What causes floating stools. How can you identify malabsorption symptoms. When should you consult a doctor about changes in bowel movements. What dietary changes can help with floating stools. How are floating stools diagnosed and treated.

The Science Behind Floating Stools: Malabsorption and Flatulence

Floating stools are a common occurrence that often raise questions about digestive health. The primary reasons for this phenomenon are poor nutrient absorption (malabsorption) and excessive gas (flatulence) in the stool. To understand why stools float, it’s essential to grasp the basics of the digestive process.

The digestive journey begins in the stomach, where food is broken down before passing into the small intestine. Here’s a simplified breakdown of the process:

1. Food enters the small intestine from the stomach
2. Nutrients are absorbed in the small intestine
3. Unabsorbed material moves to the colon
4. The colon absorbs water from the remaining food residue
5. The final product is eliminated as feces

When this process is disrupted, it can lead to floating stools. But what exactly causes this disruption?

Common Causes of Floating Stools: From Diet to Digestive Issues

Floating stools can be attributed to various factors, ranging from benign dietary changes to more serious health conditions. Let’s explore some of the most common causes:

1. Dietary Changes

A sudden change in your diet is often the most common and harmless cause of floating stools. Certain foods can increase gas production in your digestive system, leading to lighter, more buoyant stools. Which foods are most likely to cause this effect?

• High-fiber foods (e.g., fruits, vegetables, whole grains)
• Dairy products (especially for lactose-intolerant individuals)
• Artificial sweeteners
• Carbonated beverages

2. Gastrointestinal Infections

Various infections of the gastrointestinal tract can lead to floating stools. These may include viral, bacterial, or parasitic infections that disrupt normal digestion and absorption processes.

3. Malabsorption Disorders

Severe malabsorption can cause floating, greasy stools that have a foul odor. This is often accompanied by weight loss. What conditions can lead to malabsorption?

• Celiac disease
• Cystic fibrosis
• Chronic pancreatitis
• Short bowel syndrome

Identifying Malabsorption: Key Symptoms and Warning Signs

Malabsorption can manifest in various ways beyond just floating stools. What are the telltale signs of this condition?

• Chronic diarrhea
• Unexplained weight loss
• Bloating and gas
• Abdominal pain or cramping
• Fatigue
• Nutrient deficiencies

If you experience these symptoms alongside floating stools, it’s crucial to consult a healthcare professional for proper evaluation and diagnosis.

When to Seek Medical Attention: Red Flags and Urgent Symptoms

While floating stools are often harmless, certain symptoms warrant immediate medical attention. When should you contact a healthcare provider?

• Bloody stools accompanied by weight loss, dizziness, and fever
• Persistent changes in bowel movements
• Chronic diarrhea
• Unexplained weight loss
• Severe abdominal pain

These symptoms could indicate more serious underlying conditions that require prompt medical evaluation and treatment.

Diagnosing the Cause: What to Expect at Your Doctor’s Visit

When you visit your healthcare provider about floating stools, they will likely conduct a thorough examination and ask several questions to determine the cause. What can you expect during this visit?

1. Medical History and Symptom Assessment

Your doctor will inquire about:

• When you first noticed the floating stools
• The frequency of occurrence
• Your usual diet and any recent changes
• Other accompanying symptoms
• The appearance and smell of your stools

2. Physical Examination

A physical exam may be performed to check for any visible signs of underlying conditions.

3. Diagnostic Tests

Depending on your symptoms and medical history, your doctor may recommend:

• Stool sample analysis
• Blood tests to check for nutrient deficiencies or infections
• Imaging studies (in some cases)

The specific treatment plan will be determined based on the diagnosis made from these assessments.

Managing Floating Stools: Dietary Adjustments and Lifestyle Changes

In many cases, floating stools can be managed through simple dietary and lifestyle modifications. What steps can you take to address this issue?

1. Identify Trigger Foods

Keep a food diary to track which foods seem to coincide with floating stools. Common culprits include:

• Lactose-containing foods
• Gluten-rich products
• Foods high in fructose or artificial sweeteners
• Fatty or greasy foods

2. Gradually Increase Fiber Intake

While high-fiber foods can initially cause gas and floating stools, gradually increasing your fiber intake can help regulate bowel movements in the long run. How much fiber should you aim for?

The recommended daily fiber intake is:

• 25-30 grams for adults
• 21-25 grams for women
• 30-38 grams for men

3. Stay Hydrated

Proper hydration is crucial for maintaining healthy digestion. Aim to drink at least 8 glasses of water per day.

4. Consider Probiotics

Probiotics can help balance gut bacteria and improve digestion. Consult with your healthcare provider about incorporating probiotic supplements or probiotic-rich foods into your diet.

Treatment Options for Underlying Conditions

If floating stools are a symptom of an underlying condition, treatment will focus on addressing that specific issue. What are some potential treatment approaches?

1. Celiac Disease

Treatment involves strict adherence to a gluten-free diet.

2. Lactose Intolerance

Management includes avoiding lactose-containing foods or using lactase enzyme supplements.

3. Chronic Pancreatitis

Treatment may involve pancreatic enzyme replacement therapy, pain management, and dietary modifications.

4. Infections

Bacterial or parasitic infections are typically treated with appropriate antibiotics or antiparasitic medications.

It’s important to note that treatment plans should always be developed and supervised by a healthcare professional.

Preventing Floating Stools: Long-term Strategies for Digestive Health

While not all cases of floating stools can be prevented, there are several strategies you can employ to promote overall digestive health and reduce the likelihood of experiencing this issue. What steps can you take?

1. Maintain a Balanced Diet

A diet rich in fruits, vegetables, whole grains, and lean proteins can support healthy digestion. How can you ensure a balanced diet?

• Include a variety of colorful fruits and vegetables in your meals
• Choose whole grains over refined grains
• Incorporate lean proteins such as fish, poultry, and legumes
• Limit processed foods and added sugars

2. Practice Mindful Eating

Eating slowly and mindfully can improve digestion and reduce the likelihood of swallowing excess air, which can contribute to gas and floating stools. What are some mindful eating techniques?

• Chew your food thoroughly
• Eat in a relaxed environment
• Avoid distractions while eating (e.g., watching TV or using your phone)
• Pay attention to your body’s hunger and fullness cues

3. Regular Exercise

Physical activity can help stimulate digestion and promote regular bowel movements. How much exercise is recommended?

The World Health Organization recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week for adults.

4. Manage Stress

Chronic stress can negatively impact digestive health. Incorporating stress-management techniques into your daily routine can help maintain optimal digestion. What are some effective stress-reduction methods?

• Meditation or mindfulness practices
• Deep breathing exercises
• Yoga or tai chi
• Regular physical activity
• Adequate sleep (7-9 hours per night for adults)

5. Stay Informed About Your Health

Regular check-ups with your healthcare provider can help identify and address potential digestive issues before they become more serious. How often should you have a health check-up?

The frequency of check-ups depends on various factors, including age, gender, and overall health status. Generally, adults should have a comprehensive health check-up every 1-3 years.

By implementing these strategies, you can promote long-term digestive health and potentially reduce the occurrence of floating stools. Remember, while floating stools are often harmless, persistent changes in bowel habits should always be discussed with a healthcare professional to rule out any underlying conditions.

Understanding the Impact of Floating Stools on Overall Health

While floating stools are often a temporary and harmless occurrence, they can sometimes be indicative of broader health issues. How do floating stools relate to overall health and well-being?

1. Nutrient Absorption

Persistent floating stools, especially when accompanied by other symptoms, may signal malabsorption issues. This can lead to nutrient deficiencies over time, affecting various bodily functions. What are some potential consequences of long-term malabsorption?

• Anemia due to iron or vitamin B12 deficiency
• Osteoporosis from calcium and vitamin D malabsorption
• Neurological problems related to vitamin B12 deficiency
• Skin issues due to lack of essential fatty acids

2. Gut Microbiome Balance

The health of your gut microbiome plays a crucial role in overall digestion and stool consistency. Floating stools may indicate an imbalance in gut bacteria. How does gut health impact overall well-being?

A healthy gut microbiome contributes to:

• Improved digestion and nutrient absorption
• Enhanced immune function
• Better mental health (via the gut-brain axis)
• Reduced inflammation throughout the body

3. Hydration Status

In some cases, floating stools may be related to changes in hydration status. Proper hydration is essential for overall health and can impact stool consistency. What are the benefits of staying well-hydrated?

• Improved cognitive function
• Better physical performance
• Healthy skin and mucous membranes
• Proper kidney function
• Regulated body temperature

4. Metabolic Health

Certain metabolic conditions, such as pancreatic insufficiency, can lead to floating stools due to poor fat absorption. How does metabolic health relate to overall well-being?

Optimal metabolic health is associated with:

• Reduced risk of chronic diseases (e.g., diabetes, heart disease)
• Better energy levels and stamina
• Improved weight management
• Enhanced mood and mental clarity

By understanding the potential connections between floating stools and overall health, you can take a more proactive approach to your well-being. If you experience persistent floating stools or other digestive symptoms, it’s important to consult with a healthcare professional to ensure proper diagnosis and management of any underlying issues.

Stools – floating Information | Mount Sinai

Floating stools

Stools that float are most often due to poor absorption of nutrients (malabsorption) or too much gas (flatulence).

Food passes from the stomach into the small intestine. In the small intestine all nutrient absorption occurs. Whatever has not been absorbed by the small intestine passes into the colon. In the colon most of the water is absorbed from the food residue. The residue is then eliminated from the body as feces.

Considerations

Most causes of floating stools are harmless. In most cases, floating stools will go away without treatment.

Floating stools alone are not a sign of an illness or other health problem.

Causes

Many things can cause floating stools. Most of the time, floating stools are due to what you eat. A change in your diet may cause an increase in gas. Increased gas in the stool allows it to float.

Floating stools may also happen if you have a gastrointestinal infection.

Floating, greasy stools that are foul smelling may be due to severe malabsorption, particularly if you are losing weight. Malabsorption means your body is not properly absorbing nutrients.

Most floating stools are not caused by an increase in the fat content of the stool. However, in some conditions, such as long-term (chronic) pancreatitis, the fat content is increased.

Home Care

If a change in diet has caused floating stools or other health problems, try to find which food is to blame. Avoiding this food may be helpful.

When to Contact a Medical Professional

Tell your health care provider if you have changes in your stools or bowel movements. Contact your provider right away if you have bloody stools with weight loss, dizziness, and fever.

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask questions about your medical history and symptoms, such as:

• When did you first notice the floating stools?
• Does it happen all the time or from time to time?
• What is your usual diet?
• Does a change in your diet change your stools?
• Do you have other symptoms?
• Are the stools foul smelling?
• Are the stools an abnormal color (such as pale or clay-colored stools)?

A stool sample may be needed. Blood tests may be done. In most cases, however, these tests will not be needed.

Treatment depends on the specific diagnosis.

Höegenauer C, Hammer HF. Maldigestion and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 104.

Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 16.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 131.

Last reviewed on: 5/4/2022

Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Why Do Stools Float Sometimes?

Written by WebMD Editorial Contributors

• What Are Floating Stools?
• Why Would Stools Float?
• When To See a Doctor
• Treatment
• Prevention

Stools, or poop, usually sink to the bottom of the toilet, but sometimes, they can float. If your poop never sinks to the bottom of the toilet bowl, you may have too much gas in your intestines.‌

Normally, floating stools aren’t a cause for concern. Read on to learn more about why stools float, what floating stools say about your health, and more.

When stools float, it means the poop stays on the surface of the toilet water instead of sinking. Normally, poop sinks to the bottom of the toilet bowl.‌

Floating poop doesn’t mean you’re sick, but it can be a symptom of various conditions.

There are several reasons why poop floats and never seems to sink.

Too much gas. You may have too much gas in you due to your diet, which can make your stools float. 

Some people think that floating poop is caused by fat, but it’s usually caused by gas. Research has indicated that once floating stools were degassed, they weighed the same as sinking poop. This indicates that gas was responsible for making floating stools float, rather than fat inside the poop.

Gas in your digestive system is usually caused when you swallow air or eat certain types of foods that break down into gas. 

If you eat a high-fiber diet with a lot of vegetables and fruits, you may get floating stools because digesting high-fiber foods releases more air during digestion. This leads to air or gas being trapped in the stool, making it float in the toilet bowl.

Medical conditions. If your poop floats, there’s a slight chance you have steatorrhea, which means you have too much fat in your poop. Steatorrhea indicates you can’t absorb fat properly, and it can be a symptom of the following conditions:

• Celiac disease
• Exocrine pancreatic insufficiency (EPI) due to cystic fibrosis and chronic pancreatitis
• Diseases affecting small intestines such as tropical sprue, Whipple disease, and lymphoma
• Bile acid deficiency

You may also have the following conditions if you have floating poop:

• Gastrointestinal infection
• Malabsorption, which means you’re not absorbing nutrients as well as you should

Floating stools don’t necessarily mean you have an underlying health condition. To determine if a health condition is causing this, you should be on the lookout for other indicators. 

If your floating stools are smelly, sticky, or bloody, for example, you should see a doctor. Your doctor will give you a proper diagnosis and walk you through the process of understanding your condition if you have one. Here’s a closer look at what might cause these symptoms. ‌

Smelly and sticky stools. Smelly and sticky stools are typically a symptom of nutrient malabsorption. This means your body isn’t able to completely absorb and digest nutrients from your gastrointestinal tract due to damage to the small intestine, not having enough pancreatic enzymes, liver disease, HIV/AIDs, or other conditions.

If your floating stools are smelly and appear sticky, you should contact your doctor.

Blood in your stool. If your floating poop is accompanied by blood, it could be caused by:

• Bleeding in your anus or rectum
• Cancer of your digestive system
• Blood vessel abnormalities
• Inflammatory Bowel Disease such as Crohn’s Disease or Ulcerative Colitis
• Ulcers in the stomach or small intestine
• Polyps
• Diverticulitis ‌

If you find blood in your stools, you should see a doctor. If you’re experiencing weight loss, dizziness, or fever in addition to finding blood in your stools, you should talk to your doctor immediately. You should also get emergency medical help if there is a lot of blood in your poop, or if it is maroon or black and tarry.‌

Your doctor will be able to determine what is the exact cause of bloody poop through imaging tests and physical exams.

When you visit your doctor, they will likely ask you several questions about your medical history and your current health to determine why you have floating stools. They will also ask you about your diet and how long you’ve been having this issue so they can make any needed diet and medication recommendations.

Unless there is a medical condition causing you to have floating poops, there is no need to do anything to treat or prevent them.

Monitor your pooping habits. Always be aware of any changes to your stool and bowel movements. If you’re suddenly pooping more or less, or your poop looks very different, you should report these changes to your doctor. Your doctor will find it easier to diagnose any health conditions you may have if you keep an organized record about your pooping habits.

Changing your diet. Sometimes, preventing floating poop can be as easy as changing your diet, since floating poop can be caused by eating foods that cause you to have more gas.

You should avoid the following foods if you have a problem with too much gas:

• Hard candy
• Fizzy or carbonated drinks
• Gum‌

Keep a food diary so you can keep track of what you eat and narrow down what foods are giving you gas. You should bring this diary to your doctor so you can talk to them about how you can change your diet.

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Feces buoyancy linked to intestinal microbiota

American researchers figured out why some feces sink in water while others float on the surface. According to experiments on mice, the composition of the intestinal microbiota is solely responsible for this. The report on the work was published in the journal Scientific Reports .

Feces 10-15 percent of people float on the surface of the water, and this is not associated with any pathological condition. Among people with functional bowel disorders, this proportion rises to about one in four. Historically, it was believed that the buoyancy of feces is due to the high content of fat in it, but in 19In 1972, Michael Levitt, a gastroenterologist from the University of Minnesota, and his student William Duane, in experiments with the stool of 39 people (including six patients with steatorrhea), showed that even fatty feces sink when gas is removed. The researchers did not specify the origin of the gas component, and this question, which has the potential for clinical application, has remained open until now.

To understand it, staff at the Mayo Clinic in Rochester, Minnesota, under the direction of Nagarajan Kannan, used conventional C57BL/6 (B6) and gnotobiotic (born and reared in aseptic conditions that do not have a microbiome) mice. Some of the latter have been colonized with microbiota in their intestines by a single intragastric injection of the drug, either in the faeces of normal mice or one of two healthy women, or by allowing contact with environmental bacteria. Fecal sterility of germ-free mice and successful colonization of the intestines of the rest were confirmed by polymerase chain reaction, scanning electron microscopy, and measurement of bacterial DNA concentration (a measure of microbiota density).

Flow cytometry showed that the number of undigested particles of food biomass is inversely related to the density of the intestinal microbiota. In thermogravimetry, the feces of germ-free mice differed from the rest of the samples in at least three temperature ranges; pycnometry revealed its significant superiority in relative density. The shape, size and color of the stool in all groups of animals did not differ.

To assess the buoyancy of faeces, the researchers used a simple LIFT test they had previously developed – levô in fimo (literally translated from Latin as “raising in dung”) test. It consists in placing stool fragments in water and a Trump fixer solution (10 percent formaldehyde and one percent glutaraldehyde) in phosphate buffer (TFS), followed by recording their position (at the bottom or surface) after a minute, hour and day. It turned out that all samples from germ-free mice sink in water and TFS in less than a minute, while about half of the bacteria-colonized samples remain on the surface of the water and all of them continue to swim in TFS after a day.

Also, the authors of the work performed simultaneously LIFT and microbiota density determination in gnotobiotic mice before intragastric colonization (all faeces were drowned, bacterial DNA was practically not determined) and after it weekly for 12 weeks. By the third week, with all methods of microbiota formation (transplantation from mice and humans, from a non-sterile environment), the DNA concentration in the whole stool began to stabilize at a level of more than 10 thousand nanograms per milligram, from that time all biosamples floated.

Metagenomic analysis of the intestinal microbiota of conventional, artificially colonized gnotobiotic and their donor mice revealed 13 dominant species of gasogenic bacteria from 11 genera, and their composition in different animals was extremely heterogeneous. The most common was methane-producing Bacteroides ovatus , associated, as previously shown, with an increased risk of flatulence in humans.

Thus, the buoyancy of feces depends solely on the gases produced by the microbiota; Swallowed air and the chemical composition of the dense matter of the stool do not play a role in this, Kannan concluded.

In 2019, Tufts University researchers reported that fecal transplants from physically fit older adults significantly increased the grip strength of mice. At the same time, a Belgian-Dutch scientific group showed that the intestinal microbiota affects the quality of life and the risk of developing depression. In turn, the species composition of bacteria in the gastrointestinal tract depends on at least 69 main factors, including such non-obvious ones as the opinion of one’s own body weight and plans to reduce it, preferences for chocolate varieties and taking antidepressants – the Dutch, Belgian, Russian and British scientists.

You can read about the various uses of excrement in wildlife in the blog “It’s the norm: about the instrumental use of feces.” Issues related to fecal transplantation are analyzed in detail by Doctor of Biological Sciences, Professor Mikhail Gelfand.

On mice

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WARNING: CHOLERA! (reminder for the population)

Cholera is an acute intestinal infection caused when a bacterium, vibrio cholerae, enters the digestive organs.

Source of disease and mechanism of transmission. The source of infection is a person with a typical form, as well as an asymptomatic form, a convalescent (recovering person) and a healthy carrier.

Infection occurs mainly when drinking non-disinfected water, swallowing water while swimming in polluted water bodies, while washing. Infection can occur when eating food contaminated during cooking, storing, washing or distributing it, especially foods that are not subjected to heat treatment (shellfish, shrimp, dried and lightly salted fish). Contact-household (through contaminated hands) transmission route is possible. By the fecal-oral route, Vibrio cholerae enters the intestine and causes inflammation, which causes the main clinical symptoms.

Main symptoms. The incubation period lasts from several hours to 5 days, usually 1-2 days. The severity of the disease varies from an asymptomatic form to severe conditions with severe dehydration and death within 1-2 days. A typical clinical picture of cholera is characterized by: acute onset, diarrhea: copious stools from 3 to 30 per day; characteristic stool: mushy or liquid feces, first white-gray, then colorless, odorless and blood impurities, with floating flakes. All this is reminiscent of “rice water”. There is usually no pain in the abdomen. Vomiting is also characteristic: sudden, frequent, fountain, first eaten food, then liquid like “rice water”. Temperature increase: usually absent, in severe cases, the temperature is lowered to 35-35.5 ° C. (feature – only children can have an increase in body temperature). Further, dehydration develops: thirst, dryness of the mucous membranes and skin, sharpened facial features, sunken eyes, weakness, lethargy, impaired consciousness, coma. The amount of urine decreases until it disappears. There are cramps of masticatory and calf muscles, shortness of breath. The most common complication of cholera is currently pneumonia.

Treatment. If cholera is suspected, the patient must be hospitalized. Medications are prescribed to maintain the water-salt balance of the body, antibiotics, etc., which are prescribed only by a doctor.

If you have diarrhea, especially severe diarrhea, and you are in an area where cholera has been reported, seek immediate medical attention from a doctor or other healthcare professional. Drink water and other unsweetened liquids while waiting for medical attention.

Prevention. Mandatory hygiene measures:
drink guaranteed safe water and drinks (boiled water, disinfected water, drinks and water in factory packaging)
wash fruits and vegetables thoroughly with safe water
eat hot, thoroughly cooked foods.