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5 Facts About No. 2

Learn the basics — and the essentials — of bowel health

With their variations in frequency, shape and accompanying symptoms, our bowel movements and stool offer clues about our health — as well as potential health problems.

Marc Brand, MD, a colorectal surgeon at Rush, discusses five things everyone should know about bowel health. 

'Normal' is a broad term. 

Normal frequency for bowel movements can range from three times a day to once every three days, depending on a person’s eating habits and other factors. What’s important, Brand explains, is to know what’s normal for you.

"People may be within a normal range, but if they suddenly go from one extreme to the other or experience a change that’s not normal for them, that would be something worth investigating," he says.

So if you experience changes in your bowel habits that last longer than a week or two, consult your doctor (particularly if you are older than 50, the age at which people begin to have a higher risk of developing digestive problems).

Abnormal frequency has a variety of causes. 

People who fall outside the normal spectrum of frequency have either diarrhea — when bowel movements occur more frequently than normal and are often watery — or constipation. Constipation, Brand notes, does not necessarily mean that a person has an urge to go and can't (a common misconception) but that he or she doesn’t go frequently enough.

People who experience constipation or diarrhea for more than a week should visit the doctor; both problems can signal a variety of conditions including irritable bowel syndrome, inflammatory bowel disease, thyroid problems or even cancer.

Shape, color and consistency can — but don’t always — matter.

"The optimal consistency is like a banana," Brand says. "Soft, round, smooth and tapered, with very few crevices." This form protects the area around the anus from problems such as anal fissures or hemorrhoids.

Stools that become pencil-thin for several weeks can suggest obstruction from cancer or another condition, but most deviations from the ideal shouldn’t necessarily cause concern: The color, consistency and shape of your stools can change due to normal fluctuations in diet. Not consuming enough fiber or fluids, for example, can make your stool harder — as a result of which you might want to drink more water but not necessarily visit the doctor.

"A change in the consistency only becomes worrisome if combined with other symptoms such as pain," Brand says. "And color usually isn’t important unless it comes from blood."

Blood doesn’t equal a hemorrhoid. 

"A lot of people will blame everything in the anal area on hemorrhoids," he notes. "But while blood in your stool can suggest you might have a hemorrhoid, there are a lot of things beyond hemorrhoids that can cause bleeding and other symptoms."

The most serious of these causes is colon cancer, so those who experience bloody stools should visit a gastroenterologist to get tested for the condition.

The first symptom is no symptom.

If you’re older than 50, an age at which the risk of colon cancer begins to increase significantly, don’t wait to get screened until you see blood in your stool or experience other symptoms.

"Every cancer has a stage when it exists without symptoms," Brand points out. "So the earliest and most common symptom of colon cancer is no symptom."

Moreover, about two-thirds of patients diagnosed with colon cancer do not have a family history of the condition. "The bottom line," he says, "is that once you hit 50, you should start getting colon cancer screenings."