Human feces (American English) or faeces (British English), commonly and in medical literature more often called stool, commonly referred to as poo or poop, are the solid or semisolid remains of food that could not be digested or absorbed in the small intestine of humans, but has been further broken down by bacteria in the large intestine. It also contains bacteria and a relatively small amount of metabolic waste products such as bacterially altered bilirubin, and the dead epithelial cells from the lining of the gut. It is discharged through the anus during a process called defecation.
Human feces have similarities to the feces of other animals and varies significantly in appearance (i.e. size, color, texture), according to the state of the diet, digestive system, and general health. Normally, human feces are semisolid, with a mucus coating. Small pieces of harder, less moist feces can sometimes be seen impacted in the distal (final or lower) end. This is a normal occurrence when a prior bowel movement is incomplete, and feces are returned from the rectum to the large intestine, where water is further absorbed.
Human feces together with human urine are collectively called human waste or excretion. Containing human feces and preventing spread of pathogens from human feces by the fecal–oral route are the main goals of sanitation.
Characteristics Classification
The Bristol stool scale is a medical aid designed to classify the form of human feces into seven categories. Sometimes referred to in the UK as the Meyers Scale, it was developed by K.W. Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997. The form of the stool depends on the time it spends in the colon.
The seven types of stool are: Separate hard lumps, like nuts (hard to pass) Sausage-shaped but lumpy Like a sausage but with cracks on the surface Like a sausage or snake, smooth and soft Soft blobs with clear-cut edges Fluffy pieces with ragged edges, a mushy stool Watery, no solid pieces. Entirely liquid Types 1 and 2 indicate constipation. Types 3 and 4 are optimal, especially the latter, as these are the easiest to pass. Types 5–7 are associated with increasing tendency to diarrhea or urgency.
Meconium is a newborn infant's first feces.
Color Human fecal matter varies significantly in appearance, depending on diet and health.
Brown Human feces ordinarily has a light to dark brown coloration, which results from a combination of bile, and bilirubin derivatives of stercobilin and urobilin, from dead red blood cells. Normally it is semisolid, with a mucus coating.
Black or red Feces can be black due to the presence of red blood cells that have been in the intestines long enough to be broken down by digestive enzymes. This is known as melena, and is typically due to bleeding in the upper digestive tract, such as from a bleeding peptic ulcer. Conditions that can also cause blood in the stool include hemorrhoids, anal fissures, diverticulitis, colon cancer, and ulcerative colitis. The same color change can be observed after consuming foods that contain a substantial proportion of animal blood, such as black pudding or tiết canh. Black feces can also be caused by a number of medications, such as bismuth subsalicylate, activated charcoal, and dietary iron supplements, or foods such as beetroot, black liquorice, or blueberries.
Hematochezia is similarly the passage of feces that is bright red due to the presence of undigested blood, either from lower in the digestive tract, or from a more active source in the upper digestive tract. Alcoholism can also provoke abnormalities in the path of blood throughout the body, including the passing of red-black stool. Hemorrhoids can also cause surface staining of red on stools, because as they leave the body the process can compress and burst hemorrhoids near the anus.
Orange Stool may be orange due to excess β-carotene intake from vegetables including carrots.
Yellow Yellowing of feces can be caused by an infection known as giardiasis, which derives its name from Giardia, an anaerobic flagellated protozoan parasite that can cause severe and communicable yellow diarrhea. Another cause of yellowing is a condition known as Gilbert's Syndrome. Yellow stool can also indicate that food is passing through the digestive tract relatively quickly. Yellow stool can be found in people with gastroesophageal reflux disease (GERD).
Green Feces can be green due to having large amounts of unprocessed bile in the digestive tract and strong-smelling diarrhea. This can occasionally be the result from eating liquorice candy, as it is typically made with anise oil rather than liquorice herb and is predominantly sugar. Excessive sugar consumption or a sensitivity to anise oil may cause loose, green stools.Can Licorice Cause Discolored Stools? | livestrong.com It can also result from consuming excessive amounts of blue or green dye.
Blue Prussian blue, or blue, a coloring used in the treatment of radiation, cesium, and thallium poisoning, can turn the feces blue. Substantial consumption of products containing blue food dye, such as blue curaçao or grape soda, can have the same effect.
Violet or purple Violet or purple feces is a symptom of porphyria or more likely the consumption of beetroot.
Pale or gray Stool that is pale or grey may be caused by insufficient bile output due to conditions such as cholecystitis, gallstones, giardia parasitic infection, hepatitis, chronic pancreatitis, or cirrhosis. Bile pigments from the liver give stool its brownish color. If there is decreased bile output, stool is much lighter in color.
Silver A tarnished-silver or aluminium paint-like feces color characteristically results when biliary obstruction of any type (white stool) combines with gastrointestinal bleeding from any source (black stool). It can also suggest a carcinoma of the ampulla of Vater, which will result in gastrointestinal bleeding and biliary obstruction, resulting in silver stool.OpenStax CNX
Odor Feces possesses physiological odor, which can vary according to diet and health status. For example, meat protein is rich in the amino acid methionine, which is a precursor of the sulfur-containing odorous compounds listed below. The odor of human feces is suggested to be made up from the following odorant volatiles: Methyl sulfides methylmercaptan/methanethiol (MM) dimethyl sulfide (DMS) dimethyl disulfide (DMDS) dimethyl trisulfide (DMTS) Benzopyrrole volatiles indole skatole Hydrogen sulfide (H2S) (H2S) is the most common volatile sulfur compound in feces. The odor of feces may be increased when various pathologies are present, including: Celiac disease Crohn's disease Ulcerative colitis Chronic pancreatitis Cystic fibrosis Intestinal infection, e.g. Clostridium difficile infection. Malabsorption Short bowel syndrome Attempts to reduce the odor of feces (and flatus) are largely based on animal research carried out with industrial applications, such as reduced environmental impact of pig farming. See also: Flatulence#Management, odor. Many dietary modifications/supplements have been researched, including: Activated charcoal (In this study it was found that activated charcoal at a dose of 0.52g four times a day did not appreciably influence the liberation of fecal gases.) Bismuth subsalicylate Chloryphyllyn Herbs such as rosemary Yucca schidigera Zinc acetate
Average chemical characteristics On average, healthy humans eliminate 128 g of fresh feces per person per day with a pH value of around 6.6 as indicated by a Fecal pH test. Fresh feces contains around 75% water and the remaining solid fraction is 84–93% organic solids along with some insoluble phosphate salts.
These organic solids consist of: 25–54% bacterial biomass, 2–25% protein or nitrogenous matter, 25% carbohydrate or undigested plant matter, and 2–15% fat. Protein and fat come from the colon due to secretion, epithelial shedding, and gut bacterial action. These proportions vary considerably depending on many factors but mainly diet and body weight. The remaining solids are composed of insoluble calcium and iron phosphate salts, intestinal secretions, small amounts of dried epithelial cells, and mucus.
Undigested food remnants Sometimes undigested food may make an appearance in feces. Common undigested foods found in human feces are seeds, nuts, and corn, mainly because of their high fiber content. Beets may turn feces different hues of red. Artificial food coloring in some processed foods, such as highly colorful packaged breakfast cereals, can cause an unusual coloring of feces if eaten in sufficient quantities.
Undigested objects such as seeds can pass through the human digestive system, and later germinate. One result of this is tomato plants growing where treated sewage sludge has been used as fertilizer.
Analytical tools Stool analysis (stool sample) Clinical laboratory examination of feces, usually termed as stool examination or stool test, is conducted for the sake of diagnosis; for example, to detect the presence of parasites such as pinworms and their eggs (ova) or to detect disease-spreading bacteria. A stool culture—the controlled growth of microbial organisms in culture media under laboratory conditions—sometimes is performed to identify specific pathogens in stool. The stool guaiac test (or guaiac fecal occult blood test) is conducted to detect the presence of blood in stool that is not apparent to the unaided eye.
The main pathogens that are commonly looked for in feces include: Bacteroides species Salmonella and Shigella Yersinia tends to be incubated at , which is cooler than usual Campylobacter incubated at , in a special environment Aeromonas Candida if the person is immunosuppressed (e.g., undergoing cancer treatment) E. coli O157 if blood is visible in the stool sample Cryptosporidium Entamoeba histolytica
Intestinal parasites and their ova (eggs) can sometimes be visible to the naked eye.
Fecal markers Feces can be analyzed for various markers that are indicative of various diseases and conditions. For example, fecal calprotectin levels indicate an inflammatory process such as Crohn's disease, ulcerative colitis, and neoplasms (cancer). Reference ranges for fecal markersMarkerPatient typeUpper limitUnit Calprotectin 2–9 years 166 μg/g of feces 10–59 years 51 ≥ 60 years 112 Lactoferrin 2–9 years 29 ≥ 10 years 4.6 Also, feces may be analyzed for any fecal occult blood, which is indicative of a gastrointestinal bleeding.
Analysis of E. coli bacteria in water sources A quick test for fecal contamination of water sources or soil is a check for the presence of E. coli bacteria performed with the help of MacConkey agar plates or Petri dishes. E. coli bacteria uniquely develop red colonies at temperature of approximately overnight. Although most strains of E. coli are harmless, their presence is indicative of fecal contamination, and hence an increased possibility of the presence of more dangerous organisms.
Fecal contamination of water sources is highly prevalent worldwide, accounting for the majority of unsafe drinking water. In developing countries most sewage is discharged without treatment. Even in developed countries events of sanitary sewer overflow are not uncommon and regularly pollute the Seine River (France) and the River Thames (England), for example.
Diseases and conditions Diarrhea