Should I be keeping track of my toileting routine? Is that colour even normal? How does menstruation affect how and when I go?
We all spend a lot of time on the porcelain throne, but poop remains a topic that’s rarely talked about, even with our doctors. And many women have a lot of questions about what’s healthy—and what’s not. So we went to the experts to dispel some frequent misconceptions, answer the most common queries and address the biggest concerns about number two.
You don’t have to poop every day.
“Everyone’s normal poop frequency is different,” says Dr. Jennifer Kwan, a family doctor in Burlington, Ont. Some people’s systems require a bowel movement multiple times a day, while others can comfortably wait several days between visits to the loo. “It can range from three times a day to three times a week, and it depends on your dietary and fluid intake, activity level, age, medical conditions, medications, and other factors, too.” Tracking your pooping schedule is a good way to keep you aware of changes to your health.
That said, what is typical might not be optimal, says Olivia Rose, a naturopath in Toronto. “I do believe most people should be averaging around once a day,” she says. “In 15 years, I’ve never had a patient who hasn’t pooped in close to a week and felt good—even if that’s a pattern they’ve been following for years.” There could be minor shifts in your diet and lifestyle, and stress factors that might result in you skipping a day or two, but your body should catch up, says Rose. And if it doesn’t, and you’re feeling bloated or experiencing other symptoms of minor constipation, you may want to talk to your health-care practitioner about things you can do to improve your transit time.
Red stools always require a visit to the emergency department.
There are a lot of factors that can change the colour and texture of your stool. In general, all shades of brown are normal, and even green poop isn’t typically cause for concern. “This usually reflects increased vegetable intake,” says Dr. Kwan. If you had a beet salad for lunch, or ate a bowl of fresh cherries for a snack, that could be causing your poop to take on a reddish hue. Iron supplements or a dose of bismuth subsalicylate (like Pepto-Bismol) can both turn poop black and aren’t cause for concern. But if you can’t trace a dramatic change in your stool back to a meal with vibrant colour or to a medication, you should get it checked out, especially if it’s accompanied by other symptoms like cramping, rectal pain or bowel incontinence. “If you’re surprised to see red, black or white stool, talk to your doctor,” says Dr. Kwan. A medical consult can rule out the possibility of an infection, malabsorption issue or potentially serious illness.
It’s OK to push (a little).
A light push can be necessary to get things going sometimes. “Maybe you’re a bit dehydrated or haven’t had enough fibre that day,” says Rose. But if you’re pushing hard, and on a regular basis, that’s a sign that you could have an issue with constipation. “If you’re often bearing down or straining, it’s a problem because you’re building up abdominal pressure, which can be damaging,” she says. Pushing too much can increase the risk of hemorrhoids (swelling in the veins around the anus) and fissures (tearing of the skin that lines the anus), both of which can be painful. Talk to your doctor if you have discomfort when you poop, or notice blood on the stool or toilet paper after you wipe.
Diarrhea is common and not that big a deal.
Problems with too-frequent trips to the toilet are not uncommon, but they can be cause for concern. If you have diarrhea in combination with a fever, this could be a sign of a bacterial, viral or even parasitic infection. A sudden case of the runs can also occur in response to certain medications. “Antibiotics can cause diarrhea as a side effect, but doctors generally take into account the risks versus the benefits of prescribing these medications,” says Dr. Kwan. Diarrhea should typically resolve within a few days, once you’ve finished your course of meds, for example, or recovered from the illness or infection that’s causing the issue.
Chronic diarrhea, on the other hand, can be a sign of inflammatory bowel disease, a food intolerance or another digestive disorder. If a bout of diarrhea continues for more than a few days, talk to your doctor, particularly if it’s accompanied by weight loss and/or abdominal pain.
Period poop is a thing.
It’s normal to go less (or more!) on the days that you are menstruating. During your period, your body increases production of prostaglandins and decreases its output of progesterone, and both can mess with your poop cycle. Depending on what your PMS diet looks like, and how your body reacts to these hormone fluctuations, you can end up with a bit of gas and diarrhea, or some bloating and mild constipation. One way to get some relief is to take a nonsteroidal anti-inflammatory drug, like ibuprofen, right before your period starts. This drug blocks prostaglandin production and may reduce diarrhea and cramps. Check with your doctor about your period poops first, especially if you’re experiencing severe cramping or diarrhea, to rule out anything more serious. Some health conditions, like irritable bowel syndrome, for instance, can flare up during menstruation.