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Stool Size Matters

Larger bowel movements are associated with lower risk of appendicitis, colon cancer, constipation, and diverticulitis.

September 26, 2011 |
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Stool Size Matters, 4.8 out of 5 based on 5 ratings

Sources Cited

Petrakis NL, King EB. Cytological abnormalities in nipple aspirates of breast fluid from women with severe constipation. Lancet. 1981 Nov 28;2(8257):1203-4.

Cummings JH, Antoine JM, Azpiroz F, Bourdet-Sicard R, Brandtzaeg P, Calder PC, Gibson GR, Guarner F, Isolauri E, Pannemans D, Shortt C, Tuijtelaars S, Watzl B. PASSCLAIM--gut health and immunity. Eur J Nutr. 2004 Jun;43 Suppl 2:II118-II173.

Cummings JH, Bingham SA, Heaton KW, Eastwood MA. Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber). Gastroenterology. 1992 Dec;103(6):1783-9.

Watts GT. Bowel transit, stool weight, and diverticular disease. Lancet. 1977 Sep 10;2(8037):564.

Burkitt DP, Graham-Stewart CW. Haemorrhoids--postulated pathogenesis and proposed prevention. Postgrad Med J. 1975 Sep;51(599):631-6.

Burkitt DP, Moolgaokar AS, Tovey FI. Aetiology of appendicitis. Br Med J. 1979 Mar 3;1(6163):620.

Balasegaram M, Burkitt DP. Letter: Stool characteistics and western diseases. Lancet. 1976 Jan 17;1(7951):152.

Simons CC, Schouten LJ, Weijenberg MP, Goldbohm RA, van den Brandt PA. Bowel movement and constipation frequencies and the risk of colorectal cancer among men in the Netherlands Cohort Study on Diet and Cancer. Am J Epidemiol. 2010 Dec 15;172(12):1404-14. Epub 2010 Oct 27.

Burkitt DP, Walker AR, Painter NS. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet. 1972 Dec 30;2(7792):1408-12.

Acknowledgements

Transcript

The bigger our bowel movements, the healthier we may be. The risk of low stool weight includes bowel cancer, diverticular disease, appendicitis, various anal diseases—even perhaps, the healthfulness of breast tissue.

 From a study of 23 populations across dozen countries, a graph, of average daily stool weight versus colon cancer incidence.  As you can see, once you get down around 200 grams, colon cancer rates really seem to skyrocket.  That's about half a pound. And  once people start dropping quarter pounders, though,  colon cancer incidence doubles.

The link between stool size and colon cancer may be related to transit time, the number of hours it takes for food to go from your mouth to anus.  The larger your stool, the quicker the transit time, the easier it is for your intestines to move things along.

People don’t realize, though, you can have daily bowl movements and still be effectively constipated.  You can be regular, but five days late.

What you’re seeing today you may have eaten last week. If you want to test it for yourself, you can eat a big bowl of beets and see when things turns pretty in pink.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Dianne Moore.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. Be sure to check out the other videos on bowel movements. Also, there are 1,449 subjects covered in my other videos–please feel free to explore them!

Please also check out my associated blog posts: Stool Size and Breast Cancer Risk, Bowel Movements: The Scoop on Poop, and Optimal Phytosterol Dose and Source.

  • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. Be sure to check out the other videos on bowel movements. Also, there are 1,449 subjects covered in my other videos–please feel free to explore them!

    • LynnCS

      Hi Dr Greger. I so value the research and info you impart. I am 74 (F) and have been told that I need not have any more colonoscopies. I have spastic colon and an abundance of diverticula in spite of being a vegetarian, now vegan, for 32 years. My mother died of colon cancer. Therefore, I have been diligent about getting regular exams. Lately I am not forming full stools in spite of the high fiber diet. I have ordered some bowel treatment items from Dr. Schultze’s site. I am afraid not to have the colonoscopies. What would you suggest to a patient presenting as I am? Thank you very much. Lynn

  • http://nutritionfacts.org/members/georgei/ GeorgeI

    Last summer I read a PDF book by a Buddhist monk discussing vegetarianism. Contrary to popular belief, Buddhism does not mandate vegetarianism for either monks or lay people. The monk who authored this book eventually decided to go vegetarian. He explained that one of the reasons why he delayed this decision was that he was turned off by a fetish that some sectors of the veg*n community has for discussing their inner workings like bowel movements, digestion, etc. He warned readers that these things could turn other people away from vegetarianism.

  • http://nutritionfacts.org/members/BenjaminStone/ Benjamin Stone

    I have read that there are some risks with larger bowel movements, primarily poor nutrient retention due to increased size and frequency. Is it reasonable too assume there could be a risk with a diet to high in fiber that does not permit for optimal nutrient absorption?

    • http://nutritionfacts.org/members/joel/ Joel

      My guess is that that risk would be more due to inadequate hydration, which it never hurts to bring awareness back to. Excuse me while I grab some water…

  • http://nutritionfacts.org/members/bpcveg/ BPC

    The suggested home experiment of consuming a bowl of beets and estimating transit time sounded like an excellent way to do simple self-diagnosis. A clever and straightforward home health check-up! I hope to hear more tips like this in future.

  • http://nutritionfacts.org/members/joel/ Joel

    I think transit time is a relatively old tool-of-the-trade for naturopaths. I first heard of it in the early 70s via a Marin, California naturopath but I don’t know, it may have been used for centuries. It’s easy to check in any case so the connection must have been recognized quickly by the first beet eaters though they might have panicked at first thinking it was blood.

  • http://nutritionfacts.org/members/TanTruong/ Tan Truong

    Who knew that eating fruits and vegetables would cause one to drop whoppers.

  • http://nutritionfacts.org/members/joel/ Joel

    A good probiotic is also helpful in this regard, though not to “make up for” a trashy diet. A “good probiotic” is an operational definition: one that works for you. Since you may discover more than one that works well, over time I would rotate between those types and brands you find that work rather than getting the same one each time you buy a bottle.

    Another thing that is even more than helpful, it’s essential (learned from an Indian yoga teacher), is squatting for elimination. Can you argue with 100% natural? Essential but not sufficient of course. Diet seems to be #1. At an extreme, the former Roy Walford MD, longevity maven (calorie restriction studies) opined that the [Best Diet+No Exercise] would be better than the [Worst Diet+Good Exercise].

  • Eercolan

    I do not have large bowel movements but rather many small bowel movements throughout the day.  I eat a lot of fiber, especially raw vegetables.  Please comment.  Susan

  • Michael Greger M.D.

    Please also check out my associated blog post, Stool Size and Breast Cancer Risk!

    • Jtzwiefel

      Hi, I have an anal fissure that is almost healed (6 months now).  It is much better but still bothers me daily.  I am taking Mirlaxa ever day- i never used to, although i was often constipated from childhood.  Now my stools are much smaller than they used to be.  The less mirlax I take- the more my fissure hurts.  Do you have any ideas to help?  Thanks.

  • nick

    There may be people that aren’t aware of this, but another product that one should stay away from is bleached flour, & animal protein from meat, milk, & eggs which can get caught up in the pockets of the colon & create diverticulosis which can lead to diverticulitis. Just imagine anyone that has ever done paper mache will remember that the way they made glue is by taking bleached flour & water, then mixing it together.

  • Valeriesmom

    I have just started my plant based whole foods “diet”/lifestyle 2 weeks ago and I’ve noticed that I have alot less bowel movements??? I thought I would have more… Alot more gas but less of the other any insight would be great!!! Thanks

    • Toxins

      The opposite should be true, at least two a day. Exercise plays a key role in bowel movements as well. If you are not getting enough exercise this could be the case.

    • Liam

      Drink more water

  • Glenn

    My wife and I have changed to a whole foods plant based diet over a year a go. My wife recently had a physical and it showed that she had an over active thyroid. She has never had a problem before. What is the best way to remedy this through diet? We are both in our late 40′s.

  • cpgraettinger

    A delicious, whole, plant-based recipe for Pasta Fagioli. And easily made in a slow cooker. Check out the fiber content of this baby!

    http://www.gardendish.com/news/2013/5/13/slow-cooker-pasta-fagioli.html

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