Why Do We Ask About Your Poop? 

If it’s your first time seeing an acupuncturist you may be taken back by some of the questions you are asked during the intake. Even if you are just coming in for help with headaches, you’d most likely get questioned about seemingly unrelated bodily functions. While the subject of your poop may be uncomfortable at first, rest assured that, in Chinese Medicine, it has a long history of being used as an important diagnostic tool. In the case of the headache and almost any other complaint, the color, consistency, frequency, even odor of your poop can point to patterns in energy, substance and organ relationships that will inform the most effective treatment.

While your acupuncturist is investigating the imbalance that is responsible for whatever you are seeking treatment for, you will get asked specific questions about what ends up in your porcelain throne. The reason for this is because many organs are involved in the process of digestion. We often look at the absorptive functions of the stomach and small intestine, the Kidneys as the root source of digestive fire, the liver as an important player in harmonizing digestive function through the regulation of qi movement in the body and the large intestine as that main exit pathway that pulls out excess water to finally concentrate our waste material into the perfect poop. 

In explaining the state of the body based on the function of these organs, Chinese Medicine uses terms like damp, dry, heat, cold, stagnant, excess, and deficient. These terms refer to patterns of energy and substance recognized in the body that can predict other health aspects. For example, we can predict that a patient recognized as having a “damp pattern” evidenced in loose stools and edema might tend to also suffer from brain fog and difficulty losing weight.

So before getting into the various signs of imbalance, let’s lay out the ideal poop situation. When all is well a person should have a bowel movement 1-2x/day. Less can be considered constipation, while more would be considered diarrhea. According to TCM (Traditional Chinese Medicine), the perfect bowel movement is formed but not hard, it should not be odorous, there should be no blood or pus, and you should not have to push hard. If you fit the bill, this is generally indicative of not only good digestive health, but overall health as well. 

Signs of imbalance include stool that is too soft, too dry, sticky, thin, small, stinky or any color other than a nice dark brown. 

Soft or loose with undigested food: we look at spleen, stomach and small intestine absorptive function as well as the strength of the kidney yang or that fire of metabolism in the body.

Dry, hard:  generally considered to be caused by a deficiency of yin (moisturizing, cooling aspects of the body), or blood. Basically, the person is dehydrated.

Thin: can be a result of qi deficiency or qi stagnation. Consistently pencil thin stools are considered a red flag in Western medicine, and while it may just be an area of spasm in the colon, it is best to rule out more serious concerns like a blockage such as a tumor.

Sticky or Slimy: If you have to wipe multiple times, you may have excess ‘dampness’ or ‘phlegm’ in the body. (In Western medicine this is associated with the inability to break down fat). 

Pebbles: If you tell your acupuncturists that your poop looks like goat droppings, s/he will check for signs of liver function. The liver, according to TCM, is in charge of keeping a smooth flow of qi in the body. If qi becomes stagnant, waste wont move along its exit path, instead it sits and dries up, breaking down into ‘pebbles’, especially when there is also excess heat involved.

Color is important from both an Eastern and western perspective. In either case, there are some red flags such as pale or gray stools which may indicate a bile blockage. Red in your stool can be indicative of blood (are you SURE you didn’t eat beets yesterday?!) which should be further investigated.  Generally though, according to TCM, we may look for signs of heat (or infection) in the intestines if we hear that there is dark yellow stools, or want to check liver function if they tend more greenish. 

Strong odor is another sign of  heat in the intestines, While an especially foul odor indicates damp-heat. All of these distinctions are important as they inform treatment in both acupuncture and herbal approaches.

Even if you’re not experiencing any problems, it’s still a good idea to monitor your stool regularly. This can help you identify any potential health concerns before they become a bigger problem. So keep track of what your poop looks like, and if you notice any changes, talk to your acupuncturist or doctor right away.

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