Flat Stools: Causes, Concerns, and When to Seek Help

The stool is flat?

Hello doctor, I have been experiencing continuous diarrhea since December of last year, where I need to have a bowel movement right after eating, along with bowel sounds.
I suspect that my large uterine fibroids may be causing abdominal bloating (which has been a prior issue).
In January of this year, I underwent stool occult blood tests and blood tests, both of which were normal.
The doctor diagnosed me with irritable bowel syndrome, so I started taking probiotics, and my bowel movements gradually returned to normal, with occasional diarrhea.
However, after my stools became formed, I began to notice that the latter part of my stool is often flat, and sometimes the front part has an angled shape, resembling a diamond.
I researched online and found information related to colon tumors, which has made me very worried.
I am unsure if I need to undergo a colonoscopy and whether the uterine fibroids would affect the procedure.

Zhuang s, 20~29 year old female. Ask Date: 2021/04/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

A colonoscopy is not necessary; dietary and medication adjustments will suffice.

Reply Date: 2021/04/29

More Info

Understanding flat stools can be a source of concern for many individuals, especially when accompanied by other gastrointestinal symptoms. In your case, you've experienced a history of diarrhea, abdominal noise, and the presence of flat stools, which understandably raises questions about potential underlying conditions.

Firstly, it's important to recognize that stool shape can vary significantly based on a variety of factors, including diet, hydration, and gastrointestinal health. Flat stools, particularly those that appear ribbon-like or have an angular shape, can sometimes indicate a narrowing of the intestinal passage, which may be due to various reasons, including but not limited to:
1. Dietary Factors: A diet low in fiber can lead to changes in stool consistency and shape. Ensuring adequate fiber intake from fruits, vegetables, and whole grains can help maintain regular bowel movements and improve stool shape.

2. Irritable Bowel Syndrome (IBS): Given your previous diagnosis of IBS, it's possible that the changes in stool shape are related to this condition. IBS can cause a variety of symptoms, including changes in bowel habits, abdominal pain, and discomfort.

3. Structural Issues: Conditions such as strictures (narrowing of the intestines) or polyps can also lead to changes in stool shape. While these are less common, they are important to consider, especially if there are accompanying symptoms like weight loss, persistent abdominal pain, or changes in bowel habits.

4. Colorectal Cancer: While it is a concern that flat stools can be associated with colorectal cancer, especially in individuals over 50 or those with a family history of the disease, it is essential to approach this possibility with caution. The presence of other symptoms, such as blood in the stool, significant weight loss, or changes in appetite, would warrant further investigation.

Regarding your specific situation, since you have already undergone stool tests and blood work that returned normal results, this is reassuring. However, if the flat stools persist or if you experience any new symptoms, it would be prudent to consult with your healthcare provider about the possibility of undergoing a colonoscopy. A colonoscopy can provide a direct view of the colon and rectum, allowing for the identification of any structural abnormalities, polyps, or other issues that may be contributing to your symptoms.

As for your concern about uterine fibroids affecting the colonoscopy procedure, generally, fibroids should not interfere with the examination of the colon. However, it is essential to inform your healthcare provider about your fibroids and any associated symptoms, as they can provide tailored advice and reassurance.

In summary, while flat stools can be concerning, they are not always indicative of a serious condition. Maintaining a healthy diet, managing stress, and staying hydrated can significantly impact your gastrointestinal health. If your symptoms persist or worsen, seeking further evaluation through a colonoscopy may be warranted to rule out any underlying issues. Always communicate openly with your healthcare provider about your symptoms and concerns, as they can guide you in making informed decisions about your health.

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