Newsletter #5 Why Stool Monitoring is a Key Diagnostic Tool for Gut Health?

12 Direct Visual Indicators for Stool Monitoring, 10 Indirect Visual Indicators for stool monitoring, Stool Evaluation: What's Normal &What's Abnormal, 4 DIY at home tests

Welcome Back

We are honored to have you back. We are enjoying sharing our learning materials with you. Hopefully, things we shared with you are useful to you. Our request to you that you send in our feedback, questions, and suggestions so that we co-create the amazing newsletter that will be useful for everyone who wants to improve their gut health. 

Previous Edition: Water Based Therapies for Gut Health

The first edition was about the basics of gut health. In the second edition, we shared the framework to think about gut health, and how fluids we intake everyday impacts our gut health as fluid is the most important thing we input in our body. And then in the third edition, we dug deeper into the connection between water and gut microbiome. In the fourth one, we went further deep and shared many water based non invasive therapies we can self administer at home and some invasive ones that may require professional help. 

We hope you see the pattern in our edition. We start with basic and we double click on the topics to share in depth information and actionable almost zero cost self care activities. Now, we want to go back to our body as a machine framework. After an in depth overview of water as an input, we want to talk about the monitoring of the output.

The most important output of all is stool. 

Digging Deeper into Digestion: The Importance of Monitoring our Stool for a Healthy Gut

We've all been there - in the bathroom, wondering what our stool is telling us about our health. But did you know that monitoring our poop can actually give you valuable insight into the health of our gut microbiome?

It may not sound like the most glamorous topic, but trust us, paying attention to what's in the bowl can be a powerful tool in boosting our gut health. Here's how:

What is a stool?

First of all, let's define what we're talking about when we say "stool." Essentially, it's the solid waste that our body excretes after digesting food and absorbing essential nutrients. What we see in the toilet is made up of undigested food, bacteria, and mucus.

Now, here's the thing - the appearance, consistency, and frequency of our stool can give us clues about the health of our gut. For example, if we are experiencing diarrhea, this could indicate an infection or an intolerance to certain foods. On the other hand, if we are struggling with constipation, this could point to a lack of fiber in our diet or a digestive issue.

So, how can we use this information to our advantage? By tracking our stool and paying attention to any changes or patterns, we can gain a better understanding of what's going on inside our gut. This can help us make adjustments to our diet, lifestyle, or even seek medical attention if necessary.

Why is stool an important and viable health biomarker and diagnosis tool?

Stool monitoring is a viable option for the following reasons.

1. Simple and straightforward

   1. Stool monitoring is a simple and straightforward process that does not require any specialized equipment or medical training.

2. Easy to track changes

   1. Stool monitoring allows us to easily track changes in our stool, such as changes in consistency, frequency, color, and smell, which can help us identify potential digestive issues and make changes to our diet or lifestyle to address them.

3. Performed at home

   1. It can be performed at home, which saves time and money compared to other diagnostic tests that require a visit to a doctor or a medical facility.

4. Provides everyday feedback

   1. Regularly monitoring our stool can provide daily feedback on the state of our digestive health, allowing us to make changes to our diet or lifestyle as needed to improve our gut health.

5. Low-cost, low-risk, non-invasive

   1. Stool monitoring can be a low-cost, low-risk,  non-invasive way to monitor digestive health, especially when compared to other diagnostic tests like endoscopy or colonoscopy.

6. Awareness of digestive symptoms

   1. Stool monitoring helps individuals become more aware of changes in their digestive symptoms, such as frequency, consistency, color, and odor of their stool.

7. Provides insight into digestive health

   1. Stool monitoring can provide information about the health of the digestive system, including any imbalances or disruptions that may be present.

8. Identifies underlying health conditions

   1. Changes in the stool can be an indicator of underlying health conditions, such as infections, food intolerances, malabsorption, and certain medical conditions

9. Early detection or early warning signs of digestive problems 

   1. By monitoring their stool regularly, individuals can detect changes that may indicate a digestive problem early on, which allows them to seek medical attention before the issue becomes more serious.

10. Evaluating the effectiveness of dietary and lifestyle changes

    1.  By monitoring their stool after making changes to their diet or lifestyle, individuals can see how these changes are impacting their digestive health.

11. Tracking the progress of digestive treatments

    1. If an individual is undergoing digestive treatment, stool monitoring can help them track their progress and see if the treatment is working effectively.

12. Baseline to monitor for gut health

    1. It can be used as a baseline to monitor the effectiveness of any treatments or interventions aimed at improving gut health.

13. Aids in identifying food sensitivities

    1. Stool monitoring can help us identify food sensitivities, which can be a major factor in digestive issues. By monitoring changes in our stool after eating certain foods, we can determine which foods may be causing digestive issues and eliminate them from our diet.

14. Supports personalized care

    1. By tracking changes in the stool, individuals can provide valuable information to their healthcare provider, who can use this information to make informed decisions about their treatment plan. This can help optimize the benefits of medications and supplements while minimizing any negative impacts on their digestive health.

Who should monitor their stool everyday?

The simple answer is everyone. However, there are many categories of people who would have added incentives to monitoring it everyday as a biomarker for their health. Here are some of those folks who can benefit from stool monitoring.

1. People with digestive issues

   1.  Monitoring stool can help identify specific digestive problems, such as inflammatory bowel disease, Irritable Bowel Syndrome (IBS), or other digestive disorders.

2. People with a family history of colon cancer

   1. People with a family history of colon cancer or other digestive disorders.

3. Athletes

   1.  Stool monitoring can help athletes understand how their diet, exercise, and overall health are affecting their digestive system.

4. Pregnant women

   1. Monitoring stool can help pregnant women identify any digestive changes that may occur during pregnancy and help prevent constipation.

5. Babies

   1.  Stool monitoring can help parents track changes in their baby's digestive health and ensure that they are getting the nutrients they need for proper growth and development.

6. Health and wellness enthusiasts

   1. Stool monitoring can be a useful tool for those who are interested in improving their overall health and wellness and tracking their digestive system's performance.

7. Elderly 

   1. Monitoring stool can help the elderly identify any changes in their digestive health that may be associated with age-related conditions, such as poor absorption of nutrients or chronic constipation.

8. People Post surgery or procedures

   1. People who have recently undergone gastrointestinal surgery or procedures.

9. People on Medications and supplements

   1. Stool monitoring can reveal side effects such as constipation, diarrhea, abdominal pain, and other digestive symptoms, and can also help determine if a medication or supplement is not being absorbed properly. By providing this information to their healthcare provider, individuals can work together to optimize treatment benefits and minimize negative impacts on their digestive health.

But what exactly should we be looking for when tracking our stool? Here are some key visual indicators to keep in mind:

12 Direct Visual Indicators for Stool Monitoring

1. Consistency

   1. The consistency of stool can range from hard and pellet-like to loose and watery. Changes in consistency can indicate digestive issues or imbalances in the gut microbiome.

2. Shape

   1. The shape of stool can range from round to sausage-like and can be affected by various factors such as diet and digestive issues. Changes in shape can indicate digestive issues or imbalances in the gut microbiome.

3. Frequency

   1. The frequency of bowel movements can also indicate gut health, as changes in frequency can be a sign of digestive issues or imbalances in the gut microbiome.

4. Size

   1. The size of stool can be a visual indicator of gut health as it can indicate the speed of digestion and transit time through the digestive system. Normal stool size varies from person to person, but it is generally cylindrical in shape and about 1 to 2 inches in diameter and between 6 to 8 inches long.

   2. If the stool is smaller in size, this can indicate that it is passing too quickly through the digestive system, potentially leading to malnutrition and deficiencies in nutrients. On the other hand, if the stool is larger in size, this can indicate slow digestion and transit time, which can lead to constipation and increased risk of fecal matter remaining in the colon for too long, leading to potential health issues.

5. Color 

   1. The color of stool can range from light brown to dark brown and can be affected by various factors such as diet and medications. Changes in color, such as the presence of red or black streaks, can indicate digestive issues.

6. Smell

   1. The smell of stool can vary and can be affected by diet and gut microbiome. Changes in smell, such as a strong or foul odor, can indicate digestive issues.

7. Quantity

   1. Normal stool quantity can vary, but the average is about one bowel movement per day. If the quantity of stool produced decreases significantly, it may indicate constipation, which can be a sign of poor gut health. On the other hand, if the quantity of stool produced increases significantly, it may indicate diarrhea, which can also be a sign of poor gut health.

8. Mucus 

   1. The presence of mucus in stool can indicate digestive issues, such as inflammation or infection in the gut.

9. Undigested food: 

   1. The presence of undigested food in stool can indicate digestive issues, such as malabsorption or maldigestion, which can impact gut health.

10. Presence of bubbles

    1. The presence of bubbles in stool can indicate the presence of gas in the gut, which can be a sign of digestive issues or imbalances in the gut microbiome.

11. Floatability

    1. The floatability of stool can indicate the presence of fat in stool, which can be a sign of digestive issues or imbalances in the gut microbiome.

12. Strands: 

    1. The presence of strands in stool can indicate the presence of undigested fiber or parasites in the gut, which can be a sign of digestive issues or imbalances in the gut microbiome.

By tracking these indicators, we can start to get a better picture of what's going on inside our gut. This information can then be used to make adjustments to our diet and lifestyle, with the goal of boosting our gut health.

Now, we want to dig further into each of these visual indicators so that we can understand at a granular level what’s normal and what’s abnormal. 

Note: This is a general guide, and any unusual symptoms should be evaluated by a doctor.

More often than not, the visual indicators will accompany several symptoms. Let’s walk through those common symptoms. Each of the symptoms can be a newsletter topic in itself. Hence, we won’t go deeper. Instead we want to inform you that these symptoms plus the visual indicators can give a pretty good assessment about gut health. 

10 Indirect Visual Indicators for stool monitoring

In addition to changes in stool consistency, frequency, color, smell, mucus, and undigested food, there are several other indicators that can indicate poor gut health:

1. Strain

   1. Pooping should be effortless. If it requires effort or a lot of strain it’s a sign of constipation. Or on the other hand, if we can’t control it then it can be a sign of diarrhea. 

2. Satisfaction

   1. The healthy gut is that we feel empty after pooping. But if it feels incomplete then there is something not right. Although it’s subjective, keeping track of satisfaction level helps to improve bowel movement. 

3. Bloating and gas

   1. Excessive bloating and gas can indicate an imbalance in the gut microbiome or digestive issues.

4. Abdominal pain

   1. Chronic abdominal pain can be a sign of digestive issues or an imbalance in the gut microbiome.

5. Itching or pain in anus and rectum

   1. It could be a sign of fissure or hemorrhoid or other digestive diseases.

6. Fatigue

   1. Fatigue can be a sign of poor gut health, as digestive issues and imbalances in the gut microbiome can interfere with the body's ability to absorb nutrients and energy from food.

7. Skin issues

   1. Skin issues, such as eczema and acne, can be linked to gut health, as the gut microbiome can impact the immune system and overall health.

8. Mood changes

   1. Changes in mood, such as depression or anxiety, can be linked to gut health, as the gut microbiome can impact the production of neurotransmitters and overall mental health.

9. Food cravings and aversion

   1. Changes in food cravings and aversion can be a sign of an imbalance in the gut microbiome and poor gut health.

10. Constipation and Diarrhea

    1. Changes in bowel movements, including constipation and diarrhea, can be a sign of poor gut health and indicate an imbalance in the gut microbiome.

Stool Evaluation: What's Normal, What's Abnormal, and Understanding the Direct and Indirect Visual Indicators of Gut Health

Here is a summary of the 11 Direct Visual indicators for stool monitoring:

Here is a summary of the 10 Direct Visual Indicators for stool monitoring:

Obviously, it is not normal to have any of the indirect visual indicators. So, if we see any of these indirect visual indicators then it is abnormal.

Note: Normal can vary from person to person, and it's important to consult a healthcare professional for an accurate assessment of gut health.

Now, we know when our stool is normal and when it is abnormal. It’s not binary though whether it is normal and abnormal. On rare occasions we may have one or few of the indicators. But if it happens regularly then that’s cause for concern. And stool monitoring can give us ideas about the degrees of severities of the abnormal stool. We can take preventative actions or treatment to get back to normal and reduce the severity of our symptoms and problems. In the previous newsletter articles we have talked about water and water based therapies to improve gut health.  

Doesn’t seem like many indicators to monitor? Yeah it can be overwhelming especially for the beginners. And also, it will be insanely chaotic  if all of us have our own standards for measurement and monitoring. Then communication among ourselves or with healthcare providers will be confusing. 

Hence, in order to make it easy for everyone to understand and communicate there are standard stool evaluation charts. There are many such stool evaluation charts. For the scope of this newsletter, we will share the most common one called Bristol Stool Scale. 

Standard Stool Evaluation Chart: Bristol Stool Scale

One commonly used standard stool evaluation chart is the Bristol Stool Scale. This scale is a seven-point scale that categorizes stools based on their shape, texture, and ease of passage. The Bristol Stool Scale can help to determine if stool is within a normal range or if there may be an issue with digestive function.

There are seven types of stool according to the Bristol Stool Scale

Here is the Bristol Stool Scale in a tabular format:

1. It is important to note that the Bristol Stool Scale is just a general guide, and it is always best to consult with a healthcare professional for an accurate evaluation of our digestive health.

Using this scale, stools that fall into types 1-2 may indicate constipation, while stools that fall into types 6-7 may indicate diarrhea. Stools that fall into Types 3-5 are considered to be within the normal range.

Now that we know what visual indicators to keep an eye on and what standard to scale to use. Let us use this information to monitor our stool everyday. And here is how we do it.

How to monitor our stool everyday?

To monitor stool using direct and indirect visual indicators on a daily basis, we can follow these steps:

1. Keep a stool diary

   1.  Keep track of the date and time we have a bowel movement, and note any changes in the appearance of our stool, including consistency, color, shape, and the presence of mucus.

2. Observe consistency

   1. The consistency of our stool should be soft and well-formed, with a texture similar to peanut butter. If our stool is very hard, watery, or has a lumpy texture, it may be a sign of digestive problems.

3. Note color

   1. Stool color can vary depending on our diet, but it should generally be a medium to light brown color. If our stool is black, very dark brown, red, or green, it could indicate digestive problems and should be evaluated by a healthcare provider.

4. Check for undigested food

   1.  If we see undigested food in our stool, it may indicate that our digestive system is not functioning properly.

5. Monitor frequency

   1. Most people have a bowel movement once or twice a day, but this can vary. If we are having less than three bowel movements a week, or more than three per day, it may be a sign of digestive problems.

6. Observe symptoms

   1.  Pay attention to any symptoms that may be related to our digestive system, such as bloating, gas, abdominal pain, or constipation and diarrhea.

7. Keep track of medications and supplements 

   1. If we are taking any medications or supplements, make note of any changes in our stool that may be related to those substances.

8. Keep track of food, exercise, therapies etc to identify the cause and effect or correlation with stool. 

We can use pen and paper to keep the log or use apps that are available in the market to monitor the stool, and other input and processing variables. We plan to develop an app that makes it super easy to monitor all the input, processing, and output variables. Not only that, we also want to create algorithms that analyze patterns that help everyone identify triggers and predict symptoms. The idea is to enable everyone to become a scientist of their body and provide tools to run experiments to minimize health issues for folks who have chronic disease, optimize well being for health and well being enthusiasts,  and maximize performance for recreation and professional athletes. Hopefully, with our support, we will get there soon. Till the newsletter is our step towards the goal. 

After a brief tangent about our goals, we want to give a brief overview of two indicators of stool that alarm a lot of people. 

1. Color of the stool

2. Undigested food in the stool

What are different stool colors and their meanings?

Here is a summary in a tabular format of  different stool colors and their meanings.

What are common causes for undigested food in the stool?

Here is a summary in a tabular format of Common Causes for Undigested Food in the Stool.

4 DIY at home tests for Gut Health

1. The Baking Soda Test: To test whether we have enough digestive enzyme particularly stomach acid

   1. Drink half a glass (4 ounces) of cold water combined with a quarter teaspoon of baking soda, on an empty stomach. Then time how long it takes you to burp. If it takes longer than three to five minutes, the theory goes, we don’t have enough stomach acid

2. The Beetroot Test : To test the transit time whether its long or short.

   1. Eat a beetroot and monitor the color of our stool. Measure the color of the stool. When stool color is color of beet then w can calculate time it has taken for transit.

3. The String Test

   1. Swallow a string or piece of floss and monitor the time it takes to appear in the stool. A slow transit time will result in a longer time between swallowing and seeing the string in the stool.

4. The Stool Monitoring Test 

   1. Keep a record of when we eat, when we have a bowel movement, and the consistency of the stool. This will help we determine our average transit time and identify any changes in transit time that may indicate digestive issues.

We didn’t go deeper into the instructions in this edition. Because it’s getting too long. In the future, we will add more DIY at home tests. If you want detailed instructions please reply via email or write a comment. We promise we will incorporate detailed instructions as well as risks of doing these at home.

Next

So far we have shared the basics of gut health, body is a machine framework for gut health, how drinks we drink everyday impact our gut health, double clicked on water including habit frameworks to increase water intake. And in the last edition we shared at home DIY water based therapies that can have a positive impact on digestion and gut health. 

That means, we are following the body as a machine framework to sequence the newsletter editions. We have covered one input that’s one water. In this edition, we covered one output that’s stool. And now it’s time to talk about one processing variable. 

One of the most common processing variables is stress. In the next newsletter edition we will talk about how stress has a recursive relation with gut health.

There is a complex, bidirectional relationship between stress and gut health. Stress can negatively affect gut health by altering the composition and diversity of the gut microbiome, increasing inflammation and gut permeability, and leading to GI symptoms like diarrhea, constipation, and abdominal pain. In turn, poor gut health can also contribute to the development or exacerbation of stress and anxiety, as the gut microbiome can influence the production of neurotransmitters and the regulation of the stress response.

So do not miss out on the next one!

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Also, please give us feedback so that we can improve the content. And if there are any topics that you want us to cover please send us your questions and topics. Furthermore, if you try any of the things we provided information please share your experience with us.

Thank You

gutsphere Team

Research papers we are reading

1. Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. https://gut.bmj.com/content/65/1/57

2. Stool quantification of these biomarkers provides a non-invasive method to define potential pathways behind the pathogenesis of diseases and can assist in the assessment and diagnosis of various gastrointestinal conditions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 3904282/   

3. Gut Microbiota Metabolism and Interaction with Food Components. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279363/ 

   1. Understanding the gut microbe–nutrient interactions will increase our knowledge of how diet affects host health and disease, thus enabling personalized therapeutics and nutrition.

4. The Microbiome in Health and Disease from the Perspective of Modern Medicine and Ayurveda. https://www.mdpi.com/1648-9144/56/9/462 

   1. Understand the connection between the microbiome and the many different prevention and therapeutic treatment approaches of Ayurveda.

Disclaimer

Please note that the information provided in this newsletter is for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. If you have any concerns or questions about our health, please consult with a licensed healthcare professional. The information contained in this newsletter is not intended to diagnose, treat, cure, or prevent any disease. The publisher and authors of this newsletter assume no responsibility for any adverse effects that may result from the use of the information contained herein.

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