Stool Shape: What Your Bowel Movements Say About Your Health - Surgery

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Stool shape


Hello Dr.
Ke, last month I inquired about rectal bleeding after bowel movements.
I later underwent a double-contrast barium enema at a medical center, and the report indicated that nothing was found.
Since I haven't experienced any further bleeding, the doctor did not recommend additional tests.
Recently, I've been paying more attention to the shape of my stools and noticed that sometimes they are as large as my thumb (after a day of eating more vegetables and fruits), and other times they are about the size of my index finger (after a day without vegetables or fruits).
My bowel habits are about twice a day; I usually have a bowel movement first thing in the morning (with stools the size of my thumb) and then again after eating or drinking (with stools the size of my index finger).
Is this situation normal, Dr.
Ke? Last month, during a digital rectal exam, the doctor mentioned that my anus was a bit tight and that I had a small hemorrhoid measuring 0.5 cm.
Could the shape of my stools be related to this? By the way, I had hemorrhoid surgery two years ago.
Thank you, Dr.
Ke, for taking the time to respond.

Lao Shu, 40~49 year old female. Ask Date: 2010/05/16

Dr. Ke Fangxu reply Surgery


Hello, mice: A significant change in stool caliber is a common complaint, with hemorrhoids being the most frequent cause.
Hemorrhoids can swell, leading to the compression of feces as they pass through the swollen tissue, similar to how cream is piped.
Generally, shortening the time spent during bowel movements can improve this condition.
Additionally, anal stenosis can also cause this issue, but it is unrelated to the duration of bowel movements.

Reply Date: 2010/05/16

More Info


Understanding the shape and consistency of your stool can provide valuable insights into your digestive health. The variations you've observed in your bowel movements, such as the size differences between your thumb and finger, can be influenced by several factors, including your diet, hydration levels, and overall gastrointestinal function.

Firstly, it’s important to recognize that stool consistency and shape can vary significantly based on dietary intake. When you consume a diet rich in fiber—such as fruits and vegetables—your stool is likely to be bulkier and softer, which can lead to larger bowel movements, like the size of your thumb. Conversely, if your diet lacks fiber, your stool may become harder and smaller, resembling the size of your finger. This fluctuation is quite normal and reflects the body’s response to what you eat.

Regarding your bowel habits, having a regular routine of bowel movements—such as once in the morning and again after eating—is generally considered healthy. The fact that you are having two bowel movements a day is within the normal range, as bowel movement frequency can vary widely among individuals. The key is that you feel comfortable and do not experience pain or discomfort during these movements.

The tightness you mentioned during your rectal examination, along with the presence of a small hemorrhoid, could indeed be related to the shape and consistency of your stool. Hard or large stools can put additional strain on the anal region, potentially leading to or exacerbating hemorrhoids. Since you have a history of hemorrhoid surgery, it’s crucial to maintain a diet high in fiber and stay well-hydrated to prevent constipation and minimize the risk of straining during bowel movements.

If you notice that your stool consistently varies in size or if you experience any changes in your bowel habits, such as increased straining, blood in your stool, or significant changes in frequency, it would be wise to consult with your healthcare provider. They may recommend dietary adjustments, increased fluid intake, or even the use of stool softeners if necessary.

In summary, the variations in your stool size are likely related to your dietary habits and are generally normal. However, maintaining a high-fiber diet, staying hydrated, and monitoring any changes in your bowel habits are essential steps in promoting digestive health. If you have any concerns about your bowel movements or the condition of your hemorrhoids, don’t hesitate to reach out to your healthcare provider for further evaluation and guidance.

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