BARBER: So what are the things that people would see in-- like, what are the changes that they should be cautious of?
PASRICHA: Yeah. Certainly, anything that looks like blood, that is a literal red flag, unless you've had beets. If you've had a beet salad, you'll get a pass for one maroon-colored stool. But, like-- and even if you're like, no, I had it two days ago, it might be two, three days late. But then black, like tarry, sticky, black, shiny stool, that too could happen if the blood mixes with the acid from your stomach. It can turn black. So those things are emergencies. Those are like, talk to your doctor.
BARBER: Like, red and black, bad.
PASRICHA: Yes. Pain, and-- abdominal pain. It doesn't have to be 10 out of 10, "I think my appendix has burst" kind of pain. It can just be this, like, kind of low-grade, dull pain that's there, and it wasn't there before. That should bring you in. And then anything that's, like, weight loss that you didn't intend, iron deficiency anemia. And then the most important one, which I tell people about, is a change in your bowel habits. This means something has changed to your pattern. Maybe it's new diarrhea. Your stools are more loose than they used to be. Maybe they're suddenly more narrow and thin than they used to be. Any change for you-- and this requires you looking every day. You have to know what's normal for you. Probably, there will be some etiology that is perfectly reassuring, but you should at least just get someone to lay eyes on the situation.
BARBER: And there's other reasons why your poop could suddenly turn a different color, right?
PASRICHA: It's actually funny. I get this a lot from college students who, like, start drinking for the first time in large quantities. But they'll often poop, like, purple when they come to college. But they'll have drunk, like, half a bottle of red wine the night before. And I'm like, you know what? First of all, we have to have a conversation about this. But also, it's probably the anthocyanins that were in your red wine that gave you this, like, nice purplish-bluish poop the next day.
BARBER: I should have said this earlier for our listeners. You wrote a book all about this called You've Been Pooping All Wrong. And you say in the book, yellow and green are also OK.
PASRICHA: It depends. So if you were to say, I have this, like, new, yellowish poop, and I have diarrhea, and I feel ill, I would say, you need to go to the-- maybe even the urgent care or the emergency room, because maybe you have an infectious diarrhea. If you were to say, my poop is a little yellow, and I've been doing this keto diet for the last two, three weeks, then I might say, you know what? Maybe that's OK.
BARBER: All that fat.
PASRICHA: Yeah, exactly. There's another color that is an emergency, which is white. White poop or grayish, pale, clay-colored poop, that is actually the natural color of our poop without bilirubin. Bilirubin is this digestive enzyme that we produce on our own. That's what gives it the brown color, are the bile salts in this-- in this juice called bilirubin. But if you have a gallstone, potentially, if you have a cancer, potentially, or something else obstructing that bilirubin, your poop can turn white. So that is an emergency, no matter what.
