by Madiha Saeed, MD
Isn’t it funny how one word can cause a whole room of children, and sometimes adults, to burst into laughter? That word, (OK, I’m going to say it, so hold on tight!)…POOP! Have you gathered yourself? Now seriously, poop is huge. What your poop looks like is an important clue to determine what is going on in our bodies. My five year old has learned to monitor his poop to better understand how his body is responding to the environment, particularly what he eats. What is going on in our bellies, particularly what is living in our child’s belly can not only determine what their poop looks like, but also their mood, energy level, weight issues, rashes and so much more! Mind blowing!!! Almost everything about our health and physiology can be tied to the 100 trillion+ microscopic organisms that are hiding deep within, and those intestinal microbes are what make up a significant portion of our poop.
So what can your child’s poop tell you?
How frequently your child poops, and the quality of that poop can tell you a lot. Because people don’t talk a lot about their child’s stooling habits, it’s hard to know what is considered normal. While there is a range of normal stooling patterns, the following are not normal, and may point to microbial imbalance or inflammation in the digestive tract:
- Pooping infrequently (going once every couple of days is too infrequent!)
- Pooping too frequently (more than 4 or 5 times a day may be too frequent)
- Experiencing pain or difficulty when stooling
- Explosive stools
- Stools that are loose and not well-formed
- Blood, mucous or foam in the stools
- Stools that are frequently pale, white, or black
- Stools that are thin, stringy or “pencil shaped”
What might contribute to abnormal stooling?
If you notice some of these abnormal poop symptoms in your child, it might be worthwhile to evaluate the health of the microbes living in his/her gastrointestinal tract. Disturbance to the gut bacteria and the metabolites they produce (called the microbiome) can lead to intestinal dysbiosis. Dysbiosis is when the amount of healthy bacteria in your gut is too low or out of balance, and this can have a major impact on your health.
What causes dysbiosis?
A number of factors can affect microbial composition, including chronic stress, age, contaminants in the environment, food and environmental sensitivities, heredity (we inherit some of our microbes from our parents!), malnutrition, obesity, smoking, use of antibiotics and other medications, and most importantly, diet. Some strains of bacteria can cause gas, bloating, fat malabsorption and can also be responsible for diarrhea or produce toxins that damage the lining of the intestine and even prevent the body from absorbing essential nutrients.
Why does dysbiosis matter?
Dysbiosis can have a profound effect on both first and second lines of defense in our immune system. Many good or healthy microbes can protect us from bad microbes and can help regulate our immune function. Essentially, dysbiosis can trigger or promote inflammation because the lack of healthy flora, and the influence of harmful flora can cause the immune system to malfunction. A malfunction in the immune system can lead to chronic disease. I know, scary stuff! So if your child demonstrates any of the aforementioned poop symptoms, it may a warning sign that his/her immune system is compromised.
The most disruptive type of dysbiosis happens mainly in the digestive tract and the skin, but really, it can be found on any exposed surface or mucous membrane, such as the vagina, lungs, mouth, nose, sinuses, ears, nails or eyes. The only way to properly treat dysbiosis is to increase the diversity of “good” microbes and reduce populations of bad bacteria, yeast and parasites, all of which can be considered infections that fall under the radar of routine medical tests and procedures. The ecology of gut microbes is heavily influenced by the food we eat, beverages we drink and the types of medications we take, so treating dysbiosis often requires a change in what you consume.
Types of Dysbiosis
There are five common types of dysbiosis. Unfortunately, your child can have more than one kind of dysbiosis at the same time.
- Insufficient good bacteria This simply means that there is a shortage of beneficial bacteria. Nature loves diversity—this goes for the microbiome too! Greater diversity of commensal or symbiotic bacteria is correlated with a healthier microbiome and better health in general.
- Small intestinal bacterial overgrowth (SIBO) Too much of a good thing in the wrong place. SIBO occurs in the upper part of the small intestine when bacteria from the colon grows in the wrong place, causing stomach symptoms like heartburn or reflux, bloating, gas or muscle pain. A breath test can help you discover if your child has SIBO or not.
- Immunosuppressive dysbiosis Harmful bacteria, yeast, or parasites can lower your levels of good bacteria and can give off toxins that in turn break down or weaken the gut lining. This can lead to leaky gut syndrome, when the intestines become too permeable and allow things to pass through the gut lining that normally don’t.
- Inflammatory dysbiosis This type of dysbosis occurs when your body has an exaggerated response to an imbalance of bacteria in the digestive system. It includes digestive symptoms like bloating and gas, and is commonly seen in autoimmune disease.
- Parasites Parasites can cause diarrhea, cramping, and bloating. But they can also be silent, causing no obvious gut symptoms. Parasites may even trigger allergic or inflammatory symptoms such as hives or the development of food and environmental allergies that your child never had before.
You can think about these types of dysbiosis as infections that aren’t detected by routine medical tests or procedures, but really they are red flags that something (or many things) is out of balance in your child’s diet, lifestyle or environment.
Paying attention to your child’s stool patterns, habits (and yes, the actual poop itself!) can give you tremendous insight into the dysbiosis that may be present in your child’s body. Talk to your integrative physician about what you notice with your child’s poop, and together you can get closer to identifying the root causes of your child’s varied symptoms.
What is your child’s poop telling you?
 Amit Dutta, et al. Gastroenterology & Endoscopy News. 2015; 66:4