What is a Normal Poo?
Our bowel habits can have a big impact on our health and wellbeing. Everybody is different, and it is normal for our bowel habits to change from time to time. But it is useful to have an idea of what is ‘normal’ when it comes to your poo, so that you know when to seek support from a healthcare professional.
A normal poo should be soft, formed and easy to pass.
The stool chart below is a useful way of checking how healthy your poo is:
- Type 1 – 2 indicates constipation
- Types 3 – 4 is a normal poo
- Type 6 – 7 indicates diarrhoea
In terms of frequency, it is considered normal to poo within the range of: three times per week to three times per day (1).
What can cause constipation:
- A low intake of fibre and/or fluid
- Low activity level
- Stress or anxiety
- Frequently ignoring the urge to poo
- A change in routine – such as travelling
- Common during pregnancy
- A side effect of certain medication
- Medical conditions such as: coeliac disease, hypothyroidism, IBS or bowel cancer
What can cause diarrhoea:
- Food poisoning
- A virus or infection (e.g. gastroenteritis or norovirus)
- A side effect of certain medication
- Medical conditions such as: IBS, lactose intolerance, coeliac disease, diverticular disease, inflammatory bowel disease, bowel cancer or a food allergy
When to See Your Doctor
You should see your doctor if you are having any persistent problems with your gut, especially if this has been ongoing for more than 6 weeks (2).
Signs of bowel problems include:
- Constipation (if you have had less than 3 bowel movements per week) and/or diarrhoea
- Stomach pain
- Excessive Gas
- Nausea or vomiting
- Reflux or indigestion
- A feeling that you urgently need to poo
- Incomplete evacuation – feeling that you haven’t fully emptied your bowels after pooing
- Mucus in your poo
⚠ Don’t wait 6 weeks to see your doctor if you experience: worsening or persistent changes in your bowels or symptoms, blood in your poo, needing to poo frequently overnight, unintentional weight loss, fever or difficulty swallowing – especially if you have a family history of bowel cancer, coeliac disease or inflammatory bowel disease.
Medical Conditions Related to the Gut:
There are numerous medical issues which can impact our gut.
Some of the most common conditions include:
- Irritable bowel syndrome (IBS): when a group of gut symptoms are present in the absence of other medical conditions. Check out our full article on IBS for more information.
- Inflammatory bowel disease (IBD): these are medical conditions which cause chronic inflammation in your gut, such as: ulcerative colitis and Crohn’s disease.
- Coeliac disease: an autoimmune condition which involves an intolerance to gluten, a type of protein found in wheat.
- Lactose intolerance: an intolerance to lactose (the sugar naturally present in dairy) due to a deficiency of the enzyme lactase.
- Small intestinal bacterial overgrowth (SIBO): when a large amount of bacteria is found in the small intestine, leading to uncomfortable symptoms in the gut. You can read our full article on SIBO for more information.
- Gastroenteritis: an infection in the stomach and bowel which leads to vomiting and diarrhoea.
- Diverticulitis: inflammation or infection of small pouches that develop along the lining of the intestines.
- Gastritis: inflammation of the stomach lining.
- Helicobacter pylori (H. pylori) infection: this is when H. pylori bacteria builds up in the lining of the stomach. We have a full article on H. pylori infections for more information.
- Stomach ulcers: a sore that develops in the lining of your stomach, these can also occur in the oesophagus (food pipe) and the first part of the small intestine.
- Hemorrhoids (or ‘piles’): swollen veins which can form bulges on the inside or outside of the anus, these can become painful when pooing.
- Hernia: when an internal part of the body pushes through a weakness, such as when part of the intestine pushes through a weak spot in the stomach causing a bulge which can be painful.
- Cancer – including bowel and oesophagal cancer.
⚠ If you suspect that you have any of the above conditions, it is vital to see your doctor to either get an official diagnosis or to rule this out.
Reactions to medication can often lead to gut issues as well, see this summary from NHS Choices for more information about this.
Common Tests & Management Options:
Your doctor will usually carry out a physical examination and assess your symptoms in the context of any medical conditions that you have, and the medical history of your close family members.
There are a variety of tests that your doctor can use to investigate your gut health.
Some commonly used diagnostic tests include:
- Blood tests
- Endoscopy: a camera which goes down the oesophagus to examine the upper end of your digestive tract – this can also be used to take a tissue sample (a biopsy) which can be used for further lab tests.
- Colonoscopy: a camera which goes up the anus and into the intestines – a biopsy can also be taken during this procedure.
- Testing stool samples.
- Breath tests: your doctor can advise you on which types of breath tests are reliable to use.
- Barium swallow: a chalky liquid is used so that your swallow can be monitored on an X-ray while it is happening.
- X-rays, CT scans, MRI scans or genetic tests are also sometimes used.
⚠ If your doctor decides to use a blood test to check for coeliac disease, it is important to include at least 3g of gluten in your diet for 6-8 weeks before this test (i.e. 2 slices of bread or a portion of pasta every day). (3)
Management strategies will vary a lot depending on the outcome of the diagnosis and each individual situation, so it is always best to be guided by your doctor. In general, this may involve medications, medical procedures, diet and lifestyle changes.
If you don’t receive a diagnosis related to your gut but still experience some gut issues, then this is a useful summary of good foods to aid digestion from NHS Choices. For individualised advice, you can also seek support from a registered dietitian or nutritionist.
For more information about the diagnosis and management of specific gut issues, you can read our articles on:
NHS Choices also provide reliable information on diagnosing and managing a variety of gut issues.
Where to Find Support:
- Speak to your GP
- See a dietitian – your GP can refer you to a Dietitian or you can find a private practice dietitian here.
- Guts UK – a charity which supports those with digestive health issues.
- Walter et al. (2010) “Assessment of normal bowel habits in the general adult population: the Popcol study.”. Scand J Gastroenterol; 45(5): 556-66.
- Cancer Research UK (2017) “A normal bowel habit”. [accessed May 2019 via: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/normal-bowel-habit]
- Leffler et al. (2013) “Kinetics of the histological, serological and symptomatic responses to gluten challenge in adults with coeliac disease” Gut. 62(7): p. 996-1004.