Stool Color Changes (cont.)

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Maroon stools

Maroon colored stools are often due to bleeding in the GI tract. Classically, the source of bleeding for red stools is the upper GI tract (esophagus, stomach, duodenum), while the colon is the source for bright red blood. Maroon stools may arise from the small intestine (jejunum, ileum) and proximal colon, but these are not hard and fast rules. How bright the red color is depends not only upon the location of bleeding, but also how quickly the blood moves through the intestine. The faster the stool moves through the GI tract, the brighter red the color. This can be an emergency situation.

Mucous in the stool

Mucous in the stool may be a normal variant, and it may cover segments of formed feces. However, it also can occur in patients with inflammatory bowel disease or cancer. Mucous that is also associated with blood and/or abdominal pain should not be ignored and requires medical attention. Mucous in stool can also be seen in patients with irritable bowel syndrome.

Stool that floats

Most stool floats because of poor absorption of nutrients or excess flatus (gas). It is a normal variant and usually of no concern. Changes in diet can lead to stool that floats, but as an isolated symptom, no action needs to be taken and often it resolves spontaneously. Stool does not float because of increased fat content.

Malabsorption syndromes that are associated with floating stool include lactose intolerance, celiac disease, cystic fibrosis, and short bowel syndrome.

Changes in the size and shape of stool

Each person has their own size, shape and consistency of stool. It is the change in stool pattern that matters more than the absolute size and shape of stool. Narrow stool, sometimes called pencil-thin, may occur occasionally and is of no concern. People with irritable bowel syndrome may develop thinner stools.

A person with "normal" stools that has a new change in the caliber (diameter, length, width) of the bowel movement should consult his/her doctor. This may be a sign of a narrowed or scarred colon, perhaps due to a tumor, but the health care professional may want further information by taking a history and performing a physical examination before being concerned about that conclusion.

How is the cause of stool color changes evaluated?

In most cases, a diagnosis, if any, cannot be made by stool color alone.

The patient and the doctor need to consider other symptoms, past medical history, dietary changes, and medications to help decide what has caused the stool to change color. Physical examination will be important to help decide the significance of the stool color.

Stool may be tested to look for blood, fat or infection. Blood tests may be necessary depending upon the clinical situation.

Medically Reviewed by a Doctor on 6/18/2015

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