Stringy Poop: Causes and Treatment

Stringy poop is referred to as a narrow, pencil-thin or ribbon-shaped stool. Many times, it isn’t a cause for alarm, however, sometimes it could be a symptom of something serious.

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.

What Causes Stringy poop?

1. Constipation

If you do not consume enough fiber in your diet, your stool loses its bulk and becomes thin or ‘skinny’. Fiber-rich food like whole grain, beans, fruits, and vegetables add bulk to your stool.

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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 the narrowing of the intestinal passageway and less space for poop to pass through.

3. Infections

Intestinal infections lead to loose stools, which may be narrow too. Viruses are the most common infective cause of stringy stools. They can also be bacterial like salmonella and shigella or may be parasitic like giardiasis. There are usually associated symptoms like abdominal cramps, vomiting or fever.

4. Inflammatory bowel disease

This is a group of two diseases- Crohn’s disease and 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 are 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.

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6. Colorectal cancer

This is a quite rare cause of stringy poop.

The risk of stringy poop being a symptom of 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.

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. Generally, you should see your doctor if:

  • It persists for a long period rather than just a random experience.
  • 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.

Diagnostic Tests

Investigations may be blood tests, imaging, or stool samples. Endoscopy may be needed to visualize the large intestine to identify the cause. Some tests include:

  • 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.
  • Endoscopy to examine the large intestine like sigmoidoscopy and colonoscopy.

Treatment

The treatment is usually directed towards the cause.

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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.

Constipation

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

Intestinal infections

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

Inflammatory bowel disease

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

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.

Colorectal cancer

This requires the attention of an 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.

Summary

Many times, stringy poop is nothing to worry about, especially if it was a one-time event and there are no further complaints or associated symptoms like abdominal pain, bloody stool, weight loss and a drastic change in how often you poop.

If it is persistent or has additional symptoms, you should see your doctor.

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