Whether we care to talk about it, everyone poops.

If you’re living with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, getting over the fear of bathroom talk isn’t just about opening up about an embarrassing topic — it can actually help you manage your condition. Changes in our bowel habits can clue us into many issues related to IBD.

Here’s the scoop on what your poop means — and when it’s time to talk with your doctor.

Red poop can be alarming to see as it may be a sign of bleeding somewhere along the gastrointestinal (GI) tract.

On the other hand, eating red foods such as beets can cause red poop, and sometimes blood from menstrual bleeding can be mistaken for GI bleeding.

If you didn’t eat something red and you don’t have your period, it’s important to note whether the blood is mixed into your poop or if it’s just on the toilet paper, and if you are experiencing pain.

If you have IBD, blood may be a sign of a flare, especially if you experience pain and weight loss.

If you have painless bleeding with bright red blood on the toilet paper, you may have internal hemorrhoids. If you have pain around your anus and also see bright red blood on the toilet paper, you may have external hemorrhoids or an anal fissure.

Dark stools can be a sign of upper GI bleeding, such as from the esophagus, stomach, and the beginning of the small intestine.

Sometimes, Crohn’s disease can affect the upper GI tract and cause bleeding. Taking Pepto-Bismol, activated charcoal, iron supplements, or eating dark foods can also cause dark stools.

Be sure to mention dark stools to your doctor, especially if you feel fatigued or short of breath. These can be signs of iron deficiency anemia from bleeding over time.

Clostridium difficile (C. diff) is a bacterial infection of the GI tract that’s common in IBD patients, especially after antibiotic use. It also gives poop a distinct smell.

Let your gastroenterologist know if you notice these symptoms, especially after taking antibiotics:

  • new onset diarrhea
  • abdominal pain
  • fever
  • nausea

C. diff can present similarly to an IBD flare-up or may also lead to a flare.

Harder stools can be a sign of constipation. They may be hard to pass, look like pebbles, and leave you straining.

Causes of constipation include:

  • not eating enough fiber
  • dehydration
  • slower movement, or motility, of your digestive system
  • taking certain medications

People with IBD are more likely to experience diarrhea than constipation, but it’s not unheard of. Narrowed stools or constipation can be a sign of an intestinal stricture in those with Crohn’s disease.

If you experience constipation regularly, mention it to your doctor. You can also avoid constipation by staying hydrated, exercising, and eating fiber-rich foods such as fresh fruits, vegetables, and nuts.

If you have trouble tolerating fiber, try blending fruits and vegetables into smoothies and soups.

An occasional painful poop can be normal with IBD, but if you always experience pain with bowel movements or suddenly experience increased symptoms, it may be a sign of an IBD flare-up or irritable bowel syndrome (IBS).

Many people with IBD also have IBS, which classically causes pain and bloating. IBS can cause diarrhea, constipation, or both, and it’s sometimes hard to tell if symptoms are from IBD or IBS.

There are many treatment approaches for IBS including diet, exercise, stress management, and sometimes medication.

Women often experience cramps and loose stools or diarrhea right before their period.

This is usually normal, but if the pain doesn’t go away a few days into the period and it prevents you from going to school or work, you may have endometriosis, a condition in which endometrial tissue grows outside the uterus.

If your bowel symptoms seem to be related to your period, be sure to speak with your gynecologist.

It’s important to look at your poop regularly and be aware of any major, lasting changes.

Sometimes an increase in symptoms goes away quickly, but if they persist, contact your GI doctor before a flare worsens. You may need an increase in your medication, a complete switch in therapy, and some nutritional guidance.

Don’t feel bashful about talking to your doctor about your bowel symptoms, as they have likely heard it all before. There are so many factors that contribute to GI symptoms and many options to help you feel well both through medication and dietary and lifestyle changes.

Jamie Horrigan, MD, is a passionate Crohn’s disease advocate and truly believes in the power of nutrition and lifestyle. When she isn’t taking care of patients at the hospital, you can find her in the kitchen. For some awesome, gluten-free, paleo, AIP, and SCD recipes, lifestyle tips, and to keep up with her journey, be sure to follow along on her blog, Instagram, Pinterest, Facebook, and Twitter.