Why Acupuncturists Ask about Poop: The Traditional Chinese Medicine View of the GI Tract and the Bowels.

Some patients suddenly seem a bit uncomfortable when my line of questioning during their health visit turns to their bowel habits and the nature of their stools. Some are never study their stools and are repulsed by the idea. Others are strangely fascinated! In any case, it’s helpful for your health care practitioner (and even you) to understand a bit about what stool coloration can mean.

Brown is the normal stool color, the by-product of waste mixed with digestive juices and pigments. Light, clay colored stools suggest biliary (bile is the greenish-brown alkaline fluid secreted by the liver and stored in the gallbladder) deficiencies or gallbladder duct blockages. Dark black may mean the stool contains dried blood and thus indicates problems in the upper GI tract. Dark stool might indicate a large portion of protein in the diet. Normal brown mixed containing pinkish streaks may be a sign of bleeding in the lower part of the colon, such as bleeding caused by hemorrhoids. Dark yellow indicates ingested food contains a good amount of vegetables or fruits.

The odor of feces reflects bacterial action involving certain body chemicals. From the TCM perspective, a foul odor generally means stagnancy, excessive heat, or some other pathologic condition, although certainly not always serious. Odor may well relate to the type of food ingested and it can vary among individual patients.

Digestion largely occurs in the stomach and small intestine, with the latter mainly responsible for absorption of nutrients. The large intestine if the gateway to elimination. In TCM, the large intestine “governs the conveyance and transportation of waste.” It is a fu (hollow) organ, also referred to as a bowel (as opposed to a viscera such as the liver). The six bowels are the stomach, the large and small intestines, the gall-bladder, the bladder, and the triple-burners, a “bowel” peculiar to Chinese medicine. It is said that “the six bowels transform and drain matter but do not store.” The large intestine is also responsible for the downward movement of “turbid dampness.”

It’s important to pay some attention to the form, color, and odor of your fecal matter, as well as the pattern of your bowel habits (number per day, number of times per week, any pain or discomfort, etc.). Taken together with other signs and symptoms shared at intake, fecal indicators help your acupuncturist determine a pattern of disharmony (our form of diagnosis). Just as important (sometimes more so), fecal indicators may suggest that we refer you to a primary care physician or GI specialist.

Good bowel health, in which the stools move according to a regular patter and absent any pain or foul odor, and where the stool is soft-but-formed and of a normal brown color, indicates that the yin and yang and qi and body-fluids of your body are all in balance. That is, you are in homeostasis. This state is assisted by a prudent diet (including fresh vegetables and fruits), regularly spaced light meals with nothing to eat (or very light intake) four hours before retiring, adequate intake of clean water, regular and adequate sleep, regular moderate physical activity, fresh air and sunshine, and regular relaxation of the mind (i.e., managing stress).

GI and bowel pathologies run from the simple to the very complex and can range from simple nausea, diarrhea or constipation to more serious conditions such as gastritis, Crohn’s disease, or ulcerative colitis. Traditional Chinese medicine can be quite helpful for many of these conditions. Therapies may involve acupuncture but often include one or more gentle herbal formulas (learn more here). TCM therapies can be done alone or in conjunction with Western medicine. In any event, it is always good to keep your primary care physician informed of all therapies.

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