What’s your response when a patient says, “I took a picture of my stool. Do you want to see it?” Do you glance at it quickly? Do you ask clarifying questions? Or do you quickly mumble something and divert your gaze?”
Hi, I’m Alicia Muratore, a gastroenterologist at the University of North Carolina, and this is Gut Instincts.
A recent article in HuffPost explored the rising trend of patients sharing stool photographs with their physicians. It explained that patients often feel unsure about how to explain what they saw or were worried that words alone might misrepresent their symptoms. They did what many of us do when we see something unusual — they took a photo.
As gastroenterologists, we’re used to sorting through vague symptom descriptions, but more and more, our patients aren’t just telling us what they’re experiencing. They’re showing us with photos. While it might feel like a modern twist on symptom reporting, I think it’s a natural extension of what we were trained to value in medicine — the history and physical exam.
A stool photo is, in many cases, part of the patient’s history. It provides visual data that captures details patients may not recall or describe accurately later. While it might feel awkward or unexpected in the moment, this is actually a patient doing what we always hope they’ll do — paying attention to their health and trying to communicate clearly.
I have found these photos especially helpful in cases of gastrointestinal bleeding. Distinguishing melena from iron- or bismuth-colored stool can often hinge on an accurate description, and a photo can clarify what words might obscure.
The shift also reflects a larger trend. Patients are playing a more active role in their care. Technology has enabled this through smartphones, patient portals, and even at-home monitoring tools. Patients are documenting symptoms in real time, and many want to collaborate more closely in diagnostic and treatment decisions.
Emerging research suggests that this may be more than just anecdotal benefit. A 2025 study in the American Journal of Gastroenterology demonstrated that a deep learning model analyzing stool photographs could predict endoscopic mucosal inflammation in ulcerative colitis with accuracy comparable to fecal calprotectin.
Separately, a feasibility study published in Neurogastroenterology & Motility explored a smart toilet capable of automatically classifying stool form according to the Bristol Stool Form Scale. This is technology that could enable longitudinal objective monitoring of bowel habits without relying on patient memory or subjective descriptions.
As gastroenterologists, we’re trained to listen carefully, interpret subtle clues, and use all available data to guide care. In that sense, a photo shared by a patient is not all that different from a symptom diary or a lab result.It’s another data point that can inform clinical judgment when used thoughtfully
