bowel movement

introduction

The bowel movement, too defecation or Egestion called, refers to the passing of stool (feces) from the anus. It arises from the digestion of the increased food and usually has one Brown colour. The brown color comes from the so-called Sterkobilin which occurs when the bile is broken down in the intestine. Other shades are covered in the following sections of the article.

Most of the stool is made up of water (usually 75%). The remaining components are undigested food residues, fats, Intestinal bacteria (about 10%) and secretions as well as digestive juices (such as bile).

As a rule, one speaks of a normal stool frequency (frequency of bowel movements) when this not less than 3 times a week such as no more than 3 times a day occurs. If bowel movements occur frequently, this is not automatically referred to as diarrhea, but rather from a "high frequency of stool", since the diagnosis of diarrhea depends on the consistency of the stool and therefore only occurs when the stool is watery (see below: Bristol Stool Scale).

It handles the same with constipationwhich occurs when stool is difficult to pass for days. Often strong pressing is used with the abdominal muscles, which in turn leads to a Hemorrhoid disease can lead. It is therefore advisable to promote bowel movements in another way, for example by changing your diet.

The average amount of stool in an adult is 200 to 300 grams per day. However, this can vary greatly depending on the food intake. Especially with a high-fiber diet, large amounts of stool can occur 1 kg.

The smell is also an important parameter of the bowel movement. As a rule, the odor is not pleasant and is therefore described as normal if the odor is not excessively malodorous. But there is also a smell sour or putrid Note or even metallic blood odor in addition, this can indicate an existing disease.

If there are problems with bowel movements, these should be clarified at a doctor's visit.

Bristol Stool Scale

According to the Bristol Stool Scale, bowel movements are divided into different types according to their shape and texture. It is intended to serve as a diagnostic aid in order to be able to estimate how long the food needs from the time it is consumed until it is excreted.

There are seven types of chair types:

• Type 1 is the type of stool that requires the longest passage time through the intestine (up to 100 hours) and is then difficult to pass. In terms of appearance, it appears roughly the size of a hazelnut and lump-shaped.
• Type 2 is also lumpy, but already takes on a more sausage-like shape.
  Type 1 and 2 indicate a possible blockage.
• The third type appears sausage-like with cracks on the surface.
• Type 4 is sausage-like or snake-like, soft in consistency and smooth on the surface.
• Types 3 and 4 are considered to be the ideal types of stool because they are easy to pass and do not rob the body of much fluids.
• Type 5 appears as individual, soft lumps of stool with a smooth edge. They are not difficult to get rid of.
• Type 6 can be described as flaky pieces with an uneven edge or as pulpy.
• Type 5 and 6 tend towards diarrhea (Diarrhea).
• Type 7 is water-like. There are no solid components, the stool is completely liquid. Type 7 is also defined as diarrhea.

What is the normal frequency of bowel movements?

The frequency of bowel movements varies greatly from person to person. Up to three times a day can be normal for someone. If you have more than three bowel movements a day, you can speak of diarrhea. But even if someone only has a bowel movement every three days, that is perfectly normal.
These big differences can arise, for example, from different diets. Food rich in fiber stimulates bowel movements, so that you have to go to the quiet place more often. With fewer than three bowel movements per week, the affected person suffers from constipation.

You might also be interested in this topic: Fecal incontinence

What color can the stool be?

The color of the stool can tell you a lot about your health. The natural color of the stool can range from brown to brownish yellow. The yellow tones are caused by degradation products of the blood pigment, which are also excreted through the intestine. The intestinal bacteria can still produce a brown dye from this. Different shades of color can indicate different things. Light brown to yellow stools can indicate that the gut bacteria are not working properly and are making less brown dye.

The intestinal bacteria can be disrupted by antibiotics or diarrhea. Furthermore, a lighter stool can arise due to the harmless disease Meulengracht's disease. In Meulengracht's disease, an enzyme that breaks down blood works less efficiently than normal. If the color turns gray, the bile duct, through which the broken down blood pigment reaches the intestine, is kinked or squeezed. In this case one should consult a doctor.

Black or red stools are a bad sign as it suggests that there is blood in the stool. Fresh blood is red and clotted blood is black. Blood in the stool can have serious causes, but it can also be of minor concern, such as hemorrhoids. A red discoloration of the stool can also be caused by beetroot eaten the day before.

Read more on the topic: Colors of bowel movements

Yellow chair

Yellow stool is, in most cases, a natural variation in color. If there are no other symptoms, the cause is usually the food intake of the previous days. A high consumption of eggs, dairy products or starchy foods such as potatoes, cereals or legumes can lead to yellowish stools. This is also the reason why babies often (gold-) have yellow chairs if they are exclusively with (mother-) to be fed milk (so-called "breast milk chair").

Read more on this topic: Fat stool

However, there are also diseases in which the stool can turn yellow. Usually, yellow stools are not the only symptom of an existing disease. As a rule, other symptoms such as nausea, vomiting, diarrhea, abdominal pain or severe fatigue also occur. A visit to the doctor is advisable in this case. Causes can be, for example, gastrointestinal diseases such as bacterial intestinal inflammation (Enteritis) or salmonella, as well as allergies or food intolerances. If necessary, therapy is given after an existing underlying disease is present.

It should also be noted that yellow stools are often associated with the so-called "bright chair“Is confused, which can indicate diseases of the liver, gall bladder or pancreas and thus the fat metabolism.

For more detailed information, see: Yellow bowel movements - what do I have?

Black chair

If black stool occurs, it must first be differentiated whether it is just black-brown or very dark, or whether it is actually deep black. In the case of black-brown stool, analogous to the yellow stool, you should first reflect on your own food intake the previous day. Red wine, red cabbage, beetroot or even cherries can lead to such discoloration. Iron supplements also cause black stools, as do charcoal tablets and some other drugs (a look at the leaflet under "Side Effects" should answer the question).

Read more about this in our main article: Colors of bowel movements

Stool with a deep black color, which also smells bad and shines as "Tarry stool" designated. If this type of black stool occurs, a doctor should be consulted to clarify the cause. If there is additional vomiting of blood, emergency action must be taken.
Possible causes of tarry stools include bleeding from the gastrointestinal tract (Gastrointestinal tract) especially in the upper area, for example from varicose veins in the esophagus that are torn or from gastric bleeding.
In combination with very irregular bowel movements and alternating constipation and diarrhea, this can indicate a tumor.

Read more on the subject at: Black bowel movements such as Blood in the stool

Problems with bowel movements

Problems with bowel movements can be accompanied by other complaints such as abdominal pain. These can be dull or spasmodic. Abdominal pain can occur with diarrhea and also with constipation. Pain can also only occur during bowel movements. This indicates hemorrhoids. With some diseases, blood can get into the stool. Blood in the stool should always be checked by a doctor.

constipation

Even if you don't usually talk about it, many people suffer from constipation every now and then - around 10-20%. In the vast majority of cases, the constipation is not caused by a serious cause. Often it is due to the diet or one has not drunk enough. Constipation can often be easily eliminated by simple measures such as exercise, drinking a lot, hot water bottles, etc.

Laxatives at the latest then lead to the desired goal. In rare cases, an ileus, a bowel obstruction, can also be the cause. In ileus, the intestine stops working. In this case, immediate treatment by the doctor is necessary. An ileus can e.g. occur after abdominal surgery.

Read more on the topic: Intestinal obstruction

Painful bowel movements

Pain when defecating is very uncomfortable. They can occur in the context of constipation in very hard stools. When defecating, you have to press very hard and small cracks can easily develop in the intestinal mucosa. Another common cause is hemorrhoids. Hemorrhoids are nodular enlargements of the veins and erectile tissue at the anus, causing pain when defecating. In addition, a little blood can get stuck in the stool.

Read more on the topic: hemorrhoids

Anal vein thrombosis causes burning, stabbing pain. This is a blood clot that forms in a vessel near the anus. Colon cancer can also cause pain when defecating - especially if it is located at the end of the intestine.

Mucus in the stool

If mucus appears in or on the stool, its color and quantity should first be observed and attention should be paid to accompanying symptoms, since mucus on the stool alone does not have any disease value. If it occurs over a short period of time, the cause is usually a harmless one, such as a change in food intake or an infectious cause.
However, if the mucus appears over a longer period of time and is associated with other symptoms such as abdominal pain, fever or nausea, or after a trip to tropical areas, for example, then this should be clarified by a doctor.

The main causes of mucus in the stool can be food intolerances / allergies such as celiac disease (gluten intolerance) or lactose and fructose intolerance. Furthermore, with polyps in the intestine or the autoimmune diseases ulcerative colitis or Crohn's disease, mucus occurs in the stool over a longer period of time.

Mucus on the stool is treated as part of the therapy for any underlying disease.

Are you interested in this topic? You can read more about this in our next article: Slimy stool

Blood in the stool

There are many causes of blood in your stool. In addition to serious illnesses, blood in the stool can also have harmless causes.

There are different types of "blood in the stool". In so-called "hematochezia", ​​light red deposits are visible on the stool. Since this indicates fresh blood, it is usually assumed that there is bleeding in the lower part of the intestine or existing hemorrhoids.
“Meläna” (= tarry stool) should definitely be clarified by a doctor (see section “Black stool”).

If there is light-colored blood on or in the stool, it is called “red blood stool”. This can be caused by bleeding in the upper parts of the gastrointestinal tract, especially when the intestinal contents pass through the intestine very quickly and the blood is not "digested" and therefore has no time to turn black.
Furthermore, intestinal diseases such as intestinal diverticula or Crohn's disease and ulcerative colitis can cause blood in the stool.
Blood in the stool can also have "external causes", such as a bleeding crack in the anus or wider anal area.

Before starting therapy, it is therefore important to find the cause. If blood is suspected in the stool, it is possible to have a doctor carry out a "Haemoccult test". This should detect "occult (= hidden) blood". The “haemoccult test” is recommended annually from the age of 50 as a colorectal cancer check-up and can usually be arranged by your family doctor. Alternatively, it is possible to have a colonoscopy.

Read more on the subject at:

• Blood in the stool.
• Blood in your stool and stomach pain

Stimulate and encourage bowel movements

If you want to stimulate your bowel movements, changes in drinking and eating behavior usually help. Drinking a lot of water (2-3 liters per day) stimulates digestion and thus the bowel movement. It is still best to consume water or other sugar-free drinks. Coffee also has a digestive effect, but if consumed too much it can also cause constipation.

In general, a high-fiber diet is beneficial for bowel movements. On the one hand, the more the better, on the other hand, a high-fiber diet (fruit, vegetables, whole grain products) can also lead to unpleasant gas, which is why an individual level has to be found. Fruits such as grapes or pears are recommended. Dried fruits (e.g. figs, plums) also contain a lot of fiber. In addition, vegetables such as salads, tomatoes, cucumbers, and carrots usually have a digestive effect and are less likely to cause flatulence.
Care should be taken to ensure that meals are taken in peace and that time is allowed to go to the toilet, as the suppression of bowel movements has a constipation-promoting effect.

Furthermore, exercise promotes digestion and thus stimulates bowel movements. A daily walk of 30 minutes is recommended. Stress reduction and adequate sleep also promote good digestion.

What can you do about hard bowel movements?

Very often, hard bowel movements are caused by lifestyle. Ready-made products, little drinking and little exercise can lead to hard bowel movements and constipation. Therefore it is necessary to do exactly the opposite of it. Lots of exercise stimulates the intestines and aids digestion. This also makes bowel movements easier. In addition, drinking a lot helps soften stools.

Water is withdrawn from the stool in the large intestine. If the body is well supplied with fluids, the body has to remove less water from the stool. With a lack of fluids, the opposite is the case. Finally, the stool is also influenced a lot through diet. Foods rich in fiber, such as vegetables or whole grains, stimulate bowel movements and are good for the bacteria that live in the intestines, which are important for digestion. Well-tried for a good bowel movement are flea or flax seeds. These swell and thus draw a lot of fluid in the intestine. The stool becomes softer. However, you should make sure to drink enough.

What are sticky stool signs?

A sticky stool suggests that there is a problem digesting fats. Bile acid and pancreatic fluid are required for the digestion of fats. If there are problems here, it comes to so-called fatty stool or medical steatorrhea. In addition to the sticky consistency, there are other features that stand out. The color is lighter than normal.

The chair is clay or ocher in color. There is also an unpleasant odor. It smells sour to sharp. In addition to its sticky consistency, the stool can also be frothy. A film of fat can form in the toilet water. Other symptoms include gas, abdominal pain, bloating, and diarrhea. Fatty stools occur in various digestive disorders. An example of this are chronic inflammatory bowel diseases or celiac disease (gluten intolerance). Also with diseases of the pancreas it can lead to fatty stools due to the lack of digestive juices. There are also other causes.

Read more on the topic: Fat stool

These are stool softeners

Other methods can be used before medication is used to soften bowel movements. A tried and tested home remedy for hard stool are flea or flax seeds. These must be consumed with plenty of fluids. But there are also numerous medications that have a laxative effect and soften stool.

On the one hand there are osmotic (water-drawing) laxatives such as lactulose, milk sugar or macrogel, which is the active ingredient of the frequently used Movicol. There are also salty laxatives. These include magnesium sulfate and sodium sulfate. However, these laxatives cannot be used in some diseases. With stimulatory laxatives there is an increased transfer of water and salts into the intestine, as they stimulate the intestinal activity. This group includes bisacodyl, sennoside and sodium picosulfate, which is contained in laxoberal drops.

Laxatives should not be used for habitual use, only when gentle methods are not enough. In the case of recurring constipation problems, a change in diet and lifestyle should be made or a doctor should be consulted for further clarification.

Read more on the topic: laxative

Defecation after every meal- what can it be?

In principle, bowel movements more or less immediately after eating are not unusual. When you eat, the bowels and digestion are stimulated. In order to gain space for the newly ingested food, an urge to defecate occurs. Since it is not uncommon for up to three bowel movements per day, depending on diet and disposition, a bowel movement after each meal does not have to be dangerous.

In the case of food intolerance, however, it can also lead to increased bowel movements, especially after eating. As a rule, food intolerances are accompanied by abdominal pain and diarrhea. In addition, the symptoms only occur when eating these foods, such as Contains dairy products. If a food intolerance is suspected, a doctor should be consulted for clarification.

Find out more about the topic: Food intolerance

Why do you have frequent bowel movements after coffee?

Coffee has a metabolism-stimulating effect and acts in different ways on the digestion and stimulates it. On the one hand, coffee stimulates acid production in the stomach, so that the chyme is broken down more quickly there. In addition, coffee stimulates the gallbladder and the intestines. This explains the mild laxative effect of coffee.

Read more on the subject at: Diarrhea after coffee

Burning sensation after defecation

There are different causes for a burning sensation after or during a bowel movement. For one, it must be a proper one hygiene be observed around Burning sensation after defecation to avoid. However, it is important not only to ensure thorough hygiene after defecation, but also not to clean too much. Because even too thorough hygiene can, if the skin is "chafed" and becomes inflamed as a result Skin irritation that cause a burning sensation in the weakened anal mucosa.

On the other hand, diseases like hemorrhoids or Anal fissures represent a cause of the burning sensation. With hemorrhoids, the burning sensation is usually from Itching and bright red blood accompanied in the chair. Make anal fissures small cracks in the mucous membrane If stool is slipped past these cracks, it leads to a burning sensation during and after stool. It can also Inflammation come when germs enter the bloodstream through the cracks.

Lead less often Worm infections to burning after defecation. However, these should be taken into account after a long trip to mainly “tropical” countries. It is very rare Anal cancer the cause of afterburn.

Furthermore, the consumption of spicy foods, especially the consumption of chilli (pods), hot peppers or a lot of pepper to burn when you have a bowel movement. This is harmless and usually disappears completely if you do not consume spicy foods.

If the burning sensation persists after a bowel movement, a doctor should be consulted.
If the itching, which often accompanies the burning sensation, is given in, the anal mucous membrane may crack, which leads to increased burning sensation during bowel movements.

Please also read: Burning of the anus.

How can you suppress bowel movements?

In principle, one should not suppress bowel movements, but rather go to the toilet when there is an urge to defecate, even if the situation is not always the best. However, if it is very inconvenient or if there is no toilet, there are a few tricks to delay a bowel movement. First of all, it is helpful to be standing or lying down. Sitting, and especially squatting, tends to increase the urge to defecate.

In addition, pinching the buttocks pushes the stool back and defecation is delayed. Coffee should also be avoided as it has a slight laxative effect. In addition, no new food should be consumed. Furthermore, before you no longer have the opportunity to go to the toilet relaxed, you should go to the quiet place.

There are also a few mental tricks. One should not think about the need to defecate and try to distract oneself. These tricks should not be used every day, but only in exceptional situations in order to maintain a healthy bowel movement. Constantly suppressing bowel movements causes abdominal pain, harder stools and constipation, making the next bowel movement even more uncomfortable.

Can you force a bowel movement?

Forcing a bowel movement is difficult. Various home remedies can be used to try to stimulate the bowel and bowel movements in the case of constipation. This already helps in many cases. With very strong laxatives it is almost always possible to force a bowel movement.
As long as there is no medical reason for this, e.g. In the case of a colonoscopy, in which the entire intestine is cleaned from the stool using laxatives, these should not be used.

Changes in bowel movements after biliary surgery

The gallbladder is removed as part of a biliary surgery. The gallbladder serves as an intermediate storage location for bile. However, it is actually produced in the liver and then reaches the gallbladder via bile ducts, from which it is then released into the intestine. After biliary surgery, the bile flows directly into the intestine.Due to the lack of intermediate storage, slight changes in bowel movements can occur - but they do not have to. In the weeks after the operation, the stool may be a little softer than before.

In addition, you may have to go to the quiet place more often. Other changes in the stool should not occur and may indicate complications. It is a bad sign if there is no bowel movement after the operation. This indicates that the bowel is no longer working. Discoloration of the stool should also be clarified. If for some reason no more bile can get into the intestines, the stool will turn gray. This should also be clarified by a doctor as soon as possible. Overall, biliary surgery has few complications compared to other interventions.

Read more on the subject at: Defecation after biliary surgery

How does bowel movement change in colon cancer?

In the early stages of colon cancer, there is often no noticeable effect on bowel movements. Changes only occur at an advanced stage. A classic symptom of colon cancer is alternating constipation and diarrhea. Blood in your stool can also indicate colon cancer.

Read more on the topic: Colon cancer symptoms

However, blood in the stool can also have numerous other causes. In any case, however, a doctor should clarify the matter. In addition to these complaints, other symptoms can also occur, such as a feeling of fullness despite little food or cramp-like abdominal pain. Pain during bowel movements is also possible, depending on the location of the cancer in the intestine.

Also read the article on the topic: Blood in the stool

Where can you have your bowel movements examined?

A bowel movement can be examined for a wide variety of things. Standard examinations such as a haemoccult test (examining the stool for blood) can be done by your doctor. A stool sample can be given to him, which he then sends to the laboratory for further tests.

The specialist for the intestine is the gastroenterologist. The family doctor can help with further necessary examinations, such as refer to a colonoscopy.

What is a stool transplant?

In stool transplants, stool from one healthy donor is transferred to another's bowel using a capsule or endoscopy. Recipients of the stool are people who have a damaged intestinal flora. The method was developed to rebuild a more stable intestinal flora after an intestinal inflammation with the bacterium Clostridium difficile. After infection with Clostridium difficile, the intestinal flora is reduced in diversity and susceptible to new infections.

The area of ​​application of stool transplantation is currently being expanded. Stool transplants pose few risks. For the donor of the stool, preference is given to people who are related to the recipient or who live in the same home environment.

Find out more about the topic: Stool transplant