Stringy Poop: What Pencil-Thin Stools Really Mean

orange poop

Have you pooped recently and it looked stringy?

The truth is that the texture or shape of your poop can say much about your health. A stringy poop is usually no cause for alarm, even though it could mean a whole lot of things.

In this article, will answer your concerns about stringy poop, explaining its possible causes and what to do about it. Stringy poop is also commonly referred to as a narrow, thin, pencil-thin or ribbon-shaped stool.

What is stringy poop?

The normal stool is usually around 1-2 inches in diameter. The term ‘stringy poop’ is used to describe narrow and usually flat stool. It may be solid or loose and may occur in absence of other complaints.

Occasionally, it may be associated with other symptoms like abdominal cramps, stomach pain, nausea or bloody poop.  It is advised to seek medical advice if you have any of these associated symptoms.

Let’s go on to the causes of stringy poop.

What are the causes of stringy poop?

There are numerous causes of stringy, narrow stools, and the good news is most times it isn’t something to worry too much about. You should only be bothered if it persists for a long period of time. Here are some causes of stringy poop

1. Constipation

If you do not consume enough fluids or fibers in your diet, your stool loses its bulk and becomes thin or ‘skinny’. Fiber-rich food like whole grain, beans, fruits, and vegetables adds bulk to your stool. So if you are young and healthy without other complaints, then constipation is your likely cause.

2. Abdominal hernias

Hernias happen when abdominal contents push through a defect in the wall of the abdomen. The result of this push is the compression of the contents of the intestines. This could cause narrowing of the intestinal passageway and less space for food waste to pass through, leading to narrow, pencil-thin stools.

3. Infections

Intestinal infections lead to loose stools, which may be narrow too. The infection may be bacterial like salmonella and shigella or it may be parasitic like giardiasis. There are usually associated symptoms like abdominal cramps, vomiting or fever. Many times, these infections can cause diarrhea and turn your poop color green.

Sometimes there may not be an actual identified cause for having stringy poop. In that case, focus on proper lifestyle modifications and be on the look for the appearance of any other symptoms. Do not stress yourself out about it either because stress itself might be a cause too!

Read Also: What Causes Worms in Poop?

4. Inflammatory bowel disease

Whether it is Crohn’s disease or ulcerative colitis, both may cause loose thin motions too as part of the inflammatory process. These diseases tend to be chronic in nature with periods of acute symptoms depending on the disease activity. The most common symptoms for this group of diseases is bloody diarrhea and the presence of mucus in stools.

5. Irritable bowel syndrome

If you are suffering from irritable bowel syndrome then that can explain your thin narrow stools. This syndrome causes an alteration in the bowel motion and increases the production of mucus in the large intestine. The mucus-rich poop is more likely to mold into a ribbon-shaped stool.

6. Colorectal cancer

Don’t be scared, as this is a quite rare cause of stringy poop. Surely, you must be concerned about cancer being a potential cause. The idea that growing tumors inside the wall of the large intestine may compromise the caliber and result in ribbon-shaped stools, may freak you out.

According to medical data, the risk of stringy poop being is cancer is low if there are no other associated symptoms. These associated symptoms include a drastic change in how often you poop, blood in stool and unexplained weight loss. If this is the case, then you may want to check with your physician for advice and complete evaluation.

When should I see a doctor?

It’s not every case of stringy poop that is dangerous. Most times, it’s nothing to worry about. So, when should you then see a doctor? Generally, you may consider contacting your physician if:

  1. It persists for a long period rather than just a random experience.
  2. If there are associated symptoms or complaints of abdominal pains, cramping, blood or mucus in stool or a change in how often you use the toilet.

What tests might I need to do?

If your physician decides to look for a cause for the stringy poop, then you may be subject to investigations. These investigations may be blood tests, imaging, or stool samples. Furthermore, invasive scopes may be needed to visualize the large intestine and take tissue samples to rule out a cancerous cause.

Here is a list of commonly requested investigations:

  •  A stool sample for routine examination and microscopy to look for parasites or even culturing for the growth of bacteria.
  • A stool sample to examine for unseen blood called fecal occult blood stool.
  • Blood test samples for inflammatory markers and screening for other immune-mediated diseases like celiac disease.
  • A plain X-ray, an X-ray with contrast, and even a CT scan may be ordered in some cases.
  • Invasive scopes to examine the large intestine e.g. sigmoidoscopy and colonoscopy.

What are the treatment options for narrow stools?

The treatment is pretty much directed towards the cause.

Once a potential reason is identified, the appropriate advice is offered and medications are prescribed. If stringy poop is just an occasional event and you do not have any additional symptoms then no treatment is required.

However, some treatment options are listed below according to the cause.

1. Constipation:

Increase your daily intake of fiber-rich diet and drink ample amounts of fluids.

2. Intestinal infections:

You may be prescribed specific antibacterial or antiparasitic medications according to the suspected or isolated causative agent. Appropriate rehydration is pivotal in such infections to avoid further complications.

3. Inflammatory bowel disease:

This will require a specialist gastroenterologist to educate you about the disease and to decide the best treatment option for you.

4. Hernias and bowel obstruction:

Usually surgically treated. The surgery aims to place back the abdominal contents in their normal place, and then seal off the abdominal wall defect.

5. Colorectal cancer:

Necessitates the opinion of a specialist oncologist who is responsible for treating cancers. The options are usually surgical, chemotherapy, and/or radiotherapy. The treatment regimen will depend on the type of tumor, stage of the tumor, and the general condition of the patient.


In summary, almost everyone experiences stringy poop at some point in his or her lives, and it is usually nothing to worry about. If there are no further complaints or associated symptoms, then relax.

However, if you have other symptoms like abdominal pain, blood in the stool, weight loss and a drastic change in how often you poop, then kindly review your physician to make sure all is well. In general, most of the cases will be resolved with a fiber-rich diet, good hydration, and medical treatment.

Dr. Omiete Charles-Davies

Dr. Omiete holds a bachelor's degree in medicine and surgery. He's a licensed medical practitioner who loves to share health information in a simple manner. For fun, he loves to travel and experience new cultures.

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