Causes, home treatment, when to see a doctor

Occasionally, stool may be flat, squarish, or stringy. These changes are often the result of diet. However, irritable bowel syndrome, chronic constipation, and other conditions may cause long-term changes in stool shape.

Poop should generally resemble the place from which it comes: the intestines. It is usually slightly rounded, like a sausage, and smooth, with some cracks on the surface.

It can be concerning if stools are suddenly not “normal.” Most of the time, however, a change in appearance is short-lived and nothing to worry about.

Temporary changes to the shape or color of stool are common and not necessarily a sign of illness.

Sometimes, they stem from the person’s diet. For example, foods containing colorings can change the color of poop. An excess of fatty foods can lead to oily or greasy poop, and eating too little fiber can likewise give stool an unusual appearance.

If the changes only last for one or two bowel movements, or even a couple of days, they are likely no cause for concern.

However, if changes in stool shape or color last longer or accompany other symptoms, the cause may be an underlying condition that requires medical attention.

Learn more about different types of poop here.

While changes in the color or appearance of stool often stem from the diet and are temporary, some underlying health issues can cause more lasting changes.

Below, we describe some conditions that may cause flat poop:

Irritable bowel syndrome

Irritable bowel syndrome (IBS) refers to a group of gastrointestinal symptoms that occur without any visible signs of damage or disease in the digestive system.

Symptoms include:

• stomach pain
• bloating
• gastroesophageal reflux
• gas
• needing the toilet urgently
• whitish mucus in stool

Treatment may include:

• eating more fiber
• avoiding gluten
• switching to the low FODMAP diet

Learn more about the signs of IBS here.

Constipation

Constipation involves having fewer bowel movements than usual or having hard stool that is difficult to pass.

Symptoms include:

• small, hard, pellet- or pebble-like stool
• stomachache
• cramping
• gas
• frequent belching
• bloating
• no bowel movements for several days

Treatment may include:

• avoiding triggering foods
• drinking more fluids
• taking laxatives
• taking stool softeners
• taking fiber supplements

Find home remedies for constipation here.

Diarrhea

Diarrhea is the passage of loose or watery stools several times a day. It may also involve pain or discomfort.

Symptoms include:

• an urgent need to use the bathroom
• cramping
• a loss of control of bowel movements
• nausea
• pain in the abdomen

Treatment may involve:

• taking over-the-counter diarrhea medication
• treating the underlying cause
• replacing lost fluids and electrolytes

Learn how to stop diarrhea fast here.

Colorectal cancer

Changes in the shape of stool can be one sign of colon or rectal cancer. If a tumor grows in either area, it can change the shape of the bowel and cause stool to be flat or thin and pencil-like.

Symptoms include:

• blood in the stool
• darker stool, indicating bleeding further up the gastrointestinal tract
• feeling the need to have a bowel movement and no relief afterward
• diarrhea, constipation, or other changes in bowel habits that last more than a few days
• weakness and fatigue
• unintended weight loss
• vomiting

Treatment may include:

• surgery to remove the cancerous cells
• radiofrequency ablation, which involves killing these cells with a probe containing tiny electrodes
• cryosurgery, which freezes and destroys the abnormal tissue
• chemotherapy, which involves stopping cancer’s growth with drugs
• radiation therapy, which involves using high energy X-rays, for example, to kill cancerous cells or keep them from growing
• targeted therapy, which involves attacking cancerous cells, without harming regular cells, using drugs or other substances
• immunotherapy, which involves using the immune system to fight the cancer

It is important to remember that the earlier a doctor diagnoses cancer, the better the likelihood of successful treatment.

Learn more about colorectal cancer here.

Other potential causes

Anything that may cause the colon or rectum to narrow may also cause flat poop. These issues include:

• fecal impaction — a partial blockage or impaction of waste in the intestines or rectum
• hemorrhoids — swollen veins in the lower rectum or anus
• trapped abdominal hernias
• colon polyps
• a distended, or stretched, colon
• food poisoning

The best approach depends on the cause of the issue. Some home care techniques involve:

Fiber

If constipation causes flat stool, eating more fiber-rich foods can help.

Foods with high fiber content include whole grains and many fruits and vegetables. Leave the skins on, when possible.

Learn about high fiber foods here.

Water

Drinking lots of water can ease the passage of stool, making it less likely to be flat.

Learn about the symptoms of dehydration here.

Exercise

Some types of physical activity may have a positive impact on gastrointestinal problems.

Activities such as walking, yoga, aerobic exercise, and tai chi may help improve physical and mental health-related symptoms of IBS, according to research from 2019.

Low FODMAP diet

FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are short-chain carbohydrates that can be poorly absorbed by the small intestine and can cause gastrointestinal symptoms.

Evidence supports the use of a low FODMAP diet in the treatment of IBS.

Learn more about the low FODMAP diet here.

Flat poop is rarely a cause for concern. However, a person should seek medical advice if any of the following symptoms occur:

• blood in stool
• dark stool
• pus or mucus in stool
• high fever
• abdominal pain or cramping
• sudden, prolonged constipation
• pooping more or less often than usual
• drastic changes in the consistency of stool

Overall, if thin or flat stool occurs for more than 3 days, even without any of the above symptoms, a person should consider contacting a doctor.

Here are some questions people ask about flat poop.

Is flat poop normal?

Flat poop is not usually a cause for concern. However, people should speak with a doctor if they have blood in their stool or persistent changes in bowel habits for no clear reason.

What can flat poop mean?

Flat poop can be a sign of constipation, diarrhea, irritable bowel syndrome, an enlarged prostate, or colorectal cancer. Stool can also change in color and consistency according to the diet.

Bowel movements naturally vary from day to day, and these temporary changes are usually nothing to worry about.

However, prolonged changes can indicate an underlying health issue. If flat poop occurs for more than 3 days, seek medical advice. It may be wise to do so earlier if there are other symptoms.

Causes, Home Treatment, When to See a Doctor

Flat poops can happen due to changes in your diet. Some health conditions, including constipation, can cause long or flat poop. If unexplained changes last a few days, consider talking with a doctor.

Changes in stool consistency and color aren’t uncommon based on what you’ve recently eaten. Sometimes, you may notice that your poop appears especially flat, thin, or string-like. Usually, this variation isn’t cause for worry, and your poop will return to its “normal” appearance shortly after.

However, there are times when consistently flat poops may indicate a more concerning underlying condition. Keep reading to find out what they may be.

A lot of times, your poop looks a lot like your intestines. It’s slightly rounded and lumpy. Flat poop isn’t round. Instead, it’s square or string-like in appearance. Sometimes, you have flat poop along with very loose stool that may include diarrhea.

Flat poop doesn’t have a specific color or frequency. You may notice you experience more flat poops when you’ve changed your diet (such as eaten less fiber). Other times, you may see flat poop in the toilet bowl and can’t link it back to anything you did or didn’t eat.

Here’s what flat poop may look like:

Sometimes, your poop is flat and there’s no underlying cause. Just as your poop can be pebble-sized or different colors, flat poops may be one of the variations you occasionally see. However, if you start having flat poops more often, it may be due to one of the following causes.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome or IBS is a gastrointestinal disorder that occurs due to an interrupted function of your gut and brain. IBS can cause abdominal pain as well as bowel movement changes that include diarrhea, constipation, or both. Those with IBS may experience a variety of stool types, ranging from very large poops to flat ones.

An estimated 12 percent of people in the United States have IBS, so this condition can be a common cause of flat poops and other stool changes.

Constipation

Constipation can be a common cause of flat stool that is usually stringy in consistency. Constipation can occur when you don’t get enough fiber in your diet to add some extra bulk to your stool. As a result, your stool may be thinner, flat, and more difficult to pass.

Benign prostatic hyperplasia (BPH)

Sometimes, the cause of flat stool isn’t the intestinal tract itself but something around it. This is the case for benign prostatic hyperplasia or BPH. This condition causes the male prostate gland to enlarge. The prostate is positioned just in front of the rectum and below the bladder.

While BPH more commonly affects urination (such as a weak stream when peeing), some people do have symptoms related to passing stool, such as constipation and stool changes like flat poop.

Colorectal cancer

Although rare, it’s possible that thin stool can indicate colon cancer. This is because a tumor may grow in the colon that keeps your stool from moving through in its normal shape.

While colorectal cancer doesn’t always cause a lot of symptoms in its earliest stages, it can also lead to symptoms including rectal bleeding, unexplained weight loss, or problems emptying your stool.

Other possible causes

Flat poop may also be due to any condition that may affect how stool moves through or exits the colon. Examples include:

• colon polyps
• fecal impaction
• hemorrhoids
• rectal ulcers

Even abdominal hernias can cause enough narrowing of stool movement so that stool may appear flat.

Treatments or remedies for flat poop depend upon what caused your poop to be flat in the first place. Your doctor may recommend keeping a food journal and noting when you have significant stool changes so you can identify the potential foods and drinks that may cause your stool to appear flat.

Other interventions are the same as those commonly used to treat constipation and IBS. Examples include:

• increasing fiber intake by eating more whole grains as well as fruits and vegetables with the skins on whenever possible
• drinking plenty of water to make stools easier to pass
• increasing physical activity, which can help increase stool movement through the body
• taking steps to reduce stress whenever possible, through meditation, journaling, listening to soft music, deep breathing, or other stress-relieving interventions

Some people may also find their stools appear more normal in size when they take probiotics. These are supplements that contains live microorganisms similar to the ones that naturally live in your digestive tract. Probiotics are also present in foods with live and active cultures, such as yogurt and kefir. That said, check the labels before buying to make sure as not all of these foods contain them.

Pencil-thin poop isn’t always cause for concern but you should see your doctor if you are experiencing flat poop and have any of the following symptoms:

• blood in your stool or on the toilet paper
• changes in the consistency of your stool, such as increasing diarrhea
• changes in the frequency of your bowel movements, such as going more or less often
• feeling like you aren’t fully emptying your stool every time
• high fever
• stomach pain or cramping

If you have consistently flat stools for three days or more, it may be time to call your doctor.

Flat poops happen. It’s important to pay attention to any other symptoms you may be experiencing, such as abdominal pain or constipation, to understand the potential cause.

If you’re worried your flat poops could be due to an underlying condition, call your doctor to get checked out. Your doctor may also be able to make recommendations that can help your stool take on a more expected appearance.

Causes of hemorrhoids – Health Clinic 365 Yekaterinburg

Hemorrhoids occur in people who have several adverse factors. The most important causes of hemorrhoids are a violation of the outflow of blood through the veins of the rectum, insufficiency of connective tissue, dysregulation of the vascular wall, increased venous pressure in the pelvis due to constipation, prolonged sedentary work or pregnancy.

With the combined effect of these factors for a long time, the veins around the anus (anus) can expand and form hemorrhoids, which eventually increase in size and begin to protrude.

Sedentary work and physical inactivity Heavy physical labor. As a result of a long stay in a sitting position, blood stagnation occurs in the pelvic area. Excessive physical activity (for example, when lifting weights) also causes a sharp increase in intra-abdominal pressure and stagnation of blood in the veins, which leads to overflow of the pelvic veins. The veins stretch and lose their elasticity over time. On the contrary, moderate physical activity, skiing, running, swimming, gymnastics enhance and stimulate pelvic circulation, prevent stagnation of blood in the veins.

Chronic constipation . About 50% of patients who come in for hemorrhoids initially deny that they are experiencing constipation. However, upon careful questioning, almost all of these patients admitted to having many of the symptoms suggestive of chronic constipation.

The definition of constipation includes the following: infrequent stools (usually less than three times a week), difficulty with bowel movements (feeling strained during more than 25% of all bowel movements or a subjective feeling of hard stools), or a feeling of incomplete bowel movement.

Constipation is usually manifested by a change in the consistency of the stool (hard, painful stool) and a violation of the physiology of stool discharge (irregularity, difficulty in evacuating feces, straining during defecation). Although excessively hard stools usually lead to difficulty in defecation, but in elderly patients with anatomical bowel abnormalities (megacolon, diverticula) and dysmotility, soft and copious stools can also cause constipation. Constipation usually occurs in the presence of several factors: diet with insufficient dietary fiber, low physical activity, impaired nervous regulation of intestinal activity (for example, during stress), anatomical defects in the intestine, and the patient may also expect pain during stool and conscious retention of stool.

Obesity . With obesity, firstly, the pressure inside the abdominal cavity increases due to an increase in the omentum (the omentum is a duplication of the peritoneum filled with adipose tissue), and secondly, intestinal motility is disturbed due to a sedentary lifestyle.

Pregnancy (especially in the third trimester). Pregnant women have several factors at once that contribute to the occurrence of hemorrhoids:

– Violation of blood circulation in the pelvic organs (enlarged uterus compresses the inferior vena cava, and causes stagnation of blood in the veins of the pelvis and lower extremities).

– Many pregnant women experience constipation due to changes in bowel regulation during pregnancy. In addition, often doctors advise a woman to limit her fluid intake, which also leads to a change in the consistency of the stool (it becomes more solid).

– During pregnancy, a woman cannot lead the same active lifestyle as before pregnancy, which causes hypodynamia and additional stagnation of blood in the veins of the legs and pelvis.

Chronic diarrhea (frequent watery stools). Diarrhea in some patients can be observed for several months. At the same time, the volume of fecal masses increases (more than 300 g per day) and the frequency of defecation acts. As a result, irritation and inflammation of the rectum and anus occurs, which is the cause of exacerbation of previously existing hemorrhoids. In the chronic form of diarrhea, diarrhea can be replaced by severe constipation.

Anal sex . During anal sex, firstly, the blood flow to the vessels of the rectum increases significantly, and secondly, there is a stretching of the circular muscle that closes the exit from the rectum. This is the reason for the appearance of hemorrhoids and prolapse of internal hemorrhoids.

Cirrhosis of the liver . As a result of changes in the liver tissue and increased resistance to blood flow through the liver tissue, portal hypertension syndrome develops (increased pressure in the portal vein of the liver). He, in turn, leads to the expansion of veins in various organs, including in the rectum.

Heredity . The presence of pathology of the venous system in relatives of patients with hemorrhoids is usually 30-60%. Moreover, since the occurrence of hemorrhoids is due to the structure and strength of the walls of venous vessels and their regulation, relatives may have varicose disease of the extremities, esophagus and other organs.

Age over 40 . Hemorrhoids are more common in older people because the tissues that support the rectal and anise veins weaken and stretch as we age.

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Coprogram, general analysis of feces, rules for preparing for the delivery of analysis, interpretation of the results and indicators of the norm.

Hemorrhoids

Fungus

Diarrhea

Gastritis

Hepatitis

352

08 October

We remind you that independent interpretation of the results is not allowed, the information below is for reference only.

Coprogram, general analysis of feces: indications for the appointment, rules for preparing for the delivery of the analysis, interpretation of the results and indicators of the norm.

Indications for study appointment

Coprogram is a laboratory study of feces, which evaluates its various characteristics and identifies some diseases of the gastrointestinal tract (GIT), including inflammation and dysbacteriosis of the intestinal microflora.

In the absence of gastrointestinal pathologies, all food that a person consumes while passing through the gastrointestinal tract is subjected to intense action of gastric juice, bile, digestive enzymes, etc. As a result, food products are broken down into simple substances that are absorbed through the intestinal mucosa into the blood and lymph. Undigested food residues enter the large intestine, where water is partially absorbed from them. Normally, fecal masses enter the rectum, approximately 70% water and 30% dry food residues.

If any function of the organs of the gastrointestinal tract is disturbed, failures begin in the process of absorption of food products, which is reflected in the characteristics of feces.

Thus, a general analysis of feces is prescribed to diagnose diseases of the gastrointestinal tract (pathology of the liver, stomach, pancreas, duodenum, small and large intestine, gallbladder and biliary tract), if intestinal infections are suspected, to evaluate the results of therapy for gastrointestinal diseases, during the diagnosis of malignant neoplasms and genetic pathologies, as well as to establish intolerance to various products.

Preparing for procedure

Preparation for the coprogram requires compliance with some recommendations that allow you to get the correct result of the study.

• Avoid taking laxatives, enzymatic preparations, sorbents, rectal suppositories, oils.
• If possible, do a complete stool test no earlier than seven days after you stop taking antibiotics.
• Limit the intake of drugs and products that can change the color of feces for three days before the test.

• On the eve of the study, do not carry out diagnostic procedures that irritate the anus and rectum (enemas, sigmoidoscopy, colonoscopy).

• After x-ray examination of the stomach and intestines, fecal analysis should be taken no earlier than two days later.
• If it is necessary to detect hidden bleeding of the gastrointestinal tract, a 4-5-day diet is required with the exception of meat, fish, eggs and green vegetables, as well as iron, magnesium and bismuth preparations.

Stool collection in a special container

You can take a special container for collecting feces at any INVITRO medical office or buy it at a pharmacy. Its use will prevent contamination of the collected biomaterial.

Stool collection can be performed independently at home after an independent act of defecation (and not after an enema). To do this, it is better to use a medical vessel or pot, thoroughly washed beforehand, or a disposable diaper.

Immediately after a bowel movement, use a spatula to collect the stool into a container, filling it by about 30%. It is important that no traces of urine, menstrual flow or toilet water get into the collected biomaterial.

The resulting biomaterial must be delivered to the laboratory on the day of collection, the container can be stored in a refrigerator at a temperature of +4 to +8°C for no more than 6-8 hours.

Biomaterial collection container

Deadline

Up to 4 working days (not including the day of taking the biomaterial).

What can affect the results

1. Failure to follow dietary recommendations, use of an enema, performing a fluoroscopic or endoscopic examination shortly before the test.
2. Stool collection violation involving use of a non-sterile biomaterial collection container or collection directly from a toilet bowl, resulting in the introduction of foreign microorganisms from urine, genital secretions, toilet water, etc.
3. Failure to comply with the conditions for storage and transportation of feces (the biomaterial was delivered to the laboratory later than the maximum set time from the moment of collection).

If the result of the coprogram seems incorrect to you, it is better to take the analysis again, adhering to all the recommendations for preparation and collection rules.

Coprogram, general fecal analysis

You can submit a coprogram at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the “Addresses” section.

Interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.

Normal values ​​

Explanation of indicators

Consistency

Liquid feces may indicate excessively active intestinal motility, colitis, the presence of protozoal invasion.

Too tight stool indicates excessive absorption of fluid in the intestines, constipation, dehydration.

Foamy stool occurs when pancreatic insufficiency or violation of the secretory function of the stomach.

Mushy stools may indicate dyspepsia, colitis, or accelerated evacuation of feces from the large intestine.

Form

Pea-like feces are associated with hemorrhoids, anal fissures, ulcers, starvation, myxedema (mucous edema).

Feces in the form of a thin ribbon is noted in stenosis of the small intestine, as well as in the presence of neoplasms in it.

Color

Black color (tar color) can be caused by eating certain foods (currants, chokeberries, cherries), taking drugs with bismuth or iron, as well as bleeding in the stomach or duodenum, cirrhosis of the liver.

Red tint appears when bleeding in the large intestine.

Light brown stools occur in liver failure or blockage of the bile ducts.

Light-yellow color of feces occurs in pathologies of the pancreas and due to excessive consumption of dairy products.

Dark brown color indicates an excess of meat in the diet, as well as an increase in secretory function in the large intestine.

Green stool is a sign of typhoid fever.

Smell

A putrid odor occurs due to the formation of hydrogen sulfide in the intestines and indicates the presence of ulcerative colitis or tissue breakdown, tuberculosis, putrefactive dyspepsia.

A sour smell indicates an intensification of fermentation processes.

A fetid odor indicates a violation of the pancreas, a lack of bile entering the intestines.

Acidity

An increase in pH is observed in breastfed infants, in adults with putrefactive dyspepsia, as well as with high activity of the intestinal microflora.

Decrease in pH occurs in case of violation of the absorption process in the small intestine, with excessive consumption of carbohydrates, with increased fermentation processes.

Mucus

Mucus can be found both on the surface of the feces and inside it, found in ulcerative colitis and constipation.

Blood

Blood in the feces is determined by bleeding in the gastrointestinal tract caused by neoplasms, polyps, ulcers, hemorrhoids, and inflammatory processes.

An excess of bacteria and fungi can cause a false positive response.

Undigested food

Undigested food in the feces (lientorrhoea) indicates a violation of the function of the pancreas, chronic gastritis, accelerated peristalsis.

Undigested dietary fiber in stool analysis

Protein

The presence of protein in the feces indicates pathologies of the duodenum or stomach, colitis, enteritis, hemorrhoids and some other diseases of the gastrointestinal tract.

Stercobilin

The absence or significant decrease of stercobilin in the feces (negative reaction to stercobilin) ​​indicates blockage of the bile duct or a sharp decrease in the functional activity of the liver. An increase in the amount of stercobilin in the feces is observed with increased bile secretion, hemolytic jaundice.

Bilirubin

The detection of bilirubin in the feces of an adult indicates a violation of the process of its restoration in the intestine under the influence of microflora. This indicates intestinal dysbacteriosis, increased peristalsis, or taking antibacterial drugs during preparation for the test or shortly before.

Connective tissue and muscle fibers

They are underdigested remains of meat and occur with a lack of pancreatic enzymes.

Fat

Fat in the stool is one of the signs of insufficient pancreatic function or impaired bile secretion.

Excess fat in feces (steatorrhea)

Vegetable fiber

A large amount of digested vegetable fiber in the feces indicates a rapid passage of food through the stomach due to a decrease in its secretory function, the absence of hydrochloric acid in it, as well as an excess amount of bacteria in the large intestine and their penetration into the small intestine. Undigested fiber has no diagnostic value, since there are no enzymes in the gastrointestinal tract to break it down.

Starch

The increased content of starch in the feces, which appears with a lack of digestion processes in the stomach, small intestine and dysfunction of the pancreas, is called amylorrhea. In addition, a lot of starch can be found during diarrhea.

Intracellular starch granules in fecal analysis

Iodophilic flora (pathological)

The presence of pathological microflora (staphylococci, enterococci, Escherichia coli, etc.) indicates a decrease in the number of beneficial bacteria in the intestine and, accordingly, dysbacteriosis. With the consumption of a large amount of carbohydrates, clostridia begin to multiply intensively, causing fermentative dysbiosis.

Crystals

Calcium oxalate crystals in feces indicate insufficiency of stomach function, helminthic invasions, allergies.
Tripelphosphate crystals indicate an increased putrefaction of proteins in the colon.

Epithelium

A significant amount of columnar epithelium in feces is found in acute and chronic colitis. The presence of squamous epithelial cells has no diagnostic value.

Leukocytes

Leukocytes in the feces appear in colitis and intestinal enteritis, dysentery, intestinal tuberculosis.

Erythrocytes

Erythrocytes appear in the stool with hemorrhoids, rectal fissures, ulcerative processes in the large intestine, with the decay of tumors.

Protozoa

Non-pathogenic protozoa are present in healthy individuals. Pathogenic can be detected in feces delivered to the laboratory no later than two hours after the collection of the biomaterial. Their presence indicates an invasion.

Worm eggs

Helminth eggs in stool indicate worm infestation.

Roundworm larvae of the genus Strongyloides in feces

Yeasts

May be present in feces during corticosteroid or antibacterial therapy. The presence of the fungus Candida albicans indicates intestinal damage.

Sources

1. Nomenclature of medical services (new edition). Approved by order of the Ministry of Health and Social Development of the Russian Federation dated October 13, 2017 No. 804n. Valid from 01.01.2018. As amended by the Order of the Ministry of Health of Russia dated March 5, 2020 N 148n (including as amended, entered into force on April 18, 2020).
2. Shakova Kh.Kh. Evaluation of the reliability of scatological research depending on the storage time of the material. Successes of modern natural science, journal. 2003. No. 8. S. 131-131.
3. Clinical guidelines “Gastritis and duodenitis”. Developed by: Russian Gastroenterological Association, Association “Endoscopic Society “RandO””. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.