What does stool color reveal?


As with urine, the consistency and smell of stool says a lot about our health. The coloring is not insignificant either: it can sometimes put on the track of an imbalance or a pathology.

In popular parlance, our elders used to greet each other by asking themselves: “How are you feeling with your bowel movement? which is interesting because if the stools were okay, they were the right color and the right consistency, then everything was fine says Prof. Olivier Spatzierer, head of the gastroenterology unit at the American Hospital of Paris. If our ancestors had little complex to talk about their saddles, the trend has now been reversed. However, we must remain on the lookout because the color of the stool provides valuable information on our diet, but also on a possible digestive dysfunction. How to explain stool color? What does a green, red, black color mean? When should you worry? Explanations with Pr Olivier Spatzierer.

What are stools?

Also called feces or excrement, stool is the indigestible residue of the food we eat. They are made up of a very large majority of water (75%) while the rest (25%) is a mixture of mucus, bacteria and food debris. “ A healthy person has a bowel movement on average every 3 days but this frequency varies greatly depending on the transit: some will go every day to relieve themselves without this being pathological “says Professor Spatzierer. A normal stool is cylindrical in shape, 15 to 20 cm long and is lined with a transparent mucus which helps in normal expulsion, that is to say without pain. Considered unsexy, the subject of stools is rarely discussed in everyday life, which can cause problems from a medical point of view. “ If we are interested in colon cancer screeningless than 3 out of 10 French people practice prevention because bowel movements are experienced as negative and shameful, whereas in Anglo-Saxon countries, we go to 9 out of 10 people », Saddens Olivier Spatzierer. However, stool examination provides important information on physiological and mental balance.

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Olivier Spatzierer, director of the gastroenterology unit at the American Hospital of Paris

How to explain stool color?

The color of the stool varies from dark brown in the case of a high-protein meat diet, to light brown for a vegetarian diet. In all cases, this color is due to the degradation of bile which is secreted by the liver and released, via the gallbladder, into the upper part of the intestine. Bile promotes fat digestion and neutralizes stomach acid. After fulfilling its role, it is degraded and then transformed into stercobilin, a metabolite responsible for the brown color of feces.

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Is an abnormal color always a sign of a pathology?

From the moment when the cycle of degradation of the digestive system is disturbed, we will identify several anomalies which result in particular in a change in the color of the stools. “, explains Olivier Spatzierer. However, a color variation is not always pathological: spinach stains the stools green and beets dark purple. “ Often these colors indicate that the food in question has been consumed in excess, so that it has not been absorbed well by the intestine. Residues are found as such in the stool without it being a pathological dysfunction “, continues the doctor. In case of pathology, the abnormal color is often combined with other parameters such as physical symptoms (fever, loss of appetite, weight loss or weight gain), psychological (depression, etc.), as well as a variation in stool consistency.

What are abnormal colors?

Black saddles: This coloration may be due to certain food supplements or foods very rich in iron (blackberries, black pudding, spinach, beets), in which case the color is not pathological. But “ it can also correspond to a melenai.e. a gastrointestinal hemorrhage which results in the evacuation of digested blood and which is often accompanied by a foul odor “, warns Professor Spatzierer. In this case, black is the color that the hemoglobin of the blood takes on once digested. If it is not a haemorrhage, this coloration can also indicate severe constipation during which the stool remains in the intestine for a long time, or the presence of an ulcer in the internal wall of the stomach or the stomach. first part of the intestine (the duodenum).

Red stools: ” La red color indicates the presence of undigested fresh blood “, indicates the gastroenterologist. This often reflects a digestive pathology such as hemorrhoids (excessive dilation of the veins around the anus), anal fissures (wounds in the anus), diverticula (tears in the colon) but also sometimes colorectal cancer or rectum, inflammatory diseases, and more rarely, ischemic colic (due to damage to the large intestine).

Yellow stools: They are the sign of a malabsorption of fats, which are found in excess in the stool. “ This excess fat is linked to poor absorption of lipids in the intestinal mucosa or to its total interruption, so that they are not digested and accumulate: we speak of steatorrhea when there are more than 6 grams of fat per 24 hours in the stool », specifies Olivier Spatzierer. This yellow color can also be associated with celiac disease (gluten intolerance), Crohn’s disease (chronic inflammation of the digestive tract) and even Gilbert’s disease which is manifested by an abnormal increase in the level of bilirubin (yellow pigment of bile) secreted by the liver. Feces can also be yellow because of the presence of an intestinal parasite which obstructs lipid exchanges. In any case, the stools often become very odorous.

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Whitish stools: This means that there is an obstruction in the path of bile salts, elements contained in bile “says the doctor. Whitish stools can be a sign of benign pathologies, such as stones in the gallbladder, or more serious diseases such as a lesion of the bile ducts, an anomaly of the pancreas (tumor, etc.) or even an alteration in the production of bile by the liver, in case of hepatitis for example.

Mucous stools: Small whitish deposits called “ mucus are produced in the colon and rectum and serve as a natural lubricant in the anus. When these mucus become too abundant, they can testify to an erosion of the lining of the colon in the case of inflammatory diseases such as Crohn’s disease. Such substances can also result from an infection (such as salmonellosis) or from irritable bowel syndrome, a disorder of bowel function that is not serious, but responsible for significant discomfort.

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When should you worry?

If the color is spotty, it is most likely food related. It is therefore prudent to monitor the appearance of the faeces the days following the detection of a possible anomaly. “ From the moment the abnormal coloring persists over time and is associated with a procession of symptoms (pain, fever, fatigue, weight loss, etc.), do not hesitate to consult “, recommends the doctor. The diagnosis will consist of a series of questions followed by medical examinations (blood test, fibroscopy, etc.). “ For example, in the case of black stools, if the patient indicates significant fatigue, we will immediately think of an ulcer. In this case, the stomach will be palpated, a fibroscopy and a blood test will be carried out. Once the disease is identified, we can proceed to the treatment “, explains Professor Spatzierer.

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