Changes in Bowel Habits

What is a change in bowel habits?

A change in bowel habits is any departure from what counts as normal when it comes to how your stools look or how often you have a bowel movement (poop). Slight changes usually aren’t a big deal. But major changes may signal that you need to adjust some parts of your lifestyle to live healthier. Differences can provide clues about what’s happening inside your body, like a health condition a healthcare provider should know about and treat.

The most common changes usually involve stool color, consistency, frequency and how much control you have over when you go to the bathroom.

Stool color

Stool color varies, but it’s typically some shade of brown, depending on the foods you eat. A temporary color change from brown is likely harmless and diet-related. Small amounts of bright red in your stool usually mean rectal bleeding, which may or may not be serious, depending on the cause. Unusual color changes that don’t clear up (like deep red, black and tarry, clay-colored or pale stools) are signs you should see a provider.

Stool consistency (firmness)

Stools should be solid, soft and pass easily. Hard, dry stools that are tough to pass are a sign of constipation. Loose, watery stools are a sign of diarrhea. Both constipation and diarrhea are common and usually clear up within a few days. Constipation or diarrhea that lasts longer than two weeks isn’t normal. It’s time to see a provider at that point.

Frequency (how often you poop)

The normal length of time between bowel movements varies from person to person. Some people have bowel movements several times a day. Others only go once or twice a week. A general rule is that going longer than three days without pooping is too long. After three days, stool becomes harder and more difficult to pass. You may need to take steps to spur your gut into action so you can poop.

Control over your bowel movements

You should be able to control the muscles in your gut that allow you to poop or hold it. Loss or lack of control is called fecal (bowel) incontinence. It’s more common as you age. It’s important to see a provider if you lose control over your bowel.

What causes a change in bowel habits?

The most common cause is one you can control — your lifestyle. Eating too few of the foods that keep your digestive tract moving (like high-fiber foods) can affect your stools. Lack of exercise, a sudden increase in exercise intensity, not getting enough water and stress are also common causes. Bathroom visits usually return to normal once you change your habits or adapt to a routine (like a new exercise regimen).

Medications are also a key culprit. Many over-the-counter and prescription medications have side effects, like diarrhea and constipation. Stools usually return to normal once you stop taking the medicine.

Multiple conditions can cause changes in your bowel habits and stools, including:

• Anal fissures: A tear in the lining of your anus (butthole). You may notice bright red blood in your stool or on your toilet paper. Anal fissures often heal on their own in time.
• Bowel (intestinal) obstruction: A medical emergency that happens when something large blocks your intestine. Symptoms include constipation, nausea, vomiting, abdominal pain and gas.
• Celiac disease: A disorder that causes problems in your digestive system when you eat gluten (wheat products). Symptoms include constipation, diarrhea and stomach pain.
• Colon cancer: Cancer that forms in your colon’s inner lining. Bloody poop, abdominal pain, constipation, diarrhea and a frequent urge to poop are all symptoms.
• Colon polyps: Growths in your colon or rectum. Although polyps may be asymptomatic, constipation, diarrhea and bloody stool are potential symptoms.
• Diverticulitis: When small pockets lining your colon become inflamed. Symptoms include severe abdominal pain, constipation and rectal bleeding.
• Endocrine conditions: Disorders that impact your endocrine system can cause changes in your bowel habits. For example, diabetes and hypothyroidism can cause constipation.
• Food intolerance: When your digestive system can’t break down certain foods. You may get symptoms like diarrhea and belly pain. Lactose intolerance (trouble digesting the sugar in milk or dairy products) is an example.
• Hemorrhoids: Swollen veins inside your rectum or outside your butthole. They may cause you to see small amounts of bright red blood in your poop. You can usually treat (and heal) them at home.
• Infections: Viruses, bacteria and parasites can all cause symptoms affecting your gut, like diarrhea and an upset stomach.
• Inflammatory bowel disease (IBD): A group of disorders that cause inflammation in your gut. IBD causes symptoms like diarrhea, gas and abdominal cramps. Types include Crohn’s disease and ulcerative colitis.
• Irritable bowel syndrome (IBS): A group of symptoms affecting your gut. They include constipation, diarrhea and abdominal cramps or pain.
• Liver and gallbladder disorders: Liver disease and gallbladder disease can cause unpleasant symptoms affecting your bowel. A key change to look out for is pale-colored stools.
• Neurologic conditions: Conditions that affect your brain and spinal cord can prevent your muscles from receiving the signals they need to help you poop regularly. Examples include multiple sclerosis, Parkinson’s disease and stroke.
• Pancreatitis and exocrine pancreatic insufficiency (EPI): Inflammation in your pancreas or decreased production of a specific enzyme required for digestion, which makes it hard to break down fats. You may notice fatty poops that leave an oily residue in the toilet.
• Weak pelvic floor muscles: Issues with your pelvic floor muscles can make it harder to poop or control your bowel function. Pelvic floor muscles can weaken with age, overuse or because of an injury during pregnancy.

How are changes in bowel habits treated?

Treatment depends on what’s causing the changes in your bowel habits. Treatment may be as straightforward as a course of antibiotics if you’ve got a bacterial infection or as complex as surgery if the issue is more serious.

If something in your routine is causing the change, you can make some lifestyle modifications. Many of these solutions can help you prevent unpleasant bowel changes in the first place:

• Drink enough fluids to stay hydrated.
• Don’t “hold it” if you have to poop (this can lead to constipation).
• Take note of foods that upset your stomach so you can avoid them in the future.
• Don’t strain to have a bowel movement (this can damage the tissue that helps you poop).
• Incorporate high-fiber foods into your diet (like beans, chickpeas and whole-wheat breads).
• Exercise to keep your bowels moving, but don’t overdo it if you’re new to exercise.

You may need a stool softener or laxative if you have constipation and lifestyle changes aren’t helping.

When should you see a doctor or healthcare provider?

It can be tricky knowing when a change is something you should wait out at home, when it’s cause for you to call your provider and when it’s an emergency. Most changes get better eventually, either on their own or with lifestyle changes, but there are important exceptions.

Contact your healthcare provider if you have:

• Constipation or diarrhea that lasts longer than two weeks.
• Severe diarrhea (frequent bathroom trips) that occurs with other symptoms, like severe abdominal pain, fever, chills, vomiting or fainting.
• Bloody diarrhea or more than a few bright red streaks of blood in your stool.
• Stools that are deep red, maroon, black or tarry (especially if they have a noticeable odor).
• Sudden urges to have a bowel movement (this could be a sign of a mass in your rectum or IBD).
• Mucus or fluid leakage from your rectum (this could be a sign of stool lodged in your rectum).

Seek emergency care if you have:

• Symptoms of an obstruction (constipation, nausea and vomiting, abdominal pain and inability to pass gas).
• Symptoms of a liver problem (stools that are pale, clay or white, dark urine, fever, chills, right-sided upper abdominal pain or yellowing of your skin).

Do bowel habits change with age?

They do. You’re more likely to experience constipation as you grow older. The likelihood of developing fecal incontinence, or struggling to control your bowels, increases after age 65. Muscles that help you control bowel movements can weaken as you age.

Do bowel habits change during pregnancy? 

For some people, they do. Up to 39% of pregnant people experience constipation during pregnancy. It’s most common during the third trimester when the fetus is heaviest and places the most pressure on your bowels.

Do bowel habits change during menopause?

They can. And they can change in the period before menopause (perimenopause), too. In these stages, hormone levels shift. These hormone changes can affect various body systems, including your digestive system. Changes in your bowel habits may be related to these changes.

Still, don’t assume that alarming or unpleasant changes are “just hormones.” See a healthcare provider to be sure.