Is your child pooping pellets, logs, or snakes?
The father of one of my patients told me his son poops out “big ol’ turkey sausages.” What comes out of his bottom, the dad said, “you could pick up and put on the grill.”
Not a good sign!
The size, shape, and consistency of children’s poop tells a lot about whether they’re constipated.
What most adults don’t realize is that human poop isn’t supposed to resemble a Polish kielbasa. It should be mushy, like pudding or a thick milkshake or a fresh cow patty.
When adults have firm poops, due to a low-fiber diet or inactivity, we can get away with it because we empty our bowels in a timely manner. But since kids tend to hold their poop, for reasons I detail in It’s No Accident, it’s essential that their stools stay soft.
Why? Well, imagine an assembly line with the slowest worker at the end. All the products pile up at that point and then start backing up.
Remember the candy-factory scene from I Love Lucy , when Lucy and Ethel tried to keep up with the runaway conveyor belt and ended up stuffing candies into their blouses, caps, and mouths?
That’s essentially what is happening inside a constipated child’s rectum.
She holds in the poop by squeezing her sphincter, converting her colon and rectum into storage units, a job these organs are not suited for. When a child’s rectum gets stretched often enough, the child loses her ability to sense when she’s ready to empty.
Her rectum may expand so much that it loses its normal tone, like the stretched-out waistband of elastic shorts. The intestine becomes floppy and can’t squeeze down effectively to expel the entire load of poop, so some of it stays put in the rectum.
And when intestinal walls lose elasticity, some poop may just fall out. One mom told me she’d find “hard little rabbit pellets” all over her house when she’d vacuum. When her son, a second grader, would go over to a friend’s house, he’d jump on the trampoline and hard pieces of poop would drop out.
Meanwhile, the poop that’s piling up is located right next to the bladder, squishing it aside. If you’ve been pregnant (and, admittedly, I haven’t, but my wife has given me the play-by-play), you know what it’s like to have your bladder encroached upon: You have to pee more often and/or more urgently.
Well, what if, instead of a baby, a solid, grapefruit-size mass of poop was pressing on your bladder? Same effect.
The stretching of the colon also can cause the nerves that control the bladder to go haywire, making the bladder hiccup like crazy. The result: wet underwear, during the day or overnight.
To help parents and kids keep tabs on poops, we commissioned artist Cristina Acosta to create an illustrated poop chart you can download for free. It's available in both English and Spanish.
Print it out and hang it on your kids’ bathroom wall! Instruct your children to examine their poops, find the corresponding number on the chart, and report back to you. For younger kids, we recommend peering into the toilet bowl and inspecting the poop yourself. (Eh, you’ll get used to it.)
Our chart is adapted from the Bristol Stool Scale, developed by researchers at the University of Bristol. Yes, some folks in England actually stopped listening to good music and eating bad food long enough to produce a pictorial representation of the various forms of poop! We have changed the scale slightly to reflect a rating that I believe is more helpful for children.