Let’s get one thing straight: most people have no idea what “normal” poop actually is.
They know when something feels off—straining, skipping days, urgency, messiness—but they don’t always have a clear reference point for what healthy bowel movements should look like. On the other hand, people seem to have a feeling when they have the ‘perfect’ poo, which some call ‘poophoria’. My friend Ellen called the perfect poo, a ‘no push, no wipe’, and I’ve been obsessed with that term ever since. How many of us are out there to chase that high?
As a colorectal surgeon, this is one of the most common conversations I have in clinic. Patients will say, “I go every day, so I’m not constipated,” or “I’ve always gone this way, so I thought it was normal.”
Often… it isn’t.
That’s where the Bristol Stool Scale comes in.
The Bristol Stool Scale (BSS) is a simple, validated medical tool that classifies stool into seven types based on shape and consistency. It helps doctors (and patients) talk about bowel habits objectively—without guesswork or embarrassment.
While the BSS helps in narrowing down the problem, I often tell patients that the shape, color, and consistency (as defined in the scale) tell half the story– frequency of bowel movements tells the other half of the story when it comes to constipation.
“Like rabbit poop”
Indicates slow transit constipation
Stool sits too long in the colon → excess water absorbed
Often associated with straining, fissures, hemorrhoids
👉 Not normal
Still constipated, just slightly less severe
Common in people who “go every day” but strain
Often dismissed as normal—but isn’t
👉 Still constipation
Borderline normal
May require mild pushing
Often seen in people who are under-hydrated or fiber-inconsistent
👉 Acceptable, but not ideal
This is the gold standard
Easy to pass
Complete evacuation
Minimal wiping
Low strain on the pelvic floor and anus
👉 This is what we aim for
Mildly loose
Can suggest low fiber intake
May be normal short-term, but not ideal long-term
👉 Usually okay, context matters
Faster transit
Common with IBS, anxiety, food triggers
Can cause urgency and irritation
👉 Trending toward diarrhea
True diarrhea
Risk of dehydration and electrolyte imbalance
Needs evaluation if persistent
👉 Not normal
If you remember nothing else, remember this:
Normal poop is Bristol Type 3–4, ideally Type 4.
Not:
Daily but painful
Every other day with straining
“That’s just how I’ve always gone”
Normal poop should be:
Easy to pass
Predictable
Complete (no lingering urge)
Not painful
Not messy
Chronic abnormal stool form—even without obvious constipation—can contribute to:
Hemorrhoids
Anal fissures
Pelvic floor dysfunction
Rectal prolapse
Worsening bloating and abdominal pain
I see this every day. People normalize abnormal bowel habits for years—until something breaks.
Normal frequency ranges from:
1-3 times per day, 1-3 times per week
But frequency alone is meaningless without form.
👉 You can poop daily and still be constipated.
👉 You can skip a day and still be normal.
Healthy poop isn’t a mystery—and it shouldn’t be taboo.
Bristol Type 4 is the goal.
If that’s not you most days, your body is giving you useful information—not something to ignore. But a goal is a destination and the journey is half the battle. STRESSING over your poop also makes your pooping worse.
But yes—this is all fixable.
If you want a deeper dive into how diet, hydration, medications, pelvic floor mechanics, and modern life are wrecking our bowels (and what to do about it), you already know where to find me.
Until next time, that’s just the way the anus wrinkles.
Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology. 1997;32(9):920–924.
Heaton KW et al. Defecation frequency and timing, and stool form in the general population. Gut. 1992;33(6):818–824.
Rao SSC et al. Evaluation and management of chronic constipation in adults. American Journal of Gastroenterology. 2016;111(1):18–38.
Bharucha AE et al. Functional anorectal disorders. Gastroenterology. 2016;150(6):1430–1442.
Wald A. Constipation: Advances in diagnosis and treatment. JAMA. 2016;315(2):185–191.
