 Don't head to the bathroom without watching this first. Okay, if the eyes are the window to the world of the soul, then poop is the window to the gut. It's true. Something that we all do, hopefully every day, but surprisingly, we really don't discuss it much. Yes, I'm talking about your poop. Poop is extremely important for your health and it can actually indicate many health issues and also indicate how your health is doing on the good side. In this episode, I'm going to share every shape, size, color of poop out there and what it could mean to your health. Now, there are many factors that characterize your poop that maybe you haven't thought about, color, shape, size, consistency, length of time you spend in the bathroom besides reading and frequency of poops. Now there are certain shapes that you really don't want to see. And let's start there first. First of all, marbles. If you're passing marbles instead of big giant snakes, you have a problem. What do marbles look like? Well, if you've ever been out hiking or ever been where rabbits or goats or sheep congregate, you'll know that their poop comes out like little marbles. And often those marbles are all stuck together, but sometimes they come out individually. This is oftenly associated with constipation. And one of the first things to look for when you're passing marbles is dehydration. You've got to have enough hydration to actually have liquid in your poop. And many people with constipation of marbles simply aren't number one getting enough liquids in their diet. Now the good news is things like tea or coffee do not constipate you. And they do not dehydrate you. So they count as liquid. Shockingly, wine counts as a liquid. And there's actually, if we get time, benefits to your poop of drinking red wine. But we'll get to that later. So number one, if you're passing marbles, first look at the amount of water that you're drinking. The second thing, I said this over and over and over again, but normally the vast volume of your poop, believe it or not, should be living and dead bacteria, the vast majority of it. You should be pooping bacteria. Bacteria have to have fiber to grow and multiply. That's what they eat. And the more fiber, particularly soluble fiber, that you give those bacteria to eat, then the bigger your poop and the fuller your poop and the less marbles. On the other hand, if all you're seeing is marbles and you're well hydrated, those marbles could be a sign that in fact your bacteria are decimated. You don't have a lot of them, which is quite possible following a round of antibiotics or eating commercial chicken, pork, lamb, and beef that have been fed antibiotics in the process of raising them. Even farm raised seafood is fed antibiotics to prevent infections. So even you seafood eaters be wise that you may be destroying your gut microbiome. Also as I mentioned before, if you're using artificial sweeteners, particularly sucralose, which is Splenda, which is still in a lot of preparations, a lot of keto bars, a lot of low cal soft drinks, this kills gut bacteria. So if you're doing what you think is kind of everything right, that you've got marbles, always think that maybe this is a problem that you don't have a lot of gut bacteria to work with. The second thing is remember gut bacteria have to have something that they want to eat to grow. And if you don't give them what they want to eat to grow, then your poops are still going to be marbles regardless of what else you're eating. We often see this when people go on a high protein diet like an Adkins diet. We don't see it quite as much when people go on a ketogenic diet because there's a lot of fat that can quite frankly make things slippery in your poop. But if you're on one of these diets and you're starting to see marbles, the odds are that your gut bacteria aren't getting what they need to eat. Now why that's important? We know now more than ever, and with every advance in research in the microbiome, that we are functioning, our health, our brain power, our emotions are dependent on the gut microbiome getting what they need to eat. And if you take care of them, nobody gets hurt and everybody gets benefit. So your poop size may be very well telling you what's going on. Now many people have a variation of that in that they have kind of a caterpillar look, lumpy and bumpy. It's all kind of, it's log shape, but it's lumpy and bumpy. And this is just a variation on that theme. So again, if it is lumpy and bumpy, but all together, either look at not enough hydration or not enough gut bacteria diversity or you're not giving those guys what they want to eat. So look at all three of those factors and it could be a combination of all three. Now I often get questions about floaters that literally float to the top of the bowl. There can be two causes for this. Number one, if you're eating a ketogenic diet, particularly a high fat ketogenic diet, then normally we have a number of enzymes that break down fat molecules for absorption. They're primarily produced in the bile and the pancreas. And those enzymes do a pretty good job of breaking down fats into smaller molecules to get absorbed. When we overwhelm that enzyme system with an extremely high fat diet, you can as a normal consequence have some of your stool or all of it for that matter float. And just remember fat people float much better than in the water than skinny people because fat floats in water. So that's what you're seeing. Now on the other hand, if you're not following one of those diets and you still have stools that are floaty, that's a problem generally with insufficient enzymes, pancreatic enzymes, and bile liver enzymes to break down fat. If that's the case, first of all, try an enzyme supplement. There are a number of them on the market. They can be cheap and they actually work. I'm not going to give you some names on this one, but try supplementation of digestive enzymes with your meals. And if that solves the problem, then that usually fixes the issue. On the other hand, if that doesn't solve the problem, you want to look at other factors that we'll get into in just a second. So in fact, let's do that right now. Let's suppose that you have floaters, but you also notice that your stool color, which used to be dark or brown or even shades of orange or green, suddenly begins looking lighter like it's clay. Well, bilirubin, which most of us know as a bile from the liver, is what actually gives most of our stool its color, that brown color. If there's a blockage in your liver or in the ducts draining the liver and the pancreas into the gut, one of the first signs that you could see is that your stool has changed to a clay color. That may appear days, even weeks before jaundice appears, and jaundice is that typical orange color that you see in your eyes or that you see in your skin. But that tip off that a clay colored stool may be the difference of you getting to your physician and notifying them about this and getting the appropriate tests, looking for a blockage in the bile and pancreatic ducts. Now, sometimes that's caused by a stone, sometimes it's caused by something worse like a cancer, but a clay colored stool is something that you want to pay attention to. Okay, how about soft serve? Everything's kind of mushy, it needs a lot of wiping. Well, frequently, this is caused by irritation of the lining of your gut, and I can't tell you the number of people, including myself back before I knew that their leaky gut and their irritation of their gut wall by, in my case, lectin-containing foods was, I always thought that soft serve was normal because nobody told me any different. Imagine my shock when I got major lectin-containing foods out of my diet, including gluten, that my soft serve went away. Soft serve is not normal. I do have a few people who eat copious amounts of vegetables, and I literally mean copious amounts of vegetables that have up to three to six soft serve bowel movements a day, that they consider perfectly normal. On the other hand, we have to realize that almost all plants have one or more lectins that can be problematic when we eat too many of them, and so one of the things if everything else is fine, but you're having a lot of soft serve bowel movements and you're eating a lot of vegetables, try the experiment for a few days of cutting back on those vegetables and see what happens to the characteristics of your bowel movement. You might be surprised. On the other hand, if you're not eating a lot of vegetables and are still having soft serve, please, please, please look at the no list of the plant paradox and do the experiment of getting those vegetables out of your diet, getting those grains out of your diet and watch what happens to your soft serve. Okay. How about watery diarrhea? Well, there's not enough time to tell you all the causes of watery diarrhea. Interestingly enough, invariably, my patients with watery diarrhea may have come back from a foreign trip, particularly to Mexico or South America, and they have picked up one or more interesting bugs that are the cause of their watery diarrhea. Now, here's a trick, and it works almost every time, and I travel with it. Take along some Pepto-Bismol caplets or tablets and prophylactically take a few Pepto-Bismol when you're traveling, particularly to Mexico. If you develop watery diarrhea, here's a trick that almost always works. You take eight Pepto-Bismol tablets a day, two, four times a day for a week. Now, your stool will most likely become black. That does not mean that you are having blood in your stool, which black stools can indicate, but it's the process of Pepto-Bismol changing that color, but invariably, it does seem to work. Now, since I mentioned black, your stools are not supposed to be black, and if you suddenly begin having black or greenish black stools, this is frequently a sign of a slow bleeding ulcer or gastritis as the cause of this. We also see it, interestingly enough, in people who are taking high dose NSAIDs, non-steroidal anti-inflammatory agents, like the leave or Advil. These subtly cause holes in the walls of your intestines that bleed, and if you have black or blackish green stools, be on lookout for this. What about green stools? Well, I've done fun experiments in the past, taking large amounts of chlorella and spirulina to the point where my stools turned green, and according to one health expert that I was following at the time, this was many years ago, that's when you know you're taking enough chlorella and spirulina. Now, I don't have green stools anymore because I've backed off on the amount of chlorella and spirulina, but if you're into chlorella and spirulina or other allergies for that matter, or exceedingly dark green vegetables, particularly spinach and kale, you may notice a greenish tint to your stool, and there's nothing wrong with that. Now, what about bright red blood, either on the outside of your stool or when you wipe? Most always that's from an internal or external hemorrhoid. Now, in general, these are self-limiting. If it happens for a couple of days and you notice that the blood is bright red, and it's when you wipe, or that it's on the outside of the stool, or it's dripping into the toilet bright red, the odds are that's a hemorrhoid. Now, should you have that looked at? Absolutely. But if the blood is mixed in with the stool, or the blood doesn't look like blood, but there's maroon color to the stool, that's coming from farther up than just your rear end, and that's the time to talk to your gastroenterologist about getting a colonoscopy or sigmoidoscopy looking for other mischief. Now, what about yellow stools? Well, yellow stools often can occur in accompanying loose stools and diarrhea, and sometimes it's just the fact that things are going through your intestines so much faster than normal that the normal bile color and pancreatic enzymes, which are kind of yellowish, are not being absorbed fast enough and they appear in the stool. Okay, diarrhea, again, can happen for multiple reasons. Certainly, if you're traveling, you've got to look for a traveler's diarrhea cause, Montezuma's Revenge, and interestingly, Peptobismol is one of the most effective treatments. I found with chronic diarrhea that almost invariably we never pick up a pathogen on a typical stool culture or stool test. It's, in my opinion, pretty much of a waste of time. The diaries that we see frequently can be from a bile overgrowth problem. Certain bacteria love to eat bile. There are some effective bile binding agents. They are prescription based, but we found them very useful as a temporary fix to break a cycle of diarrhea. On the other hand, constipation is what we started this program with. In general, you're supposed to have a bowel movement every day. You want to have two every day? That's fine with me. Some people are on an every other day cycle, and that's still quite normal. But if you're going more than two days without a bowel movement, then something is amiss. And it can be hydration problems. It can be lack of magnesium. One of the first fixes for chronic constipation, besides looking at your hydration status, is magnesium. Most adults are profoundly deficient in magnesium. Now, milk of magnesium is concentrated magnesium. And magnesium actually allows for more motility in your gut wall, and that pushes bowel movements forward. Most people should be taking anywhere from 300 to 600 milligrams of magnesium a day. I like it at night. It helps you sleep. It helps your mood. It's a cure-all for many things. If this is a real problem, then there are certainly over-the-counter aids like milk of magnesium. I particularly like an agent called Swisschris. I've written about it in my books. But if you're chronically having to take an aid to move your bowels, there's something amiss. Also remember that many of the plant-based laxatives use a compound called Senna, or Cascara. And I've seen what we call toxic megacolons in chronic Cascara and Senna users. The bowel literally gets paralyzed and gets huge and can become a huge factor. And it's something very, very difficult to be weaned from. So just because it says all-natural laxative or plant-based laxative, buy or beware. Sure, you can use it for occasional conservation, but this is not a remedy that you want to work with. Okay, so what should your poop look like? Quite frankly, when you look into the toilet bowl, you should see a giant snake coiled looking at you. And the way to get that is the more I can get you eating large amounts of leafy greens, vegetables, other prebiotic fiber, and getting probiotics-friendly bacteria that's going to eat that, you're going to have the most pleasant bathroom experience. And tell me all about it when you write back. Make sure to check out the next one here. Fun fact, the amount of lithium in your local water may have a positive benefit on your brain health through the years.