Bowel Clues – What Your Stool Says About Your Health

6-26-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Your gut holds secrets your body wants you to hear. From color to consistency, your stool is more than waste—it's a window into your health. At Howard’s House of Medicine, we don’t ignore the clues. We follow them.

A glance behind, a daily test,

The body's truth in humble rest.

Though flushed away and out of mind,

The gut leaves markers you can find.

From shade to shape, from float to hue—

Your health may speak. It’s talking to you.

---Dr. Howard Friedman MD

Introduction: Don’t Flush the Clues

Our bodies are extraordinary, intricate systems—so complex that even our most advanced scientists have yet to unlock all their secrets. One of the most overlooked yet revealing systems is the gut. In recent years, medicine has begun to recognize what many ancient traditions have long understood: the gut is central to health.

The human digestive tract is home to a vast and dynamic ecosystem—what we call the gut microbiome. This biodome of bacteria helps digest food, regulate inflammation, and even influence mood and immunity. And just as fascinating: the waste it produces—your stool—can offer important clues about your health.

IIn this blog, I’ll walk you through what your stool says about your health—how its color, shape, consistency, and even smell can reflect deeper imbalances. From Western medicine to Eastern wisdom—whether we’re looking at the meridians of Chinese medicine or the chakra systems of Ayurveda—the gut holds a sacred, central role in our well-being.

Three of the body’s key chakras focus on this area:

• Muladhara (Root Chakra): Grounding, survival, security.

• Svadhisthana (Sacral Chakra): Creativity, pleasure, reproduction.

• Manipura (Solar Plexus Chakra): Power, will, digestion.

No matter your perspective, one thing is clear: the gut matters. Let’s take a closer look at what’s left behind.

Color: What Shade Says About Your State

Typical stool should be brown—that comes from bilirubin, a pigment produced during the breakdown of red blood cells. But variations can point to deeper issues:

• Green: Often harmless, usually due to leafy greens or rapid transit through the gut.

• Pale or Clay-Colored: May signal liver or gallbladder issues—lack of bile.

• Black or Tarry: A red flag for bleeding in the upper gastrointestinal tract.

• Yellow, Greasy, or Foul-Smelling: May indicate fat malabsorption or pancreatic problems.

• Red: Could be from hemorrhoids—or something more serious like bleeding in the lower GI tract. Don’t ignore this.

  
  

Shape and Consistency: The Bristol Stool Chart

Stool shape and texture can reveal as much as color. Enter the Bristol Stool Chart—a tool used to categorize stool types and assess digestive health.

Types 1–2: Constipation Types 3–4: Ideal Types 5–7: Loose stools/diarrhea

Here’s the breakdown:

• Type 1: Hard lumps, like nuts—very constipated.

• Type 2: Lumpy, sausage-like.

• Type 3: Sausage with cracks—normal.

• Type 4: Smooth, snake-like—ideal.

• Type 5: Soft blobs with clear edges.

• Type 6: Mushy with ragged edges.

• Type 7: Watery, no solids—diarrhea.

  
  

Diet, fiber, hydration, and gut motility all influence this chart. If your stool is consistently outside the normal range, it’s worth discussing with your doctor.

Frequency and Urgency

Bowel habits vary, but most people go anywhere from three times a day to three times a week. That said, major changes—especially if sudden—shouldn’t be ignored.

Symptoms worth noting:

• Going more than three days without a bowel movement (constipation).

• Persistent diarrhea or loose stools.

• Presence of blood or mucus.

• Pain during bowel movements.

• Floating stools, which may indicate fat malabsorption or excess gas.

• Hemorrhoids: Swollen veins near the rectum that can cause pain, bright red blood, or clots.

  
  

A sudden change in bowel habits is not just “getting older.” It could be the beginning of a bigger conversation.

Floaters, Fats, and Foul Smells

Stools that float, smell especially bad, or appear greasy may suggest steatorrhea—fat in the stool. This could stem from:

• Pancreatic insufficiency (lack of digestive enzymes like lipase).

• Celiac disease, Crohn’s, or other intestinal disorders.

• Bile salt deficiency—needed for fat breakdown.

• Infections or even medications (like certain antibiotics or fat-blockers).

• Diets very high in fat or fiber can also occasionally trigger it.

  
  

If you see pale, oily, or foul-smelling stool regularly, get evaluated. The pancreas, liver, or small intestine may be involved.

When to Worry

Some signs require prompt medical attention:

• Blood in your stool—especially dark or bright red.

• Unintentional weight loss.

• A major change in bowel habits or consistency.

• Persistent pain or bloating.

Don’t guess. Don’t Google. Get evaluated.

A Veteran’s Gut: Special Considerations

Veterans face unique gastrointestinal challenges. Service-related stress, trauma, NSAID overuse, and toxic exposures (such as burn pits) can disrupt the gut microbiome. These disruptions may lead to chronic inflammation—what I call the common thread behind most illnesses I see.

At Howard’s House of Medicine, we emphasize the gut because we know how it links to everything: brain health, immune function, energy levels, and even mood.

Inflammation is the battlefield—but you’re not in this fight alone.

Closing Thoughts: Listen to What’s Left Behind

There is no shame in studying your stool. It’s one of the most consistent and accessible markers of your health. The gut talks—we just need to listen.

What you eat, how you rest, how you respond to stress… they all show up in the bowl.

So look. Observe. And if something doesn’t seem right—ask for help.

At Howard’s House of Medicine, I write blogs like this not just to inform, but to empower. You are not just a patient. You are a partner in healing. And every sign your body gives you matters.

Thank you for reading. We walk this road together.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions:

Q: What stool colors should raise concern—and why?

A: While brown is the norm due to bile breakdown, certain colors can signal trouble. Black or tarry stool may indicate upper GI bleeding. Pale or clay-colored stool could point to liver or gallbladder dysfunction. Bright red blood might stem from hemorrhoids—or something more serious in the lower bowel. Yellow, greasy stools suggest fat malabsorption, possibly from pancreatic or intestinal issues. When in doubt, get checked.

Q: How can the shape of your stool reveal digestive health?

A: The Bristol Stool Chart categorizes stool types from 1 (hard lumps) to 7 (watery). Types 3 and 4—sausage-shaped with cracks or smooth—are considered ideal. Hard, pellet-like stool often means constipation. Loose or watery stools may reflect infection, inflammation, or poor absorption. Persistent deviations from the norm should be discussed with a healthcare provider.

Q: . Why do veterans face unique gut health challenges?

A: Veterans often deal with long-term stress, trauma, NSAID overuse, and toxin exposures (like burn pits), all of which can disrupt the gut microbiome. This disruption can trigger chronic inflammation—a common link to many conditions seen in former service members. At Howard’s House of Medicine, we recognize the gut as central to both healing and prevention.