You may be concerned if your stool is suddenly flat or ribbon-like. When stool changes from a person's "normal" for more than a few days, it's time to contact a healthcare provider.
Bowel movements (poop) come in a spectrum of normal. The Bristol Stool Chart is a visual guide to help people understand where their stool is along the gradation from constipation to diarrhea.
For most people, the goal is a soft, easily passed stool shaped like a sausage or snake. However, gastrointestinal conditions such as irritable bowel syndrome (IBS), constipation, and inflammatory diseases could cause long-term changes in stool.
This article will discuss the reasons why poop may appear flat or ribbon-like and what things can be tried at home that might be recommended by a healthcare provider to relieve it or prevent it from happening again.
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Is Flat Poop a Problem?
Stool changes depend on several factors, including diet. Flat or ribbon-like stools are not always a cause for concern. They could appear from time to time and be considered within the range of a person's "normal."
However, there are conditions that may cause flat poop. When the stool changes in size, shape, color, or frequency for more than a few days, it's a reason to seek care from a healthcare provider.
Stool that becomes progressively thinner may be a sign of a medical problem. It doesn't always mean that there is a serious reason, but it's important to understand what may be causing it.
What Causes Flat Poop?
Several types of conditions could cause stool to be flat.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction. It can cause digestive symptoms ranging from diarrhea to constipation. Due to IBS, stool can change in size and shape.
Constipation
Constipation (infrequent and/or hard stools) can have several causes. These can include medications, a lack of fiber in the diet, dehydration, or lack of physical activity. Constipation could lead to narrowed or pencil-thin stools.
Diarrhea
Diarrhea is passing three or more loose or watery stools in a day. It is a common condition that could be caused by an infection, diet, food allergies or intolerances, celiac disease, inflammatory bowel disease (IBD), IBS, small intestinal bacterial overgrowth (SIBO), or some medications. The loose stools could be narrow, thin, or flat.
Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) involves an enlarged prostate, which is normally the size of a walnut. The prostate goes around the urethra, the tube through which urine exits the body through the penis.
It is not a cancerous condition. However, it could put pressure on the bladder and the rectum, where stool is retained before a bowel movement.
Colorectal Cancer
Many people may immediately assume that flat or ribbon-like stools are from cancer, but that is not always the case. Narrowed stools are one of the signs of colorectal cancer, however. When a tumor is obstructing part of the colon, it could cause skinny, narrow, or flat stools.
Other Potential Causes
Other conditions that can cause narrowing (stricture) or constricting in the colon, such as Crohn's disease, a twisted colon, or diverticular disease, may also lead to flat poop. An abdominal hernia may compress the bowel or other organs and cause the stool to become narrow. Certain intestinal infections might also lead to skinny or flat stools.
How to Find Relief at Home
Flat stools might not always need treatment; they could stop on their own. However, people can try various things at home to prevent some of the causes of flat bowel movements.
Fiber
Adding fiber to the diet can help with constipation and diarrhea. It may also help some people with IBS that tends toward constipation.
It can take time to figure out which type of fiber and how much to add to the diet every day to relieve the symptoms. The goal may be to have stools that pass easily and are shaped like sausages.
Water
Staying hydrated is important for having stools that pass easily. It can also help avoid straining to pass hard stools. Not getting enough fluids could lead to constipation, which can be prevented by drinking more water.
Exercise
Not getting enough exercise could lead to constipation or other issues affecting the stool. Walking or other exercise can help prevent or treat constipation. For those who aren't able to get exercise regularly, working with a physical therapist may be needed.
Stress
Stress can contribute to trouble with bowel movements. Stress can have a bidirectional effect, meaning it could lead to bowel symptoms, but bowel symptoms could also lead to more stress.
Stressful life events may not be completely avoidable, but working with a healthcare provider or instituting some stress-reducing practices may be helpful.
Low-FODMAP Diet
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are types of carbohydrates and sugars found in a variety of foods. Some research indicates that eating fewer foods with FODMAPs may help with some digestive symptoms, especially in IBS.
This diet is often used on the advice of a dietitian, a healthcare provider who can advise on how to start and maintain the diet.
When to Contact a Healthcare Provider
Flat, thin, ribbon-like, or pencil-thin stools are not always due to a problem that needs treatment. A change in stools that goes away in a day or two might not mean they are caused by an ongoing condition.
Some symptoms should prompt you to seek medical care. These symptoms could be a sign of a problem that needs treatment. If any of these signs or symptoms are occurring with flat stools, talk to a healthcare provider:
- Blood in or on the stool
- Diarrhea or constipation that goes on for more than three days
- Feeling faint or dizzy, passing out
- Flat or skinny poop that goes on for more than a few days
- Losing weight unintentionally
- Not passing anything (gas or stool) from the bottom
- Severe abdominal pain
Summary
Flat poop, which might also be called ribbon-like, pencil-thin, narrow, or small-caliber stools, might not be an indication that there is anything wrong. This change in bowel habits could be temporary based on a transient event like travel or a change in diet.
If these types of stools occur for more than a few days in a row or get even narrower over time, see a healthcare provider.
