut health and diagnose related conditions.
- Vital signs, like pulse and heart rate, are essential physiological measurements that provide insights into a person's overall health. The pulse is the rhythmic throbbing of arteries as blood is pumped by the heart, typically measured at the wrist or neck. Heart rate, on the other hand, is the number of times the heart beats per minute, indicating the heart's efficiency in pumping blood throughout the body. Monitoring these vital signs helps healthcare professionals assess cardiovascular function and detect any abnormalities or potential health issues.
- Gastroenterologists are medical specialists who focus on the digestive system, including the stomach, intestines, liver, and pancreas. They diagnose and treat a wide range of gastrointestinal conditions, such as ulcers, acid reflux, and inflammatory bowel dise ...
Counterarguments
- While stool analysis can provide insights into gut health, it is not a comprehensive measure of overall health and should be considered alongside other diagnostic tools and tests.
- The percentage of bacteria in stool can vary widely among individuals and is not always as high as 60%, depending on dietary habits, antibiotic use, and other factors.
- Understanding the gut microbiome through stool composition is a complex process, and the science is still evolving; not all bacteria found in stool are well understood in terms of their impact on health.
- Stool analysis may not be as immediately indicative of health issues as vital signs, which can show real-time responses to stressors and indicate acute problems.
- While stool examination is useful, it is primarily focused on gastrointestinal health and may not provide information about other systems, such as the cardiovascular or nervous systems.
- Diagnosing ...
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Bristol Stool Scale and Gut Health
Will Bulsiewicz sheds light on the Bristol Stool Scale, an essential tool for understanding gut health through stool analysis.
Bristol Stool Scale: Types 1 (Hard, Difficult) to 7 (Liquid)
The Bristol Stool Scale, Bulsiewicz explains, categorizes stool from 1 (hard and difficult to pass) to 7 (liquid in consistency).
"Type 4 Bristol Stool: Ideal and Healthy"
A 'Type 4 Bristol Stool', described as soft, formed, like a sausage or torpedo, is considered the ideal and healthy stool type. Findings show that higher fiber intake and plant-based food consumption are associated with achieving a Bristol type 4 stool.
Deviations From a Bristol 4 Stool Indicate Gut Transit Issues and Digestive Problems
Constipation (Bristol 1-2) Is Slow Transit; Diarrhea (Bristol 6-7) Is Fast Transit
Deviations from the Bristol Four stool are considered indicators of gut transit issues and other digestive problems. A 'Type 3' stool with cracks and crevices suggests movement toward constipation. 'Type 2' implies more serious constipation, with lumpy stools appearing like marbles stuck together, while 'Type 1' indicates severe constipation with difficult-to-pass hard pellet-like stools.
On the other end of the scale, 'Type 5' stool starts ...
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Bristol Stool Scale and Gut Health
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Counterarguments
- While the Bristol Stool Scale is a useful tool, it is not the only indicator of gut health, and other factors such as stool color, frequency, and the presence of mucus or blood should also be considered.
- The scale is subjective and self-reported, which can lead to inaccuracies in categorization due to individual differences in perception.
- A Type 4 stool is generally considered ideal, but what is healthy can vary from person to person, and some individuals may naturally have stools that differ from Type 4 without experiencing any health issues.
- The association between higher fiber intake and Type 4 stools does not account for individual dietary tolerances and sensitivities, where some people may experience adverse reactions to high fiber diets.
- The text implies a direct causation between fiber intake and stool type, but other factors such as hydration, stress, and physical activity also play significant roles in digestive health.
- The idea that deviations from Type 4 stools always indicate gut transit issues may oversimplify the complexity of digestive health, as occasional variations in stool type can be normal and not necessarily indicative of a health problem.
- The assertion that slow gut transit time results in types 1 or 2 stools does not consider that some medications, medical conditions, or ...
Actionables
- You can track your stool type with a daily journal to identify patterns and digestive health. Start by creating a simple chart or use an app to log the type of stool you have each day, noting what you ate and how you felt. Over time, this can help you correlate certain foods or stress levels with changes in your stool type, guiding you toward dietary or lifestyle adjustments.
- Experiment with adding a variety of fiber sources to your meals to encourage a type 4 stool. Incorporate both soluble and insoluble fibers by trying new recipes that include legumes, whole grains, fruits, and vegetables. For example, add lentils to your soup, berries to your breakfast, or swap white rice for quinoa. Monitor how these changes affect your stool type and adjust accordingly.
- Stay hydrated by setting reminders to drink water throughout the day, aiming for a pe ...
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Diet, Gut Function, and Stool Characteristics
Understanding the relationship between diet and gut function is crucial as it informs us about how different foods can affect stool characteristics and overall digestive health.
Fiber and Plant-Based Intake Linked To Optimal Bristol 4 Stool
More Legumes, Whole Grains, Fruits, and Vegetables Lead To Healthier Bristol 4 Stools
Consistent intake of legumes, whole grains, fruits, and vegetables has been associated with healthier Bristol 4 stools, which are considered optimal. This type of stool is well-formed, smooth, and soft, indicating a high-fiber diet and good digestive health.
High-Fat Diets and Low Fiber Intake Linked To Constipation and Less Optimal Stool Forms
...
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Diet, Gut Function, and Stool Characteristics
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Counterarguments
- While high-fiber diets can lead to healthier stools, individual tolerance to fiber varies, and some people may experience bloating, gas, or discomfort when increasing fiber intake, especially if done rapidly.
- The Bristol Stool Scale is a general guide, but there is a range of normal stool types, and a "perfect" Bristol 4 stool is not necessary for everyone to achieve optimal gut health.
- High-fat diets, particularly those rich in healthy fats like omega-3 fatty acids, can be part of a balanced diet and may not necessarily lead to constipation if combined with adequate fiber and fluid intake.
- Some individuals with digestive disorders such as Irritable Bowel Syndrome (IBS) may not tolerate large amounts of fiber, particularly from certain high-FODMAP fruits and vegetables, which can exacerbate symptoms.
- Plant-based diets are generally high in fiber, but they may lack certain nutrients such as vitamin B12, iron, calcium, and omega-3 fatty acids, which are important for overall health and may need to be supplemented.
- Constipation can also be influenced by factors other than diet, such as physical acti ...
Actionables
- You can track your dietary fiber intake with a food diary app to ensure you're meeting your daily requirements. Start by setting a target based on dietary guidelines, then log your meals and snacks, focusing on including a variety of legumes, whole grains, fruits, and vegetables. Review your intake at the end of each day to identify any gaps and plan adjustments for the following day.
- Experiment with a 'rainbow challenge' where you aim to eat fruits and vegetables of different colors each day of the week. This not only makes your meals more visually appealing but also ensures a diverse intake of nutrients and fibers, which can contribute to better stool consistency. For example, have red bell peppers on Monday, orange carrots on Tuesday, and so on, aiming to cover the entire color spectrum throughout the week.
- Create a 'swap list' of ...
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Diagnostic Value of Stool Color and Appearance
Understanding the color and appearance of stool can provide crucial insights into one's health. Abnormal stool colors can be indicative of various health issues, and recognizing these symptoms can lead to early diagnosis and treatment.
Abnormal Stool Colors Can Indicate Health Issues
Abnormal colors of stool can be alarming and may signal underlying health complications that require medical attention.
Red Stool May Indicate Bleeding From Hemorrhoids or Colon Cancer
Bright red blood in the stool typically suggests that the source of the bleeding is in the lower digestive system, such as rectal polyps, hemorrhoids, or an anal fissure. Dr. Will Bulsiewicz takes the presence of blood in the stool seriously and recommends a colonoscopy to check for polyps, which can be precursors to cancer. He emphasizes the need for medical examination rather than assuming the issue is as benign as hemorrhoids, especially since colorectal cancer rates are rising in younger individuals. Colon cancer, which causes red stool, is the second leading cause of cancer death, underscoring the importance of not dismissing red stool as a minor issue.
Causes of Black Stool: Internal Bleeding or Medications
Black stool can be a result of taking bismuth medications like Pepto-Bismol. However, it can also indicate a slow gastrointestinal bleed, particularly when it originates higher up in the intestines and the blood darkens during its transit. This results in black, tar-like stool that usually carries a terrible smell. The presence of a foul odor often confirms blood in the stool.
Diet and Gastrointestinal Disorders Affect Stool Color
Identifying Health Problems Through Stool Colors
Bile is responsible for giving stool its brown color, and an absence of bile could turn stool white, indicating a bile duct blockage. Yellow stool can point to issues with digesting fats, potenti ...
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Diagnostic Value of Stool Color and Appearance
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Actionables
- Keep a food and stool diary to track correlations between your diet and stool color changes, noting any instances of unusual colors and the foods you ate prior to those changes. This can help you identify if certain foods are causing the color changes and alert you to any patterns that may warrant a doctor's visit.
- Create a bathroom checklist to remind yourself to observe stool color, consistency, and presence of oil slicks, which can be a quick daily habit to monitor your digestive health and catch early signs of potential issu ...
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