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 one of the signs of irritable bowel syndrome. According to this study, approximately half of IBS patients may experience mucus in stool. Therefore, its presence supports the diagnosis of IBS.

The famous Rome IV criteria didn’t include mucus in stool. But another less prominent criteria for IBS called “Manning criteria” did so.

According to Manning criteria, mucus in stool promotes the likelihood of IBS. So, it is usually (not always) a part of your IBS.

If this is your first landing on my blog, I’m Dr. Farahat, a gastro-enterology doctor and IBS sufferer. So, I am probably the perfect guy to hear from (about your IBS).

Today I will try to answer the most critical questions running in your head about mucus in stool with IBS.

If you don’t like reading, we made a short video for you 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 in normal conditions because of its clear color and small amount.

And it has beneficial effects:

  • Help easy passage of your stool.
  • Traps harmful organisms in your gut.

BUT

Mucus could 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.
  • Associated with abdominal cramps or tenesmus.
  • not associated with red flag signs like:
    • blood or pus with mucus.
    • Nocturnal diarrhea (diarrhea that awakens from sleep).
    • Fever.
    • Weight loss.
    • Anemia.

(Q2) what are the causes of mucus in stool other than IBS?

Answer: Mucus in stools occurs due to a variety of 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 prevalent 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 not related to food (can occur at any time0.
  • 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, have 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 think, 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. 

Symptoms:

  • 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- AnaliFissure:

An analifissure is a breakdown in the mucous membrane lining your analicanal. The most common cause of analifissures is chronic constipation.

Analifissure causes chronic irritation to the inside of your analicanal. 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 analifissure. But the severe pain during defecation is the most specific symptom.

mucus in stool with ibs: anal fissure

Symptoms & differences from IBS mucus:

  • The most common presentation of the analifissure is intense pain during defecation.
  • Usually, you have constipation for a long time (analifissures 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 analifissure:

  • Get an appointment with your doctor to confirm your case by examining your analiarea.
  • Your doctor will usually prescribe a topical cream to decrease the pain and relax your analimuscles.
  • Also, you should take a laxative to decrease constipation which is the cause of your analifissure.

(check my resources for the most recommended laxative for IBS-constipation).

 

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. It is caused by a faulty immune response to your gut cells and bacteria. 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).

Intestinal obstruction is a medical emergency. It occurs when your colon or, more commonly, the small intestine gets obstructed. 

The most common causes of intestinal obstruction are:

  • Most commonly (60%): Fibrous adhesions around your bowel loops (especially if you have previous operations inside your abdomen).
  • When a bowel loop is stuck inside a hernia.
  • A block by a cancer mass like colon cancer.
  • Volvulus: when stomach or intestine twists around itself.

This bowel obstruction prevents stool from passing through your colon, leaving mucus secreted by your colon to pass alone during poop.

Symptoms and how it is different from IBS mucus:

  • The main symptom of intestinal obstruction is “absolute constipation”; when you poop, you only pass clear mucus without a stool (unlike mucus in stool with IBS).
  • Usually associated with severe distension, abdominal cramps.
  • Persistent vomiting usually occurs as the food is unable to pass.

What to do:

If you have the triad of (absolute constipation + persistent vomiting + absolute constipation), you should consult your doctor immediately.

This is a medical emergency and usually requires surgical intervention to treat the cause.

MORE: Clear White Mucus In stool: 6 Causes explained.

(Q3) when should I worry/consult my doctor?

Mucus in stool with IBS is usually a benign condition that is a part of your IBS. If you habitually pass mucus in stool with IBS attacks, you don’t have to worry.

The mucus in stool with IBS is usually clear white, or yellow. It is not associated with blood or pus. 

Consult your doctor if you experience one of the 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 analicanal during defecation (analifissure).
  • Diarrhea with mucus that awakens you after sleeping.
  • Persistent vomiting.
  • Weight loss, anemia.
  • Recent antibiotic use.
  • Passage of mucus without stool with severe distension and persistent vomiting (intestinal obstruction).

All the above-listed flags don’t naturally occur with IBS mucus. Instead, they indicated that the underlying cause of mucus in stool is not your IBS.

If you don’t experience any of the above red flags, then the mucus in your stool is primarily due to IBS. 

(Q4) How to prevent and treat mucus in stool with IBS?

Mucus in stool with IBS is commonly associated with IBS diarrhea, and its treatment is no different from the usual treatment of IBS-D.

The 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 IBS-Diarrhea symptoms like:

  • Diarrhea and mucus in stool.
  • Abdominal cramps.
  • Bloating and distension.
  • Tenesmus.

You can try to restrict diets high in FODMAPs like:

mucus in stool with ibs: low fodmap

Instead, you can try these diets that are low in FODMAPs:

mucus in stool with ibs: low fodmap

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.

All we know is that probiotics containing “Bifidobacteria” and combinations of multiple strains have better results. But remains lots to be studied about the perfect types, dosing, and duration.

the standard rules to take probiotics:

1- only choose probiotics containing strains that research has proved its efficacy.

2- take probiotics that contain combinations of different strains in total doses.

3- Adhere to one type of probiotics for 3 to 4 weeks; if no improvement, you can shift to another kind (trial and error).

4- only choose established brands from a quality manufacturer.

Check My resources page for the best probiotics recommendation.

C- Try Peppermint Oil (over the counter supplement):

Peppermint oil is one of the most widely used over the counter drugs for IBS

It is also known for its good safety profile. Pharmacists think that the soothing effects of peppermint oil are due to a substance called menthol.

How to 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 is specifically beneficial in IBS diarrhea.

It also helps to reduce IBS gas and bloating.

When to take peppermint oil

Many clinical trials studied the antispasmodic effects of peppermint oil. Most of them concluded that people menthol could be used as a first-line therapy or for abdominal pain.

This is because of its efficacy and in the safety of the drug over 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.

For more information and my recommended peppermint oil: check my resources page

D- Take Loperamide (ImmodiumⓇ) to stop IBS-diarrhea with mucus:

Loperamide or Imodium is the go-to drug used for diarrhea.

It is an extraordinarily safe drug that is used for people with IBS predominant diarrhea.

How Imodium works

It decreases the movement of your interest, 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 the mixed type of IBS where there is constipation alternating with diarrhea

When not to take Imodium:

  • If you have IBS constipation.
  • Better not use with 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 is 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.

Check Resources pages for more information and recommendation about loperamide.

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, he will prescribe medications that may be more effective for your condition.

The treatment of IBS is highly individualized, and what applies to a specific patient may not apply to you.

Conclusion:

Mucus in stool is with IBS may be a typical sign. But it is usually get confused with other conditions that may be similar to the IBS attack.

This table summarizes these conditions and how to differentiate between each of them:

conditions How to diagnose
Mucus in the stool with IBS attacks If you habitually pass mucus in stool with IBS attacks.
More common with IBS-diarrhea
Mucus: clear white or yellow.
Not associated with blood or pus.
No fever, vomiting, night diarrhea.
Bacterial gastroenteritis mucus in stool Unusually severe abdominal cramps: not related to meals and can awaken you from sleep.
More severe diarrhea not related to food (can occur at any time.
Mucus: may be associated with blood (dysentery).
Fever: It may be a high-grade fever (exceeds 40° c).
Analifissure mucus in stool Intense pain during defecation.
More familiar with IBS-Constipation.
The mucus in stool: usually passes at first, then the stool or is mixed.
Mucus in the stool may be associated with bright red blood due to bleeding from the fissure.
IBD (inflammatory bowel disease) mucus in stool IBD is associated with diarrhea mainly; 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.
Intestinal obstruction The main symptom of intestinal obstruction is “absolute constipation”;
you only pass clear mucus without a stool (unlike mucus in stool with IBS).
Usually associated with severe distension, abdominal cramps.
Persistent vomiting usually occurs as the food is unable to pass.

MORE:

  • Evidence-based
  • Written by a doctor.

MD, Associate Lecturer of Gastroenterology and hepatology. An IBS sufferer, gut health enthusiast and writer.
Dr. I. Farahat
Dr. I. FarahatAuthor

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