Let’s Talk about Stools…

Stools are normally composed of water, bacteria, fiber, mucous, fat, dead cells, protein, and the remains of food not absorbed by the small intestines.  One can examine the stools and get a pretty good idea of just how well the digestive process is going – or not going.  In times past, pediatricians would wear bow ties to avoid soiling their regular ties during the examination of ill children’s stools. Just try getting your pediatrician to look at your child’s stool today, bow tie or not!

Mechanic’s Guide to the Body’s Exhaust Pipe:

Passing a large amount of gas:
•    Can be caused by fermenting organisms that break down sugars and carbohydrates producing carbon dioxide and methane gases
•    Certain foods like dairy, beans, some sugars, etc.
•    Can be caused by children who swallow a lot of air.  This air can be visualized on Xray by looking at the stomach which usually is very distended with air.

Soft Serve stools:
•    Poor absorption and digestion
•    Too much fruit sugar called fructose found in juices and fruits
•    Milk sugar called lactose is not properly digested
•    Gluten containing foods

Snake like stools:
•    Baring down against a partially closed sphincter
•    Straining

Pebble stools:
•    Small pebbles are often the result of the lack of fiber
•    Too little fluid intake

Stool colors:
•    Yellow: fat in stools
•    Red: blood, beets
•    Green: Gut infection
•    White/grey: lack of bile flow
•    Reddish-black: intussusception and this is an emergency

Stool Odors:
•    Very foul smelling stool: bacteria, old stool
•    Very sweet smelling/bakery/hops:  yeast overgrowth
•    Chemical: usually something the child is taking as supplement or medication

Historical Clues from your child’s past may be indicative of a gut disorder:
•    Difficulty with breast feeding
•    Persistent colic
•    Gastro-esophageal reflux (lots of spitting up/small vomits during or after eating)
•    Infantile eczema
•    Food sensitivities (hives, red cheeks, red ears, etc)
•    History of frequent antibiotic usage
•    Poor appetite
•    Failure to thrive
•    Abnormal posturing
•    Self injurious behaviors
•    Poor sleep

Initial laboratory studies to consider:
•    Stool for culture and sensitivity
•    Stool for fungal cultures
•    Stool for blood/occult blood
•    Fecal leukocytes
•    Stool for ova and parasites
•    Stool for quantitative fecal fat
•    Clostridia toxin A and B
•    Stool lactoferrin
•    Stool calprotectin

Some labs can also give you counts of HEALTHY BACTERIA

And that’s my approach to stools and autism….