Mucus In Your Stool With IBS: Causes & When To Worry
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
Mucus in the stool with IBS is a common symptom of irritable bowel syndrome. According to this study, about half of IBS patients may notice mucus in their stool. Therefore, its presence can support the diagnosis of IBS.
While the well-known Rome IV criteria don’t include mucus in stool, another less prominent criterion for IBS, the “Manning criteria,” does.
According to Manning’s criteria, mucus in stool increases the likelihood of IBS. So, it is usually (but not always) a part of your IBS.
If you’re new to my blog, I’m Dr. Farahat, a gastroenterology doctor and IBS sufferer. So, I’m probably the perfect person to help you understand your IBS.
Today, I’ll try to answer the most critical questions you might have about mucus in stool with IBS.
If you’re not a fan of reading, we’ve created a short video explaining the main points.
(Q1) Is Mucus In Stool With IBS Normal?
Answer: In short, yes, but not always.
Mucus is a natural part of your stool. It is secreted in small amounts by the mucous cells lining your colon and small intestine.
You will not notice mucus in the stool under normal conditions because of its clear color and small amount.
And it has beneficial effects:
- It helps the easy passage of your stool.
- It traps harmful organisms in your gut.
Mucus could be present in the stool of some IBS patients. However, it is more common with IBS-Diarrhea. Mucus in stool with IBS is characterized by:
- It is clear white or yellow.
- It is associated with abdominal cramps or tenesmus.
- It is not associated with red flag signs like:
- Blood or pus with mucus.
- Nocturnal diarrhea (diarrhea that awakens you from sleep).
- Weight loss.
(Q2) What causes mucus in stool other than IBS?
The short answer: Mucus in stools can occur due to various conditions. It is difficult to differentiate between IBS mucus in stool and other causes. This is because the symptoms of IBS are similar to other diseases causing mucus in stool.
I will try to break down the significant causes of mucus in stools other than IBS.
The value of this article is not to substitute medical advice from your doctor, but to:
- Initially, help you to evaluate your condition.
- Then, guide you to know when to consult your doctor.
The other causes of mucus in stools are:
A- Bacterial Infections Of Your Intestine (Gastroenteritis/Bacillary Dysentery):
Bacterial gastroenteritis is a common cause of mucus in stool. And it is common for gastroenteritis to be confused with IBS flare-ups.
Bacterial gastroenteritis is caused by a variety of bacterial species like:
- Salmonella (typhoid fever).
- Shigella (bacillary dysentery).
- Campylobacter Jeujeni.
- And others.
Symptoms and differences from IBS:
- Abdominal cramps, are more intense, not related to meals, and can awaken you from sleep.
- Usually, more severe diarrhea is not related to food (can occur at any time).
- The mucus in stool may be associated with blood (dysentery).
- Fever usually occurs with bacterial infections. It may be a high-grade fever (exceeds 40° c).
- These infections are foodborne. The severe form is called “food poisoning.”
What to do:
- If the mucus in stool is associated with the symptoms above, you should immediately consult your doctor.
- Your doctor may ask for a stool sample to define the causative bacteria.
- The condition is usually more severe than the regular IBS flare-up and requires antibiotics and symptomatic solid treatment.
B- Not Drinking Or Eating For Many Hours.
As we mentioned before, mucus typically presents in small amounts in your stool. The color is clear white or yellow, making it challenging to notice.
With dehydration, mucus tends to become more thick, and stool contains less water. Also, the amount of mucus tends to increase relative to stools. At this point, the mucus becomes visible in the stool.
Usually, dehydration causes both constipation and mucus in stool.
- Not drinking water or recurrent vomiting for any reason causes dehydration.
- No other symptoms of IBS like colics, bloating, and distension.
- No evidence of bacterial infections like fever, vomiting, and severe abdominal pain.
- Usually, the stool is hard with dehydration (constipation), mixed with mucus, or preceded by a small amount of mucus.
- The mucus is clear (no pus nor blood).
C- Anal Fissure:
An anal fissure is a breakdown in the mucous membrane lining your anal canal. The most common cause of anal fissures is chronic constipation.
Anal fissure causes chronic irritation to the inside of your anal canal. This irritation stimulates mucous cells inside your anorectum to produce more mucus.
So, mucus in stool with IBS-Constipation may indicate that you have an anal fissure. But severe pain during defecation is the most specific symptom.
Symptoms & differences from IBS mucus:
- The most common presentation of the anal fissure is intense pain during defecation.
- Usually, you have constipation for a long time (anal fissures are more familiar with IBS-Constipation).
- The mucus in stool usually passes first, then the stool (as it is formed in the last part of your colon).
- Mucus in the stool may be associated with bright red blood due to bleeding from the fissure.
What to do if you think you have an anal fissure:
- Get an appointment with your doctor to confirm your case by examining your anal area.
- Your doctor usually prescribes a topical cream to decrease the pain and relax your anal muscles.
- Also, you should take a laxative to decrease constipation which is the cause of your anal fissure.
C- Inflammatory bowel disease or IBD (Ulcerative Colitis and Crohn’s Disease):
IBD is a group of disorders characterized by actual inflammation and ulceration of your intestine. A faulty immune response to your gut cells and bacteria causes it. As a result, your immunity attacks your colon and intestine, causing ulcers and bleeding.
The condition is usually more severe than IBS. It causes mucus in stool with or without visible blood.
Symptoms and how it is different from IBS mucus:
- IBD is mainly associated with diarrhea; the diarrhea is not related to food and may awaken you from sleep.
- Mucus in stool is usually not clear; associated with pus or blood.
- Weight loss.
- Iron deficiency anemia (pallor and easy fatigue).
- It may be associated with fever.
- The fever, anemia, and weight loss are not present with IBS.
What to do if you suspect inflammatory bowel disease (IBD):
- Weight loss, anemia, fever, and unclear mucus (with pus or blood) are not a part of IBS; you should get tested immediately.
- If you have such symptoms, your doctor will ask you to do some blood and stool tests.
- Usually, the definitive diagnosis of ulcerative colitis and Crohn’s disease is by colonoscopy.
- Treatment includes a drug called “mesalazine,” and in more severe cases, corticosteroids and other medicines may be tried.
D- Intestinal Obstruction (Uncommon, but Serious)
Intestinal obstruction is a serious medical condition that requires immediate attention. It happens when your colon or, more commonly, your small intestine gets blocked.
The most common causes of intestinal obstruction include:
- Fibrous adhesions around your bowel loops, especially if you’ve had previous surgeries in your abdomen.
- A bowel loop getting stuck inside a hernia.
- A blockage caused by a cancerous mass, such as colon cancer.
- Volvulus, which is when the stomach or intestine twists around itself.
This obstruction prevents stool from passing through your colon, causing the mucus secreted by your colon to pass alone during bowel movements.
Here’s how the symptoms differ from IBS mucus:
- The primary symptom of intestinal obstruction is “absolute constipation”; when you have a bowel movement, you only pass clear mucus without any stool (unlike mucus in stool with IBS).
- It’s usually associated with severe distension and abdominal cramps.
- Persistent vomiting often occurs because food can’t pass through the obstructed area.
What to do:
If you’re experiencing absolute constipation, persistent vomiting, and severe distension, you should consult your doctor immediately. This is a medical emergency that usually requires surgical intervention to treat the cause.
(Q3) When Should I Worry/Consult My Doctor?
Mucus in stool with IBS is typically a benign condition that’s part of your IBS. If you regularly pass mucus in stool with IBS attacks, there’s usually no need to worry.
The mucus in stool with IBS is usually clear white or yellow. It’s not associated with blood or pus.
You should consult your doctor if you experience any of the following red flags:
- Passage of pus (unclear mucus) with severe tenesmus.
- Passage of blood with mucus.
- Diarrhea associated with fever and/or vomiting.
- Intense pain at the anal canal during defecation (anal fissure).
- Diarrhea with mucus that wakes you up from sleep.
- Persistent vomiting.
- Weight loss, anemia.
- Recent antibiotic use.
- Passage of mucus without stool with severe distension and persistent vomiting (intestinal obstruction).
These red flags don’t typically occur with IBS mucus. Instead, they suggest that the underlying cause of mucus in stool isn’t your IBS.
If you don’t experience any of these red flags, then the mucus in your stool is likely due to IBS.
(Q4) How Can I Prevent and Treat Mucus in Stool with IBS?
Mucus in stool with IBS is commonly associated with IBS diarrhea, and its treatment is similar to the usual treatment of IBS-D.
Here are some treatment options you can try:
A- Modify Your Diet
The best dietary modification to control IBS-D and decrease mucus is to stick to a low FODMAP diet. FODMAPs are short-chain, highly fermentable fibers and polyols.
Eating a diet high in FODMAPs is linked to symptoms of IBS-Diarrhea like:
- Diarrhea and mucus in stool.
- Abdominal cramps.
- Bloating and distension.
You can try to restrict diets high in FODMAPs like:
Instead, you can try these diets that are low in FODMAPs:
B- Take Probiotics (Over the Counter Supplement):
Probiotics are available in many forms (capsule supplements, probiotic yogurt, probiotic milk). Unfortunately, there are no standard dosing, duration, and strains that fit all IBS patients.
What we do know is that probiotics containing “Bifidobacteria” and combinations of multiple strains tend to have better results. But there’s still a lot to learn about the ideal types, dosing, and duration.
Here are some standard rules for taking probiotics:
1- Only choose probiotics containing strains that research has proven effective.
2- Take probiotics that contain combinations of different strains in total doses.
3- Stick to one type of probiotic for 3 to 4 weeks; if there’s no improvement, you can try another type (trial and error).
4- Only choose established brands from a quality manufacturer.
C- Try Peppermint Oil (Over the Counter Supplement):
Peppermint oil is one of the most widely used over-the-counter remedies for IBS. It’s also known for its good safety profile. Pharmacists believe that the soothing effects of peppermint oil are due to a substance called menthol.
Here’s how peppermint oil works for IBS:
- It decreases the contractions of smooth muscles of the colon, thus decreasing your abdominal pain.
- It regulates the motility of your gut; it’s specifically beneficial in IBS diarrhea.
- It also helps to reduce IBS gas and bloating.
When to take peppermint oil:
Many clinical trials have studied the antispasmodic effects of peppermint oil. Most of them concluded that menthol could be used as a first-line therapy for abdominal pain.
This is because of its efficacy and the safety of the drug compared to other prescription antispasmodics.
You can use peppermint oil for:
- IBS abdominal pain
- IBS gas and bloating
- IBS diarrhea and mucus in stool
- Also, with mild constipation.
D- Take Loperamide (ImmodiumⓇ) to Stop IBS-Diarrhea with Mucus:
Loperamide or Imodium is the go-to drug used for diarrhea. It’s an extraordinarily safe drug that’s used for people with IBS predominant diarrhea.
Here’s how Imodium works:
- It decreases the movement of your intestines, thus slowing down the passage of contents.
- It increases the absorption of fluid and nutrients from your intestine into the blood.
- It prevents the secretion of fluids into your intestinal lumen, thus preventing the formation of loose stools.
When to take Imodium:
You can take Imodium if you have IBS diarrhea with or without abdominal pain.
Imodium is also beneficial if you have a mixed type of IBS where there is constipation alternating with diarrhea.
When not to take Imodium:
- If you have IBS constipation.
- Better not to use Buscopan IBS relief.
- If your diarrhea is not due to IBS (diarrhea not associated with food, awakens you at night, or is associated with fever). It’s better to consult your doctor.
- If you have IBS pain without diarrhea.
- If you have dysentery, inflammatory bowel syndrome, or a condition called membranous colitis.
E- Consult Your Doctor:
If the previous strategies don’t work for you, consult your doctor. Your doctor will evaluate you for the causes of mucus in stool other than IBS. Also, they will prescribe medications that may be more effective for your condition.
The treatment of IBS is highly individualized, and what works for one patient may not work for you.
Mucus in stool with IBS may be a typical sign. But it often gets confused with other conditions that may resemble an IBS attack.
This table summarizes these conditions and how to differentiate between each of them:
Q: Is mucus in stool with IBS dangerous?
A: Mucus in stool with IBS is typically not dangerous. It’s a common symptom of IBS, especially in cases of IBS-D (diarrhea-predominant IBS). However, if the mucus is accompanied by other symptoms such as blood, severe abdominal pain, weight loss, or changes in bowel habits, it’s important to consult a healthcare professional as these could be signs of a more serious condition.
Q: Does mucus in the stool of IBS patients mean cancer?
A: Mucus in stool is a common symptom of IBS and does not necessarily indicate cancer. However, if you notice a significant increase in the amount of mucus, or if it’s accompanied by other symptoms like blood in the stool, unexplained weight loss, or changes in bowel habits, it’s important to consult your doctor. These could be signs of a more serious condition, including colorectal cancer.
Q: What does it mean to have mucus with IBS constipation?
A: Mucus in stool can occur with both IBS-D (diarrhea-predominant IBS) and IBS-C (constipation-predominant IBS). The mucus is produced by the lining of the intestines to help stool pass through. If you have IBS-C and notice mucus in your stool, it’s likely a normal part of your condition. However, if the amount of mucus significantly increases or if it’s accompanied by other symptoms like blood or severe abdominal pain, you should consult your doctor.
Q: What color is IBS mucus in stool?
A: The mucus in stool with IBS is usually clear, white, or yellow. It’s not typically associated with blood or pus. However, if you notice a change in the color of the mucus, especially if it becomes green, dark, or bloody, it’s important to consult your doctor as this could indicate a more serious condition.
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