What your poo can tell you Mention poo - or bowel motions, number twos or whatever you want to call them - and most people pull a face and change the subject. Yet there's much you need to know about poo.
What goes in must come out, right? So, when was the last time you took a good long look after you went to the toilet?
 
It's one thing to talk about the delicious food you've been eating, but you probably avoid thinking about what happens to that food as it passes through your body.
 
Yet when it comes out, it may have a message for you.
 
According to gastroenterologist Dr Derwin Williams, the most important thing poo can let us know about our health is whether we have a bowel tumour. Bowel tumours often bleed so you should always talk to your doctor if you see any blood after you poo.
 
"What is important is that any blood in your poo should be reported to your doctor," Williams says.
 
You might notice blood on the outside of stools, on toilet paper after you wipe or in the bottom of the toilet bowl. As well, certain coloured stools are associated with bleeding. So maroon, dark red, bright red or very black poo (especially if it's extremely smelly) are worth getting checked out.
 
While you should never ignore any blood associated with your poo, it's worth remembering not all bleeding is bowel cancer. Haemorrhoids, anal fissures, bowel polyps, peptic ulcers and a range of other digestive diseases can also cause bleeding.

There's a chart
 
But what else can poo tell us about our health? And what is a "normal" poo?
 
Poo, or faeces or stool as it is referred to in medical circles, text books and polite conversation, is composed of water and solid matter consisting of dead bacteria, indigestible food matter, cholesterol and fats, protein and inorganic substances like iron phosphate. These are all collected along the digestive tract from your mouth to your bottom.
 
Bowel motions come in a variety of shapes, sizes and consistencies, as described in the Bristol Stool Scale, first published in 1997. The chart aimed to classify human poo into seven categories and was designed as a tool to ascertain a person's bowel transit time – the time it takes for food to pass through the digestive tract.
 
便便健康.jpg
 
These days the chart is more often used to help concerned patients better describe their bowel motions, with numbers 3 or 4 considered 'the perfect poo'.
 
Williams says the Bristol Stool Scale is not clinically important and he doesn't know any colleagues who use it.
 
"The chart's really an attempt to work out if someone is constipated [so] every toilet should have a poster," he says.
 
"However, if there is any persistent change in the consistency of your poo, it sometimes indicates a problem and should be reported to your doctor."
 
Some people tend be obsessed with their poo, and patients have been known to bring photographs and even samples to the doctor's for an opinion.
 
But everyone's poo is different and its appearance changes from day to day. You may see mucus on Monday and have a hard poo on Tuesday. Williams says these variations are nothing to be worried about, unless they are still there a few days later because some factors may be relevant depending on your medical history.
 
At the far end of the scale (number 7) is diarrhoea. This can be a sign of anything from a tummy bug or food poisoning to a food intolerance, or possibly just a reminder that you had too many alcoholic drinks the night before. As well, some medications can cause diarrhoea. In most cases diarrhoea will clear up after a day or two, but sometimes it will warrant a trip to the doctor.

Colour coding
 
When we think of poo, we tend to think of a certain shade of brown. But what ends up in the toilet bowel can be anything from brown to green to black. While what you eat can affect the colour of your stools, so can certain health conditions.
 
Stool gets its brown colour from bile, a digestive fluid produced by the liver. During the digestion process bile mixes with we have eaten, and it changes colour from green to brown as it travels to our colon. Generally, a meal takes three days to pass through the body to reappear in your toilet bowl. In some instances however, this process is sped up (for instance, if you have diarrhoea) and this can lead to green poo.
 
"A bright green poo indicates a quick transition through the bowel where the bile has had no time to change to brown," Williams says.
 
Black poo may contain blood from further up your digestive tract, but it can also mean you are taking iron tablets – or gorging yourself on licorice or blueberries.
 
While bright red blood on your stools warrant a trip to your doctor as it can mean bleeding in your digestive tract, beetroot can also make your poo look red.
 
A very pale poo, which can mean a lack of bile, is "pretty rare", Williams says, although it could mean a bile duct obstruction, which requires medical treatment.
 
Any changes to your poo's consistency or colour which last more than a few days should be reported to your doctor, Williams says. But if the only thing that has changed is the colour of your poo – and you have no other symptoms (or any sign of blood) or pre-existing health conditions and these changes don't last too long – then don't worry too much.
 
"The gist of it is that everyone should look at their poo [and] any blood or consistent change should be reported to your GP.
 
"In our Western culture, we tend to just sit on the loo and flush and we lose the opportunity to take a look. Everyone should look for blood and leave it at that."
 
在西方文化中,人们倾向于坐在马桶上上完厕所,然后冲水,错失了观察自己排泄物的机会。专家指出,每个人都应该仔细看看自己的便便,因为便便能告诉你许多身体健康状况的信息。
 
肠癌是澳大利亚第二大癌症杀手,最近一次调查显示,澳大利亚的肠癌患者有年轻化趋势。过去一般认为肠癌主要发生在50岁以上的人群。可是调查发现,从1990年至2010年,30-39岁的肠癌患者人数猛增了35%。这与年轻人常常忽略肠癌的早期信号例如腹痛和便血不无关系。
 
说到便便或者肠胃蠕动,不少人会选择做个鬼脸绕开这个话题,但有些关便便的常识是你应该知道的。
 
肠胃病专家德尔文·威廉姆斯博士(Dr Derwin Williams)认为,便便能告诉我们最重要的信息就是让我们了解自己的健康状况,知道自己是否有肠道肿瘤。由于肠道肿瘤经常出血,所以一旦在排便完看到任何血迹都应该去看医生。
 
无论是马桶内的血迹,还是厕纸擦拭后的血迹都值得注意。特定颜色的粪便也跟出血有关。因此,如果你的便便是枣红色、暗红色、鲜红色或者很黑(尤其是还很臭)的时候,就应该去检查了。值得一提的是,并不是所有的出血都与肠道肿瘤,痔疮、肛裂、肠息肉和胃溃疡等消化系统疾病一样会引发出血。
 
粪便、排泄物等都是医学界较为礼貌的叫法,它们由水、固体物质组成的死细菌、消化食物、胆固醇、脂肪、蛋白质和无机物质组成,在经过消化道后排出。肠蠕动使得粪便形状、大小不一。1997年,布里斯托粪便模型(Bristol Stool Scale)把人类的粪便划分为七类,该模型旨在确定肠蠕动的食物消化时间。
 
如今该图表常常用以让病人更好地描述自己的肠蠕动情况,3号和4号便便被认为是最优状态。
 
威廉博士认为该图表在临床上意义不大,不过倒是可以让人们知道自己是否便秘,每个卫生间都应该贴上这样的海报。
 
每个人的便便都是不同的,同一个人每天排泄物的样子也不尽相同,可能周一粘稠周二就硬硬的。威廉表示,不需要担心这样的变化,除非持续几天的异样,那就可能与身体健康状况有关。
 
粪便模型表最底端的7号便便就是腹泻,这可能是肠胃病毒或食物中毒等引起的。或者也可能是前一晚喝了太多酒。同时,一些药物也会引发腹泻,多数情况下腹泻会持续一两天,但有时需要去看看医生。
 
当我们想到粪便,总觉得应该是深棕色的。但它可能是绿色到黑色之间的任何颜色。你的饮食和健康状况都会影响粪便的颜色。
 
粪便从肝脏产生的消化液——胆汁那里获得棕色。在消化的过程中,胆汁与我们的所吃的食物混合,当穿过结肠时,颜色从绿色慢慢变棕。一般来讲,一餐饭需要3天的时间穿过我们的身体被排泄出来。在某些情况下例如腹泻时,这个过程会加速,于是可能导致绿色粪便的产生。
 
威廉博士指出,明亮的绿色便便是因为食物穿过身体的速度过快,而胆汁还没来得及与它们混合染色。黑色的便便则可能是含有血液,也可能是你正在服用补铁剂,或是狼吞虎咽了甘草、蓝莓。如果是明亮的红色便便,就值得去看看医生了。它可能意味着你的消化道出血。还有甜菜头(beetroot)也可能让你的便便看起来红红的。颜色过浅的粪便可能是人体缺乏胆汁,是"非常罕见的"。威廉博士认为这可能意味着胆管阻塞,需要进行治疗。
 
当便便发生任何变化,并持续数日时,就需要与医生沟通了。但如果仅仅是颜色变化,而你又没有其他症状(任何出血现象)、没有相关病史,且这些变化并未持续很久,那就不必太过担心。