WELL......... It is time to grow up and get past all that. Join me with a labcoat and glasses as we talk about the body as a system for a moment. What is the number one output from your system? Okay, how about number two? LOL - get it? Number two? How can you consider the health of the system without considering the output of the system? If I want to know the quality of the product from a factory, wouldn't I just grab a box cutter and head to the loading dock to check out some of the stuff in the boxes? Well, your poo is the product from you digestive tract and it contains excellent clues as to the health of the system.
Believe it or not there are actually websites dedicated to tracking poo. Like reading scat on a trail. Except incredibly bizarre because real live humans are willing to upload their toilet pics. I am hopeful they each removed the GPS info from their cell phone pics and NO - I never posted on one of those sites.
For the rest of us polite folk, we just don't talk about it. Surprisingly, doctors seldom ask us about it. That fact shocks me. I think there are some eloquent phrases to describe this reason - something about "delicacies" and "etiquette." Well, I call BU!!S*** on that. If the evidence of a crime were in front of a detective, don't you think (s)he would at least take a look?
So let's put on our clean, white labcoat and our detective hat. Here is a picture of the Bristol Stool Chart. No idea how many lab assistants it took to look in toilets and determine this charting tool. It's actually kind of funny to think about and how would YOU like to be the guy who is famous for creating this picture? No thanks. My last name may be a little funny but I don't want "Stool Chart" after it for the rest of my life. Ha!
What you want is poo that looks like a four or five. Some people say sixes are fine too - I personally am not thrilled to see those in my home. We are honest to goodness poo peekers in our home - I've taught my girls to always look at it and let me know. I am thrilled with fours, okay with fives and start looking for a big picture issue or solution if we have anything else on an ongoing basis.
Note: If you are doing the SCD/GAPS diet your stooling can shift back and forth quite a bit. Don't freak out if you get one random 3 or 6 or whatever. But if you get more than one start looking for a culprit or a solution. Keeping a food / supplement / emotional / poo journal can be very helpful. It took awhile to figure it out but cucumbers and zucchini had my older daughter living with 6s. Once we removed the foods she settled back into 4s and 5s.
So enough random chatter, since we have labcoats on today let's get in there and start dissecting the matter at hand.
The Big DDiarrhea cha cha cha. Surprisingly I cannot remember the rest of that grade school rhyme but I realy consider that a good thing.
The reason loose stools / diarrhea are a big deal (a 6 or 7 on the scale) is that it means the person's bowels are moving too quickly and they are likely losing all the amazing nutrition they have put into their body. On this diet, that is literally flushing a lot of $$ down the toilet. I know about the loss of great nutrients this way from my older daughter's experience. It has been a big deal for her and something she struggles with intermittently. It seems to be related to allergies for her. In the meantime she is not growing much at all (her formerly "failure to thrive" little sister is catching up to her). Coincidence? I think not.
Diarrhea is one of the developing world's biggest killers of young children, killing close to 2 million children per year. If you expand the age group and set of nations it kills between 4 and 6 million per year. It should be taken seriously and not ignored. Stress can cause it. Diuretic foods / veggies / juices can cause it. Bacteria can cause it. Yeast can cause it. Food allergies / intolerances can cause it. Getting to the bottom of it (ha - didn't even have to try on that pun) can take awhile and you just have to experiment a bit to eliminate possible causes and find out which one is the primary underlying problem.
So, if you rank a 7 on the Bristol scale, how do you want to handle it? First, remove anything from the diet that can irritate your digestive lining. When the gut lining is irritated it just flushes everything out as fast as it can (AKA diarrhea). Remove nuts, seeds, roughage/fiber and just drink broth. Eat boiled or broiled meats, particularly easy to digest food like fish. Really go easy until you get it under control and then add things in slowly, starting with well-cooked vegetables. Sounds quite a bit like intro, right? Glad you thought of that! That is actually a great idea you just had - just go back to intro to get a little healing. Listen to your body and see what it is crying out for - your intuition will be a better guide than anything I can type. Observe how foods impact you and pay attention.
If you rank more like a 6 on the Bristol scale, particularly if you have undigested food, you may be looking at a yeast overgrowth issue or a lack of stomach acid / enzyme action (they are frequently linked). If this kind of poop has been going on awhile, then consider doing a little research on using HCl with Betaine to increase your stomach acid and give a boost to your digestive enzymes. Alternatively, you can start out a little more gently with apple cider vinegar (ACV) or sauerkraut juice twenty minutes before a meal. If you think it is yeast, there are a bunch of other things to consider toying with as well. I'll write a separate yeast post soon (and I'll come back and link it). But addressing low stomach acid may help with yeast as well because yeast can grow in a stomach that is not at its optimal level of acidity.
With the 6s and 7s on the Bristol scale, keep an eye on the foods you are eating and look for a culprit. Allergies can definitely show up like diarrhea. Just ask my little girl. Gosh, I hope these posts are history by the time she has a prom date. But in the interest of Mamas sharing information we'll keep going!
The Big CFor the anal retentive among us, constipation is a physiologic disaster. It'll make you grumpy and mean. Probably because all the toxins your body wants to get out of the way are sitting in your colon being reabsorbed.
Do you want to reabsorb that which your body is trying to dispose? Definitely NOT! So if you are anything less than a 4 on the Bristol scale you will want to take steps to get things moving. Here is a listing, in no particular order, of things to consider / try:
- If your constipation kicked in as a result of a change in probiotics (or fermented foods which are a great source of probiotics) consider going lower/slower. Probiotics are wonderful and necessary for improving gut health but they can also cause some die off as your body acclimates. It is a delicate balance and is particular to each body so listen to what yours is telling you and adjust accordingly!
- Consider your diet - are you consuming enough fat? Sugars? Both play a role in elimination of waste from your body. We don't do a lot of sugars in our home but I do keep up with the winter squashes since we are mostly avoiding fruit right now. But I notice a big difference in gut motility when eating a lot of fat versus not enough fat. And it's also a lot of fun to cook with loads of it. It makes my body feel GREAT!
- When you wake, first thing, drink a glass of water with a whole lemon or lime squeezed in it. Not only is this great for constipation it is also a nice bit of vitamin C which will nourish your adrenals. Some say it is helpful to the gallbladder and liver. Drink the lemon/lime water on an empty stomach and do not eat anything for thirty minutes and you can reasonably expect to see *some* difference in your bowels and morning digestion. Do it a lot and your body will begin to crave the morning lemon/lime water!
- Magnesium... magnesium is something I struggle with keeping in my body on this diet. Perhaps because my body is dumping oxalates (if that sounds like a foreign language I promise a future post) and perhaps because the grains I used to count on for magnesium are not in my diet anymore. Then there is the whole "health of our soils" that makes our food and water sources low in minerals they used to include. Regardless of the cause of low levels, magnesium is usually one of the first items I consider when talking about constipation. Feeling stressed out? Mean? Yelling at the kids? Got a kid throwing tantrums (who isn't eating processed foods / sugars)? Consider your magnesium levels. My favorite forms of magnesium are epsom baths (2 cups of a high quality epsom in a hot bath for 20 mins), Natural Calm (a magnesium supplement), or magnesium spray/cream. If you need magnesium but are not constipated then try the transdermal methods for getting magnesium into your body. If you are constipated, try an oral supplement + a bath/cream/spray.
- Increase quantities of broth/soup, particularly those with a load of gelatin in them. The gelatin is very soothing to the gut wall.
- Sauerkraut! And if the sauerkraut is too advanced for someone to digest just the sauerkraut juices will be helpful and taste wonderful added to a warm (but not hot - you don't want to lose the probiotics in the kraut) broth or soup.
- To help heal the wall of the colon butyrates are helpful. Just to mention it in case someone is curious. Butyrates are most commonly taken in the form of an oral supplement but the original delivery method studied and pronounced successful was via enema. Two birds, one stone? Sorry. Trying to keep it all light-hearted. Supposedly bifido bacteria make butyrates so if you are following a GAPS probiotic protocol versus an SCD probiotic protocol you may have a better supply of butyrates as a result.
- I saved the best for last. Really. How about a coffee enema? I have no personal experience (I swear) on this one but I'd be remiss not to mention it since Dr. NCM covers it in her book and the chat groups are all lit up with people talking about it. I personally focus on the magnesium but that may be because I need to chill out and I am *not* curious enough to find out caffeine's ability to be absorbed in the colon. Really.
ColorJust a quick word on color - it should be a nice dark brown. If it is light yellow / greyish then that is likely a stomach acid issue and again I would suggest researching HCl with Betaine. Dr. NCM has a chapter called Digestive Enzymes that is particularly helpful in understanding this.
If the color is black that can be blood in the digestive tract and it is worth a quick visit to your doctor for a testing kit. Sometimes you can just call in and get them to put a kit at the front desk for you - you don't necessarily need a consultation to get the kit.
As far as other rainbow colors, sometimes poo can take on a shade of red (think of the red flaking off poo when someone eat beets) or orange-ish poo after a load of butternut squash. There can be shades of green, particularly with a lot of blueberries. What I have found in my family is that if a food is coloring things in a major way it is likely nothing to worry about but I do watch to see if perhaps it is another symptom of not fully digesting the food.
If your poo leaves a streak on the porcelain express, that is a symptom of fat malabsorption. Again, see the notes on considering HCl with Betaine. If there is an oil slick on the surface that is again a symptom of fat your body did not absorb as well. This may or may not be something to worry about - depends on whether or not you had escolar (an amazing tasting but exceptionally fatty fish) a day or two before. I'm really not kidding on that one. But the words "etiquette" and "delicacies" is coming to mind so I won't tell the story. ;-)
Also, watch the frequency of the poos. Plenty of Mamas get to know their baby's poo cycle as a young child. If something suddenly shifts, see the above notes on "D" and "C." Plenty of poo bloggers say it is ideal to poo once for every large meal you eat. I don't think our family has quite experienced that, even when things are all looking awesome, but certainly 2x / day seems pretty normal. Just 1x / day seems a bit on the "C" side of things and 4+ / day seems a bit on the "D" side of things. Just try to normalize it all and consider frequency in addition to the way it looks on the Bristol scale.
Thanks for joining me today in the poo lab - you can drop your labcoat in the laundry bag on your way out. If you'd like we can all pretend we didn't just look at that / talk about that / get that on the labcoat. Someday we may be ready to admit that poo is a big deal but until we are there you can just hang out with me in the back of the room and we'll whisper about it. I don't want to be known as a freak either.