Steatorrhea is a symptom of


What is steatorrhea?

Steatorrhea is the medical term for fat in stool. Fat in the stool can cause bulky stool that floats, has an oily or greasy appearance, and smells foul. Fat in the stool is fat that the digestive tract was unable to absorb. Temporary steatorrhea may result from dietary changes or intestinal infections. Steatorrhea that is persistent may result from diseases of the biliary tract, pancreas, or intestines.

Fat absorption is dependent upon bile (which is produced in the liver and stored in the gallbladder), pancreatic lipases (enzymes that break down fat), and normal intestine function. Absence of bile is often due to blockage of the biliary tract and can result in pale colored fatty stool and jaundice. Absence of pancreatic lipases is uncommon, but can occur as a result of a diseased pancreas, cystic fibrosis, or an abnormality that is present at birth.

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Inflammation of the lining of the intestines, which may occur with conditions such as ulcerative colitis (inflammation of the colon and rectum), Crohn’s disease (inflammation of the bowels), and celiac disease (a severe sensitivity to gluten in the diet), can interfere with absorption of fats. Also, fat absorption may be affected by surgical removal of a portion of the intestines.

Often, steatorrhea is a short-lived problem related to diet or infection; however, if it lasts for more than a couple of weeks, becomes more severe, or is accompanied by other symptoms, it may be due to a more serious condition. Seek immediate medical care (call 911) if you have bloody stool, black or tarry stool, stool with pus, severe abdominal pain or cramping, or high fever (higher than 101 degrees Fahrenheit).

If your steatorrhea is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with steatorrhea?

Steatorrhea may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Conditions that affect the digestive tract may also involve other body systems.

Digestive tract symptoms that may occur along with steatorrhea

Steatorrhea may accompany other symptoms affecting the digestive tract including:

  • Abdominal pain or cramping
  • Abdominal swelling, distension or bloating
  • Abnormally foul-smelling stools
  • Bloody stool (the blood may be red, black or tarry in texture)
  • Diarrhea
  • Gas
  • Nausea with or without vomiting
  • Pale feces

Other symptoms that may occur along with steatorrhea

Steatorrhea may accompany symptoms related to other body systems including:

  • Cough
  • Dark urine
  • Frequent infections
  • Itchy skin
  • Unexplained weight loss
  • Yellowing of the skin and whites of the eyes (jaundice)

Serious symptoms that might indicate a life-threatening condition

In some cases, steatorrhea may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bloody stool (blood may be red, black, or tarry in texture)
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Chest pain, chest tightness, chest pressure, or palpitations
  • High fever (higher than 101 degrees Fahrenheit)
  • Not producing any urine, or an infant who does not produce the usual amount of wet diapers
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, or labored breathing
  • Rigidity of the abdomen
  • Severe abdominal pain or sharp pain that comes on suddenly

What causes steatorrhea?

Temporary steatorrhea may result from dietary changes or intestinal infections. Steatorrhea that is persistent may result from diseases affecting the biliary tract, pancreas, or intestines.

Intestinal causes of steatorrhea

Steatorrhea may be caused by conditions affecting the intestines including:

  • Bacterial, parasitic or viral infection of the gastrointestinal tract

  • Bariatric (weight-loss) surgery

  • Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)

  • Food intolerances (difficulty digesting certain foods without the symptoms of a food allergy)

  • Inflammatory bowel disease (including Crohn’s disease and ulcerative colitis)

  • Short-bowel syndrome (shortening of the intestine)

Biliary tract causes of steatorrhea

Steatorrhea can also be caused by diseases of the biliary tract including:

  • Biliary atresia (condition present at birth that involves failure of development of the bile ducts)

  • Biliary stricture (narrowing of the common bile duct, the tube that carries bile from the liver and gallbladder to the intestines)

  • Cholangiocarcinoma (cancer of the biliary tracts or gallbladder)

  • Gallstones

Causes of steatorrhea related to the pancreas

Steatorrhea can also be caused by conditions that affect the pancreas including:

  • Congenital pancreatic lipase deficiency (an abnormality of lipase production in the pancreas that is present at birth)

  • Cystic fibrosis (genetic disorder that interferes with lung and pancreatic function)

  • Pancreatic cancer

  • Pancreatitis (inflammation of the pancreas)

Questions for diagnosing the cause of steatorrhea

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your steatorrhea including:

  • When did you first notice steatorrhea?

  • Have you noticed any blood, mucus or pus in your stool?

  • Have you noticed a change in the color of your stool?

  • Do you have any other symptoms?

  • Have you recently made any changes to your diet?

  • Does anything make your symptoms go away or make it worse?

  • Have you had symptoms like this before?

  • Have you had surgery to remove part of your intestines?

  • What medications are you taking?

What are the potential complications of steatorrhea?

Because steatorrhea can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Anemia (low red blood cell count)

  • Failure to thrive in infants and children

  • Frequent serious or opportunistic infections

  • Growth problems in children

  • Intestinal obstruction and rupture of the intestinal wall

  • Poor nutrition due to vomiting, diarrhea, or a decreased desire to eat

  • Spread of cancer

  • Spread of infection

  • Surgery to remove parts of the digestive tract due to a serious infection or malignant condition

A 15-Year-Old Girl With Steatorrhea Who Can’t See at Night

EPI is characterized by a deficiency of the above mentioned exocrine pancreatic enzymes, which results in an inability to digest food properly (maldigestion). Because pancreatic lipase accounts for up to 90% of fat digestion, maldigestion of fat is more profound in EPI than maldigestion of proteins and carbohydrates. Undigested fat, rather than being absorbed, is excreted in the feces. Major symptoms include steatorrhea and weight loss. Steatorrhea is the result of fat malabsorption and is characterized by pale, bulky, and malodorous stools. These stools often float on top of the toilet water with oily droplets and are difficult to flush. Weight loss and fatigue are common.

Other unabsorbed food substances release gaseous products such as hydrogen and methane. Flatulence often causes uncomfortable abdominal distention and cramps. Bleeding disorders are usually a consequence of vitamin K malabsorption and subsequent hypoprothrombinemia. Ecchymosis usually is the manifesting symptom, although melena and hematuria may occur on occasion.

Metabolic bone disease (vitamin D deficiency) and impaired night vision have been observed in patients with chronic pancreatitis because impaired enzyme secretion may be complicated by fat-soluble vitamin deficiencies. Vitamin A scarcity explains the poor night vision acuity, whereas prothrombin time may be prolonged because of malabsorption of vitamin K that yields poor coagulation, explaining the thigh bruise observed in the patient in this case.

EPI may also cause vitamin B12 deficiency because a decreased intestinal pH adversely affects the transfer of vitamin B12 from R protein to intrinsic factor. Patients with EPI may thus develop microcytic anemia due to iron deficiency or macrocytic anemia due to vitamin B12 or folate malabsorption.

In patients with cystic fibrosis, reduced chloride transport in the pancreas leads to reduced water content of secretions, precipitation of proteins, and plugging of ductules and acini, preventing the pancreatic enzymes from reaching the gut; autodigestion of the pancreas occasionally leads to pancreatitis.

Nesidioblastosis, or the more recent and accurate terms congenital hyperinsulinism or persistent hyperinsulinemic hypoglycemia of infancy, presents shortly after birth with symptoms of hypoglycemia (eg, hunger, jitteriness, lethargy, apnea, seizures). Older children, in addition to these symptoms, may also show diaphoresis, confusion, or unusual mood or behavior changes. Hypoglycemia is persistent, requiring frequent or continuous glucose infusions or feedings to maintain adequate blood glucose levels. Presenting symptoms of congenital hyperinsulinism reported in adults include confusion, headaches, dizziness, syncope, and loss of consciousness. The symptoms may be exacerbated by fasting and may improve after eating.

Zollinger-Ellison syndrome is caused by a non-beta islet cell gastrin-secreting tumor of the pancreas that stimulates the acid-secreting cells of the stomach to maximal activity, with consequent gastrointestinal mucosal ulceration. The primary tumor is usually located in the pancreas, but ectopic locations have also been described (eg, heart, ovary, gall bladder, liver, kidney). Seventy five percent of patients present with upper abdominal pain that mimics peptic ulcer disease.

This patient did not show symptoms that suggest any form of autoimmune disease.

5 Things Your Poop Can Tell You About Your Health

  1. Rocks and Pebbles

    Poop that is hard and shaped like tiny rocks or pebbles is likely just a sign of constipation . You can still be considered constipated even if you are able to pass a small amount of stool.

    The large intestine helps to concentrate waste by absorbing water. If muscle contractions in the large intestine are not working properly, waste left in the colon becomes even more concentrated, resulting in harder stool.

  2. Color Changes

    “One of the most common concerns I hear from patients is worry about the change of poop color,” says Dr. Linda Lee . The color of stool is impacted by the foods you eat and the kind of bacteria living in your colon.

    “There are a lot of food colorings added to what we eat and drink, so of course the color of your stool is then going to change,” says Lee. “When I perform a colonoscopy, I can actually tell what color the beverage was they used to take the prep.”

    A change in the color of stool is usually not cause for concern, unless it appears to be black or bloody, which could signal other problems with the digestive system.

  3. Black and Tarry

    The most common cause of black and tarry poop is from taking iron supplements or a medication containing bismuth, such as Pepto-Bismol. However, it could mean you’re losing blood somewhere in your gastrointestinal tract, such as in the stomach or small intestine.

  4. Oily or Greasy Stools

    If you have poop that appears oily, has a greasy consistency and is difficult to flush, it could be a signal that your body is not able to properly digest fat. The consistency changes could be caused by an infection, nutrients not being digested due to celiac disease or a problem with the pancreas, such as pancreatic cancer or pancreatitis.

  5. Pencil-Thin

    Stool that is only occasionally very thin is not a cause for concern. It is likely due to muscle contractions in the large intestine as it helps to concentrate waste.

    If there is a sudden and consistent change in your stool always being thin, it could mean there is a blockage in your colon, and you should see your doctor.

Why Is My Diarrhea Oily?

Why Is My Diarrhea Oily?

There are many different causes of oily diarrhea in both children and adults.Some may be more of a nuisance while others can indicate a serious condition. Educating yourself about the reasons this can happen will allow you to determine if you should seek out medical intervention.

Oily bowel movements or diarrhea are indicated by oil droplets which float in the toilet water, stools that may have white or yellow fat in them or stools that float (this is caused by a large amount oil in the stool). Some people have even reported orange or waxy bowel movements. If you notice this is happening then it is important to be aware of the many causes so you can seek out medical help if necessary.

Find the Best Products for Oily Diarrhea

Here are the most common reasons you may be experiencing oily bowel movements or diarrhea:

  • Caused by foods-You may be surprised to learn simply by eating certain foods can cause this condition. Most often the culprit behind this problem is fish. There are 2 fish that are commonly the reason for this to happen. Escolar and oil fish are the by catches (often caught up in the nets of common fish) from many different fisherman. These fish are known to have an indigestible type of fat which is referred to as wax esters. This can build up in the rectum and when the body will not tolerate any more then an oily diarrhea can be the result.
  • Caused by medications-There are a number of different drugs which can cause this to happen. Before you begin any new medication, you should check with your pharmacist to see if this is a common side effect. One of the most common reasons individuals have this happen is when they are taking the drug known as Orlistat. This drug is most often prescribed for weight loss. The drug Alli is the brand name version and can be bought over the counter. This drug works by inhibiting an enzyme called lipase which is released from the stomach and pancreas. The gastrointestinal system needs lipase to break down fat. In effect, this drug causes fat mal-absorption. This is the reason many users of this drug find they have oily bowel movements and diarrhea.
  • Caused by medical conditions-There are a number of different medical conditions which can also cause this to happen. Some of these conditions include but are not limited to: cystic fibrosis, celiac sprue, inflammatory bowel disease, acute or chronic pancreatitis and pancreatic cancer. If you are experiencing chronic oily diarrhea along with other symptoms of any of these conditions you should immediately call your doctor. Because these medical conditions are serious anyone who is dealing with chronic diarrhea (oily or not), will need treatment in order to resolve this. Do not let fear or embarrassment keep you from seeking medical treatment. Keep in mind the earlier a diagnosis is made the easier and more effective treatment can be.

November 18, 2017

This Poop Chart Tells You What’s Happening in Your Gut and How to Fix It

  • Paying attention to your poop can help you build a stronger gut, check your organ function and boost nutrient absorption from the foods you eat.
  • The color, shape, texture and consistency of your poop can tell you whether your diet needs adjusting. (Just take a glance in the toilet. This is not a hands-on exercise.)
  • Check out the poop chart below to see where your stools fall on the spectrum. Then, get tips to improve your digestion and gut health.

Paying attention to your body and making small changes can make a huge difference in how you feel and perform. That’s what being Bulletproof is all about. Right now, you may be ignoring one of your body’s informational super-sources: your poop.

Your poop can tell you if you should adjust your diet, drink more water or see your doctor. Next time you’re in the bathroom, take a look in the toilet and then check the Bulletproof Poop Chart (below). A small change could help you build a stronger gut, absorb more nutrients from your food and improve your good gut bacteria, which will help you look and feel your best.

Read on to learn what different types of poop means about your biology, and how you can make adjustments to improve your gut health.

Shop Bulletproof Detox and Gut Health Supplements

The ultimate gut health poop chart

1. Is it soft, hard or runny?

The first thing to check is your poop’s consistency. You’ve probably already noticed the extremes, like runny or hard. Now, notice the subtleties. Did you know that the firmness of your poop suggests a wealth of information about your body? Take a look at the Bulletproof Poop Chart. Basically, if your poop is a 4 or a 5, you’re good. Anything firmer or softer than that means there may be something going on with your biology.

If you’re constipated:

  • Drink more water.
  • Add magnesium to your list of daily supplements. It tells your body to send water to your bowels, which helps everything move more smoothly. You should probably take it anyway — most Americans are deficient.
  • Eat a plate full of salad greens (or add to smoothies) at every meal to make stools softer and larger.
  • Be sure you’re getting enough healthful foods to help soften stools. Eating prunes, apples and grapes can help.
  • If that doesn’t do the trick, see a doctor about testing your thyroid. You may be under-producing thyroid hormones that affect your gut function.

If you’re having frequent diarrhea:

  • Fiber is a great way to firm up your stool. Eat plenty of fiber-rich veggies to make sure you’re still getting the nutrients you need, but cook them so they’re easier to digest.
  • Eliminate grains, nuts, legumes, caffeine and alcohol, which can affect your stomach lining and impact the diversity of your gut bacteria.
  • Feed your biome with prebiotic-rich foods like sweet potato, carrots, and asparagus.
  • Experiment with fermented foods like kombucha, sauerkraut and (if you tolerate dairy) grass-fed kefir. These fermented foods contain bacteria and yeasts that may be beneficial for your gut — but keep in mind that fermented foods don’t work for everyone.
  • To help eliminate toxins from your gut, take activated coconut charcoal between meals. Coconut charcoal binds with toxins and flushes them out.
  • Take collagen protein to support your body’s tissues, including the mucous membrane lining your gut. Bulletproof Collagen Protein Gut Boost is specifically formulated for gut support.
  • If it’s constant, get your thyroid checked. Diarrhea has been linked to hyperthyroidism.
  • Track your poop over time. If it begins to look more like a 4 or a 5, you’re on the right track, and odds are your good gut bacteria are flourishing.

2. Does it float or sink?

The next thing to notice is whether your poop floats or sinks. Your stool’s buoyancy is especially useful info when you’re eating a lower-carb, high-fat diet like the Bulletproof Diet because it’s a good test of whether you’re metabolizing and absorbing the fat you eat.

Generally, poop should sink. If your poop is solid and occasionally floats, it could just be that you ate an especially large amount of fiber that day, which isn’t anything to write home about. But if your poop floats regularly, it could be a sign that you aren’t digesting fat. Watch for:

  • Regularly soft, floating poop
  • Oil slicks from the poop that coat the toilet bowl (like the grease left in the box when you pick up a piece of pizza. Yeah. That’s gross. Sorry.)
  • Mucus in your poop

If your poop is oily once in a while, it could just be that you ate too much fat. If it happens regularly, check your diet. Did you just switch over to a higher-fat diet? If so, your body can take a couple weeks to start producing enough lipase, the enzyme you need to break down fat. To help in the meantime, taking lipase for a few days as a digestive supplement may help.

If you haven’t changed anything and your poop floats in an oil slick on a regular basis, visit a doctor. If you ever see mucus in your poop, definitely go to a doctor. Mucousy stools can be signs of gallbladder trouble, infection, or autoimmune issues.

Related: How to Own Your Gut Bacteria and Fix Leaky Gut Syndrome

3. Is there food in your poop?

Food in your poop could be totally normal, especially if it’s vegetable matter. A lot of veggies contain cellulose, which humans lack the enzymes to digest. The result is that they come out the same way they go in. The size and consistency depends on how well you chew your food.

Quick side note: Most seeds (like chia seeds and hemp seeds) have a cellulose covering that prevents you from digesting them, and they’ll come out of you intact. If you’re not just eating them for the fiber, be sure you grind them first — otherwise you won’t absorb any of their nutrients. And for the record, there are much better sources of omega-3s than chia or hemp, like krill and fish oil.

A little bit of food in your poop is fine, but if your poop is mostly undigested food, something’s going on. It’s likely that you lack the good gut bacteria that break down fibers.

Related: Signs that Your Gut Is Unhealthy and Why You Should Fix It

4. What color is your poop?

Keep an eye on your poop’s color. It tells you how well your body is processing the food you eat. Here’s a handy reference for different poop colors:

  • Brown, yellow, or green poop: The gold standard. Things look good. The difference in colors depends on what you eat and how much bile you’re producing. Generally, poop ranging in shades of brown to green is a good sign.
  • Pale, clay-colored poop: Light gray, clay-like poop can suggest a problem with your digestion. Your gallbladder may not be dumping bile and red blood waste into your small intestine, or you may have an issue with your liver. If your poop is regularly pale and gray, get yourself to a doctor.
  • Red or black poop: Did you eat beets recently? If so, don’t worry about red poop. But if you haven’t eaten beets and your poop is red or black, you may have some kind of internal bleeding like an ulcer, internal hemorrhoids or you could be dealing with IBS (especially if you’re having red diarrhea). Red or black poop can also be a sign of E. coli infection. Again, see a doctor.

5. How often do you poop?

The final thing to note about your poop is frequency. One or two poops a day, or only three times a week?

If you’re on a fairly regular schedule, that’s a sign that your digestion is strong. Your poops should also generally feel “complete” — that is, like you’ve evacuated everything, and there isn’t more to come out.

  • Less than three times a week: You’re constipated. Take magnesium to help your body send more water to your bowels. Drink lots of water and get your thyroid checked if things don’t become more regular.
  • Three or more times a day: You should probably eat more fiber from vegetables. Fiber slows down food passage through your intestines, which gives you more time to absorb precious nutrients. If you’re getting lots of veggies and still pooping three or more times a day, see a doctor. You may have an infection (especially if most of your poops feel incomplete).

Poop is a treasure trove of information about what’s going on inside your body. It may seem strange, but taking note of your poop gives you valuable insight into your digestion, organ function, gut bacteria and more.

Keep tabs on your poop (or keep a poop journal, if you’re hardcore). It’s a great indicator of how small changes in your diet affect your gut — and it lets you know if you’re moving in the right direction.

Don’t forget to subscribe below for more great ways to be Bulletproof.

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  • 10 Possible Greasy Stool Conditions

    The list below shows results from the use of our quiz by Buoy users who experienced greasy stool. This list does not constitute medical advice and may not accurately represent what you have.

    Irritable bowel syndrome (ibs)

    Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine. It is characterized by recurrent abdominal pain and bowel movement issues that can be difficult to treat. Signs and symptoms of IBS are usually not severe or life-threateni…

    Chronic gallstones

    Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver.

    Rarity: Uncommon

    Top Symptoms: nausea, loss of appetite, unintentional weight loss, vomiting, pain in the upper right abdomen

    Urgency: Primary care doctor


    Gallstones are small, round deposits found in the gallbladder, the organ where bile is stored. Gallstones can be subclassified a number of ways. Oftentimes, gallstones will be referred to as either cholesterol stones or pigment stones depending on the makeup of the gallstone.

    Gallstones can also be class…

    Chronic hepatitis c

    Chronic hepatitis C is a liver inflammation caused by Hepacivirus C.

    If someone is infected with hepatitis C and gets the acute form of the disease, there is about a 50% chance of the disease becoming chronic. This means that the virus remains in the body after the acute, short-term disease is over, and may or may not cause further illness.

    Some patients have no symptoms of chronic hepatitis C until years later, when liver damage has developed and the signs of cirrhosis (scarring) begin to appear. Hepatitis C can also lead to liver cancer.

    Diagnosis is made through blood tests.

    Treatment for chronic hepatitis C involves taking medications prescribed by the physician; avoiding alcohol; and using no supplements or prescription medications without a doctor’s clearance. In some cases, a liver transplant will be needed to save the patient’s life.

    The best prevention is to never share needles, toothbrushes, or other personal care items, and to always practice safe sex. There is no vaccine for hepatitis C.

    Rarity: Common

    Top Symptoms: fatigue, nausea, muscle aches, loss of appetite, joint pain

    Symptoms that never occur with chronic hepatitis c: pain in the lower right abdomen, pain in the lower left abdomen, pain in the upper left abdomen, pain around the belly button

    Urgency: Primary care doctor

    Ulcerative colitis

    Ulcerative colitis is a chronic, long-term inflammatory disease of the gastrointestinal tract, specifically involving ulcers and sores of the large intestine (colon) and the rectum. Ulcerative colitis often begins gradually and worsens over time with periods of remission interspers…

    Greasy Stool Symptom Checker

    Take a quiz to find out what might be causing your greasy stool

    Pancreatic cancer

    Pancreatic adenocarcinoma is also called pancreatic exocrine cancer, and means that tumors have begun to grow in the exocrine cells of the pancreas. These cells manufacture the enzymes that help digest fats.

    The exact cause of any pancreatic cancer is unknown. Risk factors include smoking; obesity; alcoholism; exposure to certain chemicals; family history of the disease; and pre-existing diabetes, pancreatitis, or cirrhosis of the liver.

    Symptoms include jaundice, which is a yellowing of the skin and eyes; dark urine; pale-colored stools; abdominal and/or back pain; loss of appetite; and unintended weight loss.

    Diagnosis is made through patient history; physical examination; blood tests; abdominal imaging such as ultrasound or CT scan; and sometimes biopsy of the pancreas or other minor surgical procedure to help make the diagnosis.

    Treatment involves a combination of several methods, including chemotherapy; radiation therapy; surgery to remove all or part of the pancreas as well as to help relieve some of the symptoms of the disease; pain management; and psychological support.

    Rarity: Rare

    Top Symptoms: fatigue, nausea, loss of appetite, diarrhea, unintentional weight loss

    Urgency: Primary care doctor

    Celiac disease

    Celiac disease is also called gluten-sensitive enteropathy, coeliac, or sprue. It is an autoimmune response in the gut to gluten, a protein in wheat, rye, and barley.

    • Repeated exposure to gluten causes damage to the lining of the small intestine.

    Most at risk are Caucasians with:

    • Family history of celiac disease.
    • Down syndrome.
    • Type 1 diabetes.
    • Rheumatoid arthritis.
    • Autoimmune thyroid disease.

    Symptoms include digestive upset with gas, bloating, and diarrhea. The malnutrition causes fatigue, weight loss, fragile bones, severe skin rash, mouth ulcers, anemia, and damage to the spleen and nervous system.

    A swollen belly, failure to thrive, muscle wasting, and learning disabilities are seen in children, and normal growth and development can be severely affected.

    Diagnosis is made through blood testing and endoscopy, and sometimes biopsy of the small intestine.

    There is no cure for the condition, but celiac disease can be managed by removing all gluten from the diet. Nutritional supplements will be used and sometimes steroid medication is given to help heal the gut.

    Rarity: Rare

    Top Symptoms: fatigue, stomach bloating, nausea, constipation, diarrhea

    Urgency: Primary care doctor

    Cystic fibrosis

    Cystic fibrosis (CF) is an inherited disease of the mucus and sweat glands, affecting multiple organs, especially the lungs. The mucus clogs the lungs, causing breathing problems and making it easy for bacteria to grow. This can lead to problems such as repeated lung infections and lung damage.

    Rarity: Rare

    Top Symptoms: shortness of breath, productive cough, salty-tasting skin, decreased exercise tolerance, recurring problem with leaking urine

    Urgency: Primary care doctor

    Diabetes insipidus

    Diabetes insipidus (DI) is caused by a lack of, or decreased sensitivity to the hormone vasopressin. Vasopressin is needed for the kidneys to concentrate urine, making sure you do lose to much fluids. If this function is impaired, it will result in urinating frequently and large amounts, extreme thirst and dehydration.

    Rarity: Rare

    Top Symptoms: fatigue, irritability, constipation, excesive thirst, dry mouth

    Urgency: Primary care doctor

    Acute pancreatitis

    Acute pancreatitis is the inflammation of the pancreas, which creates and releases insulin and glucagon to keep the sugar levels in your blood stable. It also creates the enzymes that digest your food in the small intestine. When these enzymes accidentally get activated in the pancreas, they digest the pancreas itself, causing pain and inflammation.

    Rarity: Rare

    Top Symptoms: constant abdominal pain, nausea or vomiting, being severely ill, severe abdominal pain, fever

    Symptoms that always occur with acute pancreatitis: constant abdominal pain

    Urgency: Hospital emergency room

    Poop 101: A beginner’s guide to reading your own poop

    The next time you ponder your poop before you flush, one thing to keep in mind is that your feces passed through a lot of important organs on their way out. (And if you don’t take a peek, well, congratulations on your moral superiority, I guess?) So it might be possible that your stool can tell you when there’s something wrong with the squishy internal Rube Goldberg machine that converts food into feces.

    Ponder your poop before you flush

    I have a lot of questions about what this external nugget of evidence says about the inner workings of my body: is that the shape it’s supposed to be? When did I eat that corn? Why is it blue? (That only happened once.)

    The quick and dirty version of the digestion process starts as soon as we take a bite. Little molecular wrenches called enzymes start dismantling our food in the mouth, then the stomach. In the small intestine, enzymes do even finer work — breaking down fats, proteins, and starches into molecules small enough to pass through the intestine’s walls and into the bloodstream. That’s how you absorb the food’s nutrients. Muscle contractions called peristalsis push the food — now a soupy, messy slop — along to the large intestine, where water is sucked back into the body. What you’re left with is, usually, is a somewhat solid mélange of indigestible food leftovers, microbes, dead cells, and all sorts of waste products our bodies need to expel. The stool hangs out in the rectum before squeezing out through the anus.

    Once the poop is in the toilet, what can it tell you about your body? Since the porcelain bowl isn’t a magic mirror, I quizzed gastroenterologist Justin Sewell from the University of California, San Francisco while he grabbed a quick lunch on the other end of the phone.

    A photo posted by Nabhan Al Abdullatif (@nabhan_illustrations) on Feb 6, 2013 at 10:42am PST

    Earth tones are healthy — but so are lots of other colors

    Poop can come in a rainbow of colors depending on what you eat. But earth tones like brown, yellow, and green are the most common, Sewell says. These muddy hues are the result of mixing digested food with broken down bits of dead red blood cells that get dumped into the small intestine along with bile, an enzyme produced by the liver to digest fats.

    There’s a huge range of normal

    If your poop falls outside this range of shades (like, say, blue), it’s not necessarily unhealthy. But if your poop is gray, black, red, or maroon, those colors could be signs of a health problem. Pale or gray could mean that something is preventing bile and its accompanying red blood cell waste from reaching the small intestine. That could be from a problem anywhere in the liver, the gallbladder (which stores bile), and the connecting ductwork. Often, people with gray poops show other signs of liver problems, like jaundice.

    Flickr/Justin Dolske (CC BY-SA 2.0)

    Black, red, or maroon-hued poop can all be from bleeding. Tarry and sticky stools usually suggest bleeding from the stomach or upper small intestine — like from an ulcer, for example. Dark red or maroon poops could mean bleeding in the upper colon or lower small intestine. Red diarrhea could be due to an inflammatory bowel disease like Crohn’s disease or ulcerative colitis — or it could mean that your colon is infected with bacteria like certain strains of E. coli. And bright red blood on the toilet paper could be due to hemorrhoids — itchy, swollen veins in the rectum or anus that bleed. That’s the much more common, and much less scary option: because it could also be from polyps or colon cancer.

    Poop can come in a rainbow of colors

    But remember, poop is food waste so you might just be seeing the results of something you ate. Iron supplements or Pepto-Bismol can also make your poop black, and beets can make your poop red. (It also turns your pee red. I thought I was dying the first time this happened.)

    There’s no ideal poop shape

    When I create a perfect, uninterrupted log I feel victorious — like I peeled an apple without breaking the spiral of skin. But Sewell tells me that my quest for the perfect poop is misguided: There’s no such thing.

    “I’ve had people bring me pictures of their poop and say ‘This is not right, it’s supposed to be a perfect, smooth log shape.’ And yes, for some people that’s normal but for other people, that’s just not the way their body works,” he says. “There’s no ideal poop.”

    “There’s no ideal poop.”

    Poop types and shapes can grouped into seven categories in the Bristol Stool Scale, which describes the range of imaginable stools — from hard little rabbit pellets (type one — a sign of constipation) to watery diarrhea (type seven — which could be due to anything from an infection to having just gone for a run). As long as your poop falls into types two through six on the Scale, you’re probably doing just fine.

    Wikimedia Commons/Cabot Health (CC BY-SA 3.0)

    “Anywhere from formed logs to soft and falling apart is fine — and that just depends on individual people’s bodies and their diet,” Sewell says. If it’s hard or sticky, however, you might want to add fiber and water to the menu. If it’s mushy or watery, drink more water to rehydrate.

    Food bits are fine, but lots of them is weird

    Sighting food in poop isn’t unusual, Sewell says. But pay attention to how the food looks. It’s totally normal to find pieces of corn kernels, for example, which have indigestible bits made of a plant fiber called cellulose. “If you eat a bunch of greens, you’re going to see pieces of partially digested plant material come out,” Sewell says. And the chunks can be bigger or smaller depending on how well you chew.

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    But if your poop is almost entirely composed of recognizable food bits, it could be signs of a digestion problem. Your gut might be squeezing food through too quickly to get properly digested. Anything from parasites, to certain types of gastrointestinal infections, to even irritable bowel syndrome and severe celiac disease can get peristalsis moving faster than it should. So if what comes out strongly resembles what went in, maybe you should see a doctor.

    Mucus and fat aren’t okay

    If you see mucus on your poop, that can be a sign of an autoimmune disease or an infection. But what does mucus even look like when it’s coming out of an orifice other than your nose? It’s white, semi-solid, and stringy, Sewell says. Like egg drop soup, he adds.

    Seeing that in the toilet bowl suggests inflammation, most likely in the lower gut. The inflammation could be from ulcerative colitis or Crohn’s disease — or from some kind of parasitic, viral, or bacterial infection.

    A photo posted by Nabhan Al Abdullatif (@nabhan_illustrations) on Jul 11, 2015 at 3:42pm PDT

    Be on lookout for fat in poop as well. A fatty stool usually floats and can leave an oil slick on the surface of the water. After you flush, there might be orange ring of what looks like pizza grease that lingers around the bowl. Like when you’re cooking something oily, Sewell says, “and you pour out the water, and there’s a rim of fat that sticks to the edge of the container.”

    Fatty poop can come from a number of things — including diet pills like Alli that can make fat leak out your butt. It can also be a sign of pancreatic or liver disease, because it means the enzymes they produce that should be breaking down fat aren’t doing their jobs. Intestinal disorders like Crohn’s disease or celiac disease can cause this, as well.

    So what does your poop say about you?

    The main thing to keep in mind is that there’s a huge range of normal. That also includes the frequency with which you poop — generally, anything less than three times per week is constipation, and anything more than three times a day is too frequent. Most people poop one to two times a day, or once every other day, Sewell says. Variation in urgency is common, too — having to go right now isn’t unusual, but if that’s a constant sensation, you may want to check in with a doctor.

    “Pay attention — but don’t obsess.”

    “I think it’s healthy for people to look at what they produce, note any major changes, and ask their doctor about it,” Sewell says. “People do obsess over having, they want the perfect shape poop, they want it harder, they want it softer. It’s not really much under your control besides eating more or less fiber, or consuming more or less water. So pay attention — but don’t obsess.”


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