Celiac Disease Poop: What Your Poop Says

Celiac disease poop can be crappy (pun intended). This post will decode what your celiac poop is telling you about your health and healing.

The goal is for your toilet bowl to contain more answers than questions.

Table of Contents

This post was written with the help of dietetic intern Abby Pitman.

Signs of Healthy Poop

When it comes to celiac disease poop, it’s good to know what healthy poop looks like. Your mental image of a healthy poop might be close to the poop emoji. If so, you are not far off.

While the iconic swirl isn’t often present (or the smiling face), a healthy poop should resemble the emoji in a few ways. The qualities of a healthy poop include:

  • Well-formed shape (log, sausage or snakelike)
  • No hard pellets or mushy, watery messes (A healthy poop falls in that Goldilocks area of being not too soft but not too hard)
  • Brown in color (hints of green and orange are normal if your diet is heavy in green or orange vegetables)
  • Easy to pass without pain
  • Takes anywhere between 1-15 minutes
  • Occurs around the same time every day (frequency can vary by individual, but ranges from every other day to three times a day is considered healthy)
  • Moderately bad smell, but not a really bad smell

All of those things together are a sign of a healthy celiac bowel movement.

Signs of Unhealthy Poop

Unhealthy poops are often reduced to either severe diarrhea or constipation. While severe constipation or diarrhea are certainly worrying bowel movements, unhealthy poops include other symptoms, such as:

  • Hard pellets or mushy and watery
  • Float or stick to the side of the toilet bowl
  • Painful and difficult to pass
  • Feeling like not all the poop has passed
  • Bowel movement takes more than 15 minutes
  • Occurs less than 3 times per week*
  • Black, red, green, yellow, or pale/white in color
  • Offensive (more than normal) smell
  • Covered in mucus 

*According to John Hopkins, constipation occurs when an individual has fewer than three bowel movements per week. There is a misconception that constipation only occurs when you are unable to have a bowel movement for a much longer period of time.

The Bristol Poop Chart

If you’re a visual learner, understanding celiac disease poop via the Bristol Poop Chart may be helpful. The Bristol Stool Chart is a tool to easily evaluate your poop based on its shape and overall form. The chart divides stool into seven types with 1 being the most firm and 7 being the loosest. 

  • Type 1: Separate, hard lumps (severe constipation)
  • Type 2: Lumpy and sausage-like (mild constipation)
  • Type 3: Sausage-shape with cracks in the surface
  • Type 4: Smooth, soft sausage or snake 
  • Type 5: Soft blobs with clear-cut edges
  • Type 6: Mushy consistency; fluffy pieces with ragged edges (mild diarrhea)
  • Type 7: Watery; liquid consistency with no solid pieces (severe diarrhea)

Type 3 or 4 are your poop goals: well-formed and passed without pain. Your poop is moving through your body at a good speed, and you’re likely consuming appropriate amounts of water and fiber. This is the general healthy poop range.

Types 1 and 2 are harder and often painful to pass. These lumpy, hard poops point to constipation. You may also notice bloating, abdominal pain, or painful straining as the hard lumps slowly move through your digestive system. 

On the opposite end of the Bristol Stool Chart are Types 5, 6 and 7. All three have passed through the digestive system too quickly, leading to overly soft poops. Type 6 and 7 are when you’re reaching diarrhea levels.

Should Your Poop Float or Sink?

Often a question people wonder about celiac disease poop is should it float or sink? On average, water makes up 75% of your poop. The other 25% consists of solid material, like fiber, protein, indigestible fat, and bacteria.

A healthy poop (with appropriate amounts of solid material) makes a “plop” when it hits the toilet and sinks to the bottom.

Floating poop is lacking that dense material that bulks up your poop. The water content is higher than normal, causing a floater. Another culprit for floating poop is gas. Swallowing a lot of air while eating or eating foods that release a lot of gas can lead to excessive gas getting trapped in your poop, making it float. 

The occasional floating poop is not a reason for major concern. It can temporarily be caused by eating foods that make you gassy or a minor stomach bug. It’s time to see a doctor if your poop floats more often than it sinks, as malabsorption, chronic gas or IBS may be the cause.

What Does Malabsorption Poop Look Like?

Celiac disease poop has some key characteristics. As a celiac, monitoring your bowel movements is a great way to keep tabs on your intestinal healing.

Damaged intestines cannot absorb sufficient amounts of nutrients, leading to malnutrition. Malabsorption poops are greasy, floating bowel movements that smell awful.

The oily or greasy appearance can be caused by poorly digested fat remaining in your poop. Due to this improperly absorbed fat, malabsorption poops may stick to the side of your toilet bowl and can be difficult to flush.

Additionally, ongoing diarrhea is not uncommon with malabsorption.

What the color of your poop might mean - Celiac poop - Tayler Silfverduk - Celiac Dietitian

What color is unhealthy poop?

The last place you want to see a colorful rainbow is in your toilet bowl. While healthy poops do have a surprisingly wide range of acceptable shades, there are certain colors that you want to look out for.

  • Bright red stool could be indicative of bleeding within the large intestine or rectal bleeding. Hemorrhoids are common causes of bright blood on stool or on the toilet paper after you wipe. Another potential cause for rectal bleeding are anal fissures or small tears around your anus from straining to poop. 
  • Black poop may be caused by bleeding higher up in your GI tract. Very dark and tar-like poop often results from bleeding in the stomach from ulcers. Iron supplements or anti-diarrheal medications can also cause black poop. 
  • Long-lasting, completely green stool could indicate that your poop is moving too fast through your GI tract. The lightning-speed movement does not allow enough time for bile to completely break down, leaving a startling green color. 
  • Pale, clay-like poops result from a lack of bile in your poop. An issue with bile production in the liver or a bile duct blockage would both prevent normal amounts of bile from reaching your poop. Certain anti-diarrheal medications, like Pepto-Bismol or antacids, can cause this discoloration too. 
  • Yellow coloration in poop results from an excess of fat in the stool. However, eating too much fat is not the ultimate culprit; yellow, fatty poops occur with a malabsorption disorder, such as untreated celiac disease.

One-off or infrequent colorful poops shouldn’t send you rushing to the ER. Often, the source of unusual colors resides in your diet. Food coloring, iron supplements, medications, or colorful vegetables (leafy greens, carrots, sweet potatoes, beets, cranberries, etc) may be causing your colorful poops.

However, if a funky color sticks around for more than a couple days, speak to your healthcare provider about it.

How Does Celiac Affect Poop

While alluded to briefly in previous paragraphs, celiac disease affects poop in a variety of ways. Most importantly to note, if you are still healing or have unmanaged celiac, the autoimmune reaction and intestinal damage can impact your poop in some specific ways.

In some untreated celiacs, bowel movements may be hard to pass and painful, loose or watery, and/or yellow or pale. Long-term diarrhea or constipation (or alternating between the two) is common.

Unsurprisingly, research has shown that untreated celiac patients (those not adhering to a gluten-free diet) had more indigestion, diarrhea, and abdominal pain than those keeping a GF diet. As you adopt a gluten-free diet and your intestines heal, your poops should normalize.

However, the same study also found that treated celiac patients still experienced more gastrointestinal symptoms than non-celiacs. Long-term treated women experienced more symptoms than their male counterparts. Once gluten was ruled out as a potential cause (as shown by well-recovered histology and antibody levels), other potential causes of persistent symptoms include small-intestinal bacterial overgrowth, and concomitant disorders (IBD, microscopic colitis), or refractory celiac disease.

Research continues to look into how the diversity of duodenal microbiota interacts with the gastrointestinal symptoms; one study found that GF celiacs with persistent symptoms had different duodenal microbiota than GF celiacs without symptoms. 

Celiac is not a one-size-fits-all, despite the misconception that treatment and healing is immediate after going gluten-free. Some celiacs will take longer than a year to see relief from symptoms; others will continue to have mild to moderate gastrointestinal symptoms despite a strict and long-term GF diet.

What Does Poop Look Like With Celiac Disease?

Celiac disease poop will look different depending on what phase of treatment you’re in. Meaning, celiac poop will look different with untreated, healing, and a healed small intestine

In celiacs with intestinal damage (untreated, undiagnosed, or still healing), abnormal or unhealthy poops are to be expected. This ranges from pooping too much, pooping too little, diarrhea, and/or constipation.

Celiac disease poop can come in all colors however, yellow poop, which is caused by malabsorption, may be highly indicative of celiac disease. This is because bile begins as a yellow/yellow-green color, and enzymes change it to brown shade as it moves through the GI tract.

The brown tint is also caused by bilirubin, a pigment resulting from the breakdown of red blood cells. In untreated or healing celiacs, food moves through the GI system faster, preventing bilirubin from accumulating properly in the poop.

Additionally, celiac disease may cause malabsorption of fat, leading to excess fat being passed in the poop. Together, the lack of bilirubin and increased fat causes yellow poops.

Mucus may also be present on poop as a result of the damage done to your GI tract. These bowel movements may feel normal if you have had the symptoms for a long period of time, which is why knowing what healthy poops should look like is so important. 

In celiacs on a gluten-free diet with functioning villi, gluten exposure can cause temporary inflammation and abnormal poops. Celiacs following a gluten-free diet may also experience constipation, due to the potential lack of fiber in a gluten-free diet.

Grains with gluten are a major source of dietary fiber. By avoiding grains with gluten, celiacs risk not getting enough fiber. Don’t be too scared though – a balanced gluten-free diet with sufficient fiber is possible!

What Your Poop Says About Your Celiac

Ultimately, your celiac disease poop should be normal if your celiac is managed. If you need help with figuring out how to manage celiac disease and you need tools to heal after a celiac diagnosis, I cover all of the basics in the Celiac Crash Course.

That being said, if you are managing your celiac and your poop is unhealthy, it could be a sign that something else is going on. You definitely want to bring up these concerns with your celiac dietitian and doctor. If you need help finding a celiac dietitian, I’m happy to help.

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