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Ask a Doctor: Are my bowel movements normal?

The frequency and color of poop can vary widely. Most of the time, they shouldn’t cause alarm.

A photo illustration using a black and white photo of several rolls of toilet paper in the background, while on top of it two blue check marks and one red x appear and disappear.
(Washington Post illustration/Unsplash)

Q: I’ve heard that going once a day is normal, but is it bad if I poop every few days? Should I be concerned if my poop is sometimes a strange color? What’s really “normal” for bowel movements?

A: It often amazes me how little we are taught about something so intrinsic to our basic functioning. Recall, for example, how many times proper tooth-brushing technique was drilled into our heads as children. But for reasons inexplicable to a gastroenterologist like myself, when it comes to pooping, we draw the line.

As a result, most of the adults who come to my gastroenterology clinic have no idea what would be considered a “normal” bowel pattern.

A general rule of thumb is that anywhere from three bowel movements per day to three per week is within the range of “normal.” If we look at the numbers closely, stool frequency varies by geographic region, age, sex and cultural habits. In the United States, the majority of people who consider themselves to have normal bowel habits report having between 3-7 bowel movements per week. In eastern India, however, where more people are vegetarian and the typical diet is much higher in fiber, people have a median of 14 stools per week. In Italy, meanwhile, people tend to defecate once per day.

Women and older people tend to have less frequent stools.

With so many factors at play, there isn’t a one-size-fits-all approach to normal stool frequency. But there are some important features about bowel movements you should know to be considered healthy.

Normal is what’s comfortable for you

Once-a-day bowel movement is great for many people. But the key to a healthy stool frequency is that however often it happens, it should be comfortable and occur in a socially appropriate context.

If you consistently have a bowel movement once a day, but to do so, you have to strain significantly, take four laxatives in the morning, and never feel like you’ve quite … evacuated … everything, then I’d say there is a problem. You shouldn’t be scrolling through TikTok for 30 minutes while trying to poop (you risk developing hemorrhoids). If this sounds like you, speak with your doctor about ways to have easier bowel movements. Sometimes simple fixes such as increasing your water and fiber intake or boosting your exercise routine (which can stimulate your bowels) can make a big difference. On the other hand, if you only have a bowel movement every second or third day, but doing so is effortless without bloating, pain or undue straining, then that’s a healthy and “normal” pattern.

Maybe you’re someone who has three bowel movements each day, but they’re soft and never feel so urgent as to disrupt important work meetings or stymie your agenda at happy hour. I’d say to leave it alone and consider yourself “normal.” But when the urge to poop occurs at frequent and inconvenient times, making you afraid to socialize for fear of an embarrassing call of nature, it’s worth talking to a physician about potential ways to address it.

So if you find that your bathroom habits are comfortable and don’t hold you back socially, then poop in peace, even if it’s not always precisely once per day.

Different poop colors

Usually, but not always, our stool is some shade of brown. But when you see poop of other colors, it’s very common to wonder what that means. Most of the time, it’s nothing to worry about and probably a result of what you ate and how your body processed it.

The main colors I become concerned about are red, maroon and tarry black. These could indicate bleeding from somewhere in the gastrointestinal tract (note: eating beets can give you a false alarm). If you see these colors and are vomiting, feeling lightheaded or having severe abdominal pain, please go to the emergency room.

But most other hues are variations of normal and related to fluctuations in your diet. When I hear about these colors, I usually react as follows:

Green: Don’t sweat it.

Yellow: No big deal.

Orange: Not worried.

Dark brown: Still not worried. If it’s not black like the hue of your TV screen and sticky, it’s probably not because of bleeding.

While most of these color and shade variations are essentially “normal,” keep in mind if stools are also newly loose and watery, or accompanied by other symptoms such as fever or abdominal pain, that is worth investigating.

White: You have my attention. Bilirubin, the waste product found in bile, is what gives your poop its characteristic brown color. Without it, stools are pale. White or clay-colored poop could suggest a blockage, such as from a gallstone that is preventing bile from reaching your intestine. This should be discussed as soon as possible with your physician.

Silver: Do tell. There was a vivid case report about the stool of a patient with simultaneous gastrointestinal bleeding and bile duct blockage, leading to shiny silvery stool. But this would be exceedingly rare.

When it comes to bowel movements, what’s normal for you may not be normal for your family member or friend. And that’s normal. If you’re bothered about any aspect of your bowel habits, always talk to your doctor — even if to get reassurance. For physicians, especially gastroenterologists, no questions are off-limits or too embarrassing, but perceived stigma about discussing poop can keep people from getting the answers and help they need.

Meet the doctor: Trisha S. Pasricha is a gastroenterologist at the Massachusetts General Hospital Center for Neurointestinal Health and a medical journalist.

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