What is the normal color, shape, smell of stools?

The color, shape, and smell of the stool can vary from person to person, but each of us can notice differences in our stool from day to day or even within the same day. Where do these differences come from and what can they mean? Do we finally have to observe our feces? Can their observation provide useful information about the state of health?

Composition of the stool

Stools are made up of water, protein, indigestible fat, polysaccharides, microbial biomass, ash, and indigestible food residues. The predominant components of faeces, as expressed as a percentage of total (liquid) weight, are oxygen (74%), hydrogen (10%), carbon (5%), and nitrogen (0.7%). 75% on average is the water content of the stool, with fluctuations depending on the fiber content of the diet, as they absorb a large amount of water in the large intestine. Therefore the remaining 25% of the feces consists of solid material, which mostly concerns organic matter.

Normally there should be no admixtures of blood or mucus or a large amount of fat in the stool.

Why is Blood in my stool

The presence of blood in the stool may be so large that it can be seen with the naked eye, but it may be so small that it can only be detected by microscopic examination of the stool. In both cases the causes are many, more or less serious, and life-threatening, so one should consult a doctor who based on age, history and any additional tests will identify the underlying disease. Blood in the stool may be bright red or black (black stools). In general, the higher the cause of the bleeding in the gastrointestinal tract, the darker the color, while conversely, the brighter the red, the lower the gastrointestinal tract is the problem. The most common cause of the presence of blood, intense red color, in the stool are hemorrhoids. In the case of hemorrhoids, the blood is not mixed with the stool and may drip into the pelvis or paper.

Causes of Blood in the stool

• Anal fissure

• Colon diversions

• Colon polyps

• Colon cancer

• Idiopathic inflammatory bowel disease (Crohn's disease, ulcerative colitis)

• Radial enteritis

• Gastric or peptic ulcer

• Stomach cancer

• Esophageal varices

• Esophageal cancer

• Esophagitis

• Hemorrhagic gastritis

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Cause of Mucus in my stool

The intestinal epithelium is covered by a layer of mucus so as to protect it from contact with the bacteria of the intestinal flora, but also to facilitate the passage of feces. A small amount of mucus is normal in the stool, however, it is so small that it is not visible to the naked eye. If the presence of mucus in the stool is large and obvious, then it is probably related to some disease of the gastrointestinal tract.

When there is an inflammatory process of the intestinal epithelium, the mucus breaks down and is excreted in the feces. This is commonly found in idiopathic inflammatory bowel disease (Crohn's disease and ulcerative colitis), irritable bowel syndrome, gastroenteritis, and intestinal parasitic infections. Mucus can also be seen in the feces of patients with cystic fibrosis, but also in malabsorption syndromes, such as lactase deficiency and celiac disease.

Cause of Fat in the stool

A small amount of indigestible fat is normally present in the stool. However, some pathological conditions result in the malabsorption of fat and the presence of a large amount in the stool, the so-called steatorrhea. Steatorrhea is defined as the excretion of 7 grams of fat per day in the stool. In the case of steatorrhea, the stools have a fatty appearance, light color, and a very strong and unpleasant odor. Some of the diseases that can be associated with steatorrhea are:

• Pancreatitis

• Crohn's disease

• Liver disease

• Cholecystopathy

• Cholelithiasis

Because steatorrhea is not a disease, but a clinical manifestation of a disease, it is necessary to treat the underlying disease along with reducing fat intake through diet.

What are the normal form and types of stools?

Various scales have been used to characterize the shape and form of the stool, however the most popular is the Bristol Scale Stool Form which was first developed in 1997 by Dr. Stephen Lewis and Dr. Ken Heaton. This is a simple scale with easy application, which is based on the visual observation of feces and classifies them into 7 categories, as shown below:

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The Bristol stool scale

Normally the shape of the stool should be type 3 or 4. Abnormal form of stool is considered to be that of types 1, 6 and 7. If it is type 1 or 2 then chances are we are talking about constipation, while types 5, 6 or 7 tend to diarrhea.

What is the normal color of human stool?

The color of the stool ranges from light to dark brown. The brown color is due to the presence of oxidized bilirubin in the stool. Bilirubin is a byproduct of red blood cell hemoglobin metabolism. The color also depends on the diet as well as the age. Thus the yellow or green color of the feces of breastfed infants is normal due to the rapid passage of intestinal contents, as well as the green color of the feces of an adult who consumes a lot of vegetables. The table below shows the possible colors of the stool as well as the causes that result from them.

Stool odor types when should we really worry?

Normally stools smell bad and this is mainly due to the metabolic processes of the bacteria that make up the microbial flora of the gut during the breakdown of food components. the odor is affected by both dietary changes and changes in the microbial flora. It is very much related to the type of bacteria that prevails each time.

Pathological conditions that can change the microbial flora resulting in a particularly bad stool odor are:

• the diarrhea

• flatulence

• malabsorption syndromes: celiac disease, idiopathic inflammatory bowel disease (Crohn's disease, ulcerative colitis), lactose intolerance, short bowel syndrome

• gastroenteritis

"Bad stool odor can be observed in diseases such as pancreatitis and cystic fibrosis, due to malabsorption of fat and the presence of steatorrhea"

Observing the stool can provide useful information about our state of health. A change in the characteristics of the stool (shape, color, odor) can be a warning of a pathological condition whose diagnosis may be delayed, but can also be a useful tool for monitoring the course of an already known pathological condition. In any case, it is useful to consult a specialist doctor, who will evaluate the changes we have observed and through a detailed examination will make the diagnosis.

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