Life After 65: 5 Things Doctors Want You Looking for When Pooping

As we age, our digestive health can change in subtle—or sometimes dramatic—ways. Paying attention to your poop can help you catch problems early, from minor nutrient issues to serious liver or gastrointestinal conditions. Here are the five key things doctors urge anyone over 65 to watch for when you’re on the toilet.

1. Color Changes

Your stool’s color is one of the easiest signs to monitor—and one of the most important.

• Black, tarry stool (melena):
  • Often indicates bleeding in the upper digestive tract (esophagus, stomach or small intestine).
  • In people with cirrhosis or portal hypertension, varices (enlarged veins) can rupture and bleed, leading to dark, sticky stool (Garcia‐Tsao et al., 2017).
• Bright red blood (hematochezia):
  • Suggests bleeding lower in the colon or rectum—common causes include hemorrhoids or diverticular disease.
• Clay-colored or pale stool:
  • May signal a bile duct blockage, gallstones or advanced liver disease (Wiesner et al., 2003).

If you notice persistent or unexplained color changes, especially black or red blood, seek medical advice promptly.

2. Consistency & Frequency

How often and how soft (or hard) your stool is can tell a lot about your digestion, hydration and overall health.

• Diarrhea:
  • Acute cases often stem from infections (viral, bacterial) or certain medications.
  • Chronic diarrhea (lasting more than four weeks) can indicate malabsorption, inflammatory bowel disease or even pancreatic insufficiency.
  • Risks in older adults: dehydration, electrolyte imbalances, falls due to urgency.
• Constipation:
  • Defined as fewer than three bowel movements per week or straining to pass stool.
  • Common causes: low fiber intake, dehydration, certain pain medications, slowed gut motility with age.
  • Prolonged constipation can lead to fecal impaction, hemorrhoids or rectal damage.

Maintaining a diet rich in fiber, drinking plenty of fluids and staying active can help regulate your bowel habits. If changes persist beyond a couple of weeks, talk to your doctor.

3. Shape & Size

The form of your stool can hint at blockages, narrowing and other structural issues.

• Pencil-thin or ribbon-like stool:
  • May suggest a narrowing of the colon, possibly due to polyps or colorectal cancer.
  • Don’t ignore a sudden change from your normal, healthy stool shape.
• Large, lumpy stools:
  • Often a sign of slow transit through the colon or severe constipation.

If you notice ongoing shifts in stool diameter or shape—especially if accompanied by weight loss, fatigue or abdominal pain—seek evaluation.

4. Presence of Fat or Oil (Steatorrhea)

Greasy, floating stools that’re hard to flush often point to fat malabsorption.

• Characteristics of steatorrhea:
  • Pale, bulky, foul-smelling stool that floats.
  • Oily sheen or visible oil droplets in the toilet bowl.
• Potential causes:
  • Pancreatic insufficiency (poor enzyme production).
  • Bile acid deficiency (gallbladder disease or bile duct blockages).
  • Celiac disease or other malabsorption syndromes.

Since fat-soluble vitamins (A, D, E, K) rely on proper fat absorption, chronic steatorrhea can lead to nutritional deficiencies and bone health issues over time.

5. Pain, Straining & Urgency

How you feel before, during and after a bowel movement matters for comfort and safety.

• Pain or straining:
  • Sharp pain can be a sign of anal fissures, hemorrhoids or proctitis.
  • Persistent straining raises risk for pelvic floor issues, hernias or hemorrhoid flare-ups.
• Urgency or inability to control:
  • Sudden urges may point to irritable bowel syndrome, infections or medication side effects.
  • Incontinence or leakage can arise from weakened pelvic muscles or nerve damage.

If you’re experiencing severe pain, blood with each movement or loss of control, don’t wait—contact your healthcare provider.

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When to Seek Help

While mild, occasional changes in your poop often resolve with diet tweaks or hydration, some signs warrant timely medical attention:

• Black, tarry stool or bright red blood
• Severe, unrelenting abdominal pain
• Sudden, dramatic weight loss
• Signs of dehydration: dizziness, dry mouth, decreased urination
• Chronic diarrhea lasting more than two weeks

You might also consider doing a free, online “symptom check for ” to get personalized guidance on what to do next. But remember, online tools aren’t a substitute for professional care.

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Take Action & Keep Tracking

Making small adjustments can go a long way in keeping your digestive system running smoothly:

• Eat a balanced diet rich in fruits, vegetables, whole grains and lean proteins.
• Stay hydrated—aim for 6–8 cups of fluid daily, unless your doctor advises otherwise.
• Remain active; even light walking can stimulate bowel motility.
• Review your medications with your physician or pharmacist for constipation or diarrhea side effects.
• Keep a simple symptom diary: note dates, stool characteristics and any related symptoms.

Finally, if you ever notice signs that could be life threatening or serious, please speak to a doctor right away. Your healthcare provider can evaluate your symptoms, order tests if needed and guide you toward the best treatment plan for your needs.