Bowel routine varies from person to person. However, a sudden or persistent change in bowel movement, be it the consistency, color or frequency, is a strong indication of an underlying health problem, which can be an infection or a serious pathology requiring immediate medical attention.

Change in Bowel Movements

Changes in bowel movements can be easily picked by observing its color, consistency, frequency or odor. Now let's explain one by one.

1. Frequency Change

The frequency of bowel movements shouldn't be a problem and it can occur once a day, twice a day, once in two days or twice a week as long as there's no discomfort. But a change in routine, say instead of twice a day if the movement occurs once in three or more days (constipation) or three or more times a day (diarrhea), should definitely make you concerned.

2. Change In Color

While the color of stool varies from person to person, in general it is brown because of the effect of bile produced by liver. Bile is responsible for emulsification of fats and it plays an important role in digestion. Let's throw some light on what a color change in bowel movements means:

• Black or tarry stool indicates upper digestive tract disorder or injury. It could mean bleeding due to an ulcer or inflammation in the upper digestive tract, which was turned into black as it passes through the digestive tract. Other causes could be intake of lead, iron pills, black licorice, bismuth containing medicines and blueberries.
• Green stool could be a sign of high intake of green leafy vegetables, food rich in artificial green color, and diarrhea. Furthermore, iron supplements can also give stool a greenish tinge. Persistent green stool in adults indicates intestinal infection. Green, greenish yellow stools are common and normal in babies since birth till the time they start taking top feed.
• Clay colored or pale white stool is a clear indication that something is wrong in liver, gall bladder or pancreas. Possibilities include infection, cysts, blockage, gallstones, tumor, anti-diarrheal drugs, bismuth containing medicines, etc.
• Red stool is a sign of bleeding from lower gastrointestinal tract (large bowel, rectum and anus). Other causes of red stool include hemorrhoids, diverticulosis, intestinal tumor, abnormal blood vessels, high intake of beets, tomatoes and food rich in artificial red color, constipation. In children, small amount of blood could be due to milk allergy.

3. Consistency Change

Another way of keeping a tab on change in bowel movements is by observing the consistency of stool, which could be harder or softer than usual. Consistency changes that could be a sign of illness include;

• Narrow stool is normal if not passed regularly, but pencil thin and extremely narrow stool indicate IBS (Irritable bowel syndrome) or an obstruction in colon (cancer).
• Hard, dry and rough stool, needless to say, are signs of constipation which make it longer for stool to leave the gastrointestinal tract or GIT.
• Floating stool can be caused by improper fat digestion, excessive gas produced by bacteria due to GIT infection and diarrhea.
• Watery stool that quickly passes through GIT is also a sign of illness, like diarrhea.
• Stool with undigested food is a sign of high-fiber intake, which doesn’t get digested.
• Stool with mucus and pus: Mucus may be present in small amounts, but a lot of mucus and pus is not good and could be caused by GIT infection, inflammation or irritation in conditions like Crohn’s disease, irritable bowel syndrome, ulcerative colitis, colon cancer, etc.

4. Odor Changes

Although often ignored, the odor change in bowel movements is very important. You need to worry if the stool doesn't quite smell like usual. Well, it does stink because of the bacteria, but a smellier than usual stool can mean a different variety of food, or it can point towards underlying conditions like celiac disease, ulcerative colitis, or Crohn’s disease.

When to Worry About a Change in Bowel Movements

While the color, consistency, odor and frequency may change every now and then, one may wonder what type of changes in bowel movements would require an immediate medical attention. Well, the following symptoms should definitely be reported to a healthcare provider as soon as possible:

• A change in normal bowel routine that lasts for more than 2 weeks;
• Change in the texture of stool, either being much harder or softer than usual;
• Persistent stools that are narrower than usual for a period of 2-4 weeks;
• Change in color (paler or darker stools with blood or tarry appearance);
• Bowel movements that float and that look fatty or greasy;
• Bowel movements that cause pain or hard to pass;
• Cramps in stomach, abdominal pain, bloating and no movement of bowel for more than 3-4 days;
• Notice blood in stools, on toilet paper or in clothes.