Clear White Mucus In stool: 6 Causes explained.
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Can clear mucus in stool be a normal finding?
Have you ever questioned why our amazing gastrointestinal system can digest food but not itself?
Well, the answer is mucus.
Mucus is found everywhere in your digestive system, It covers all the cells inside your digestive system from the stomach to the rectum. The stomach and the colon are further covered by two layers of mucus (reference).
The mucus in your digestive system is a white, clear, and viscid substance. It is found in the stool all the time but in unnoticeable amounts.
Mucus serves many important functions such as:
- A barrier protecting the lining stomach cells from self-digestion.
- A trap for harmful bacteria, viruses, and other organisms.
- A lubricant helps the intestinal contents to pass smoothly through the digestive tract.
- A site at which commensal organisms live.
Does clear or white mucus in stool always mean something is wrong?
Mucus can appear in stool under normal conditions such as:
- Prolonged fasting.
- in the baby stool.
No need as long as there are no other symptoms and the mucus is clear. However, see a doctor if you constantly experience increased mucus in stool or have other symptoms as:
- Abdominal pain.
- Blood in stool.
- Constant bloating or distension.
- Severe constipation.
- Nausea or vomiting.
- Anorectal pain.
- Change the color of the mucus (greenish or reddish).
The most important and most common causes of clear or white mucus in the stool are discussed in detail below:
1 . Food intolerance (or allergy).
Food intolerance is a widespread condition. For example, Lactose intolerance (the commonest type of food intolerance) can affect up to 100% of people (reference).
Intolerance is difficulty digesting or absorption certain types of foods or food constituents. When you eat the offending food, you will experience symptoms such as:
- Abdominal pain.
- Mucus in the stool (often white and clear).
- Bloating and distension.
- Nausea (and sometimes, vomiting).
Food allergy is another form of food reaction that is immune-mediated. The differences, features, and examples of food intolerances and food allergies are in the table below:
Food allergy and food intolerance are very common conditions and are overlooked by many doctors and patients. A large subset of people who are diagnosed with IBS may have underlying food intolerance causing their IBS-like symptoms.
The most common symptoms of food intolerance are diarrhea with can be yellow diarrhea. In the table below, you can learn about the difference between food intolerance and food allergy.
|Food intolerance||Food allergy|
|Affects 15-20% of the population||Affects nearly 2-5% of adults|
|Difficulty digesting certain types of food (not immune-mediated allergy).||An immune-mediated reaction to certain foods or food components.|
|Causes “recurrent acute” or “chronic” attacks of diarrhea.||Usually causes acute attacks related to the ingestion of offending food. It also can cause yellow diarrhea.|
|Intestinal symptoms: diarrhea, extensive gas, bloating, and abdominal pain, mucus in stool.||Intestinal symptoms are the same|
|No extra-intestinal symptoms||Extraintestinal symptoms like rashes, urticaria, swollen lips or face or severe life-threatening allergic reactions.|
|The severity of your symptoms is proportional to the amount you eat from the offending food.||Even trace amounts of the offending food can produce severe symptoms.|
|Common offending foods:||Common offending foods: (examples)|
2. Irritable bowel syndrome.
Another common cause of abdominal pain and loose yellow stool is Irritable bowel syndrome.
IBS affects around 11 to 15% of the population (ref). Although, currently no reliable test to diagnose IBS, IBS is interpreted according to some clinical criteria.
The fundamental symptom of IBS is abdominal pain that occurs at least once per week. The onset of abdominal pain is associated with at least 2 of the below:
- Defecation: abdominal pain is relieved (or worsened) during or after defecation.
- Change in stool form: stool becomes more hard or loose (and yellow).
- Change in stool frequency: more frequent or less frequent bowel movements (constipation or diarrhea)
Only 30% of people matching IBS criteria will consult their doctors about IBS symptoms (ref).
This leaves 70% of people matching the diagnostic criteria of IBS without even knowing they’ve IBS!
If you have recurrent abdominal pain and yellow stool, Read this in-depth guide to figure out if you have IBS or Not.
A- Dysentry (especially Bacillary dysentery):
Dysentery is the passage of blood, mucus, or both blood and mucus with stool. In severe cases of dysentery, mucus or blood comes out without stool. The condition is usually accompanied by severe urgency to poop and frequency.
Dysentery (especially bacillary dysentery) is the most common cause of acute onset proctitis. Having a recent onset urgency to poop with only mucus coming out is commonly due to dysentery.
Symptoms (How to suspect):
- The onset is acute: if you have recurrent or chronic mucus only stool, then dysentery is unlikely.
- Diarrhea may present at first, then only mucus or blood comes out.
- Tenesmus: intense urgency to poop, only a small amount of mucus comes out. This is followed by a sense of incomplete evacuation.
- Intense abdominal pain (usually localized in the lower abdomen).
- Fever: usually acute onset, and high grade.
- Nausea, vomiting, or both. (rarely present with bacillary dysentery).
Another common cause of dysentery is amoebic dysentery. Amoebic dysentery is caused by a protozoan called “Entamoeba Histolytica”.
B- Other types of food-borne illnesses that can cause proctitis.
Some foodborne illnesses can cause dysentery and proctitis other than bacillary dysentery.
Foodborne illnesses (AKA food poisoning) occur due to a wide variety of organisms. From which, some are known to cause proctitis. which is manifested by an intense urge to poop, with only mucus or blood coming out.
Common causes: (ref)
- Salmonella (Typhoid Fever).
- E-coli (Shiga toxin-producing strains and entero-invasive strains).
- Clostroides difficile colitis and proctitis.
- Cytomegalovirus colitis and proctitis.
The symptoms are usually milder than bacillary dysentery but may become severe especially if you are immunocompromised.
3- sexually transmitted diseases (STDs) causing proctitis.
Recent sexiual practice involving the anoretcal area followed by anorectal discharge (mucus only coming out with urgency) may indicate a sexiually transmitted disease.
Unfortunately, Your partner doesn’t have to be symptomatic to transmit the infection to you.
Common causes of STD causing proctitis:
- Anoretcal gonorrhea.
- Chlamydia infection: chlamydia infection of the anoretcum commonly causes a severe urge to poop and only mucus comes out.
- Syphilis: causes painful ulcers in the anoretcum with the discharge of pus and mucus.
- sexiually transmitted campylobacter Jejuni: causes retcaliulcer, mucus-only diarrhea, intense urgency, and abdominal cramps.
Symptoms of STDs as a cause of proctitis:
- Tenesmus: a sense of complete evacuation of theoretcum after defecation.
- Recent history of anallisexi activities (even with a partner without symptoms).
- Urgency: sudden and intense urge to poop.
- Frequency: frequent attacks of stool urgency with nothing coming out or only mucus or pus.
- retcal discharge: pus, mucus, blood, or mixed discharge.
- Fever may occur.
- Other genital symptoms may be also present such as ulcers or abnormal discharge.
Consult your doctor or an STD specialist immediately if you suspect you have an STD.
4. Inflammed fissures or hemorrhoids.
A. Anall fissures.
Fissures commonly occur due to:
- Chronic constipation.
- Normal delivery in females.
- Local trauma of the anorectum.
- Chronic inflammatory diseases of the anorectum such as Crohn’s disease or anoretcal cancer.
symptoms of anall fissures:
- Severe anoretcal pain increases while your poop is the main symptom. Almost, there is no fissure without sharp pain.
- History of the causes such as severe constipation or local trauma to theianorectum.
- With chronic fissures, you may feel a skin tag at the opening of your anoretcal canall.
Inflamed Hemorrhoids (piles):
Hemorrhoids are dilated inflamed veins in the wall of the anall canall. Inflamed hemorrhoids can irritate the canall and secrete mucus.
Mucus from the inflamed hemorrhoids can come out without stool. It is associated with the urge to poop even after having a bowel movement (ref).
A bulge or a skin tag may be felt at the opening of the anorectum. Whether you are diagnosed with hemorrhoids before or not, you have to see your doctor if you’re pooping only mucus with the hemorrhoids.
5. Inflammatory bowel disease.
inflammatory bowel disease refers to 2 major conditions:
- Crohn’s disease: Unexplained inflammation and ulceration at any part of your gut (from the mouth to the anorectum).
- Ulcerative colitis: Unexplained inflammation and ulceration affecting the large intestine only (the colon and the rectum).
About 1.8 million U.S adults (0.9%) had inflammatory bowel disease, according to the CDC.
symptoms of IBD:
- Persistent or recurrent diarrhea.
- Abdominal pain.
- Blood or blood and mucus coming out with or without a stool.
- Weight loss.
- Generalized fatigue.
- Fever may occur.
- Loss of appetite.
Suspect IBD if you have a prolonged history of abdominal pain, mucus, constant diarrhea, and blood in stool without obvious cause.
The main differences between Crohn’s and ulcerative colitis are summarized in the below table.
|Type||Crohn’s Disease||Ulcerative Colitis|
|1- Site||Any part of the GI tract (from the mouth to the anorectum)||The colon and retcum.|
|2- Lesions||Deeper, it can involve all the layers of the GI wall.||Usually superficial (only in the innermost layer)|
|3-Predominant symptom||Crampy abdominal pain||Bloody diarrhea. (can be constant)|
|4- Complications||Fistulas, abscess, intestinal obstruction||hemorrhagic toxic megacolon.|
|5- Risk of colon cancer||Slight increase||Marked increase|
Ulcerative colitis and Crohn’s disease are major diseases that require medical care and follow-up.
Consult your doctor if you have a long history of recurrent abdominal pain, constant diarrhea with blood, and mucus in stool.
6. Other causes of clear white mucus in stool.
- Anorectal and colorectal cancers.
- rectal ulcer.
- Diversion colitits.
- Antibiotic-associated colitis.
- Intestinal obstruction.
- Radiation therapy.
- Eosinophilic proctitis.
- Severe forms of food intolerance and food allergy.
- Anorectal fistulas or sinus.
- Cystic fibrosis.