What Does Flat Poop Mean? Causes & When It’s Serious

Key takeaways:

• While occasional flat stools can be normal, persistent ribbon-like bowel movements may indicate underlying health conditions that require medical evaluation.
• Flat stools accompanied by symptoms like unexplained weight loss, blood in stool, or severe pain require immediate medical attention.
• Most cases of flat stools can be resolved through dietary changes and hydration, but chronic cases should be evaluated to rule out serious conditions.

Changes in stool shape can be an important sign of your digestive health. Flat or ribbon-like stools can often cause concern when people notice this change.

There are many common and benign causes of flat stool. While the causes of flat poop are not always serious, it is essential to understand what causes flat stools and recognize when they might signal a serious underlying health condition that needs immediate attention.

What is ribbon-like, flat poop?

Doctors use the Bristol scale to classify stools. The Bristol scale is based on seven images of different types of stool. Knowing the shape of your stool is essential as it can help your doctor understand what is happening inside your GI tract. A thin, narrow appearance characterizes flat or ribbon-like stools. They are often described as pencil-thin or tape-like rather than the round or oval shape of normal poop.

Is flat poop normal?

While everyone's bowel movements can vary daily, understanding what is normal is essential for monitoring your digestive health. Occasional flat stools might occur due to temporary dietary changes or minor digestive issues, but lasting changes in stool shape should get your attention and possibly medical evaluation.

Normal variations in your poop might occur after you change your diet or when you are under stress. It may also happen when you are dehydrated, if you suddenly change the level of your physical activity, or when you have a temporary GI condition.

Causes of flat poop

It's helpful to consider the causes of flat poop to understand better what might be causing any change in your stool shape and consistency. Some common causes of flat, ribbon-like poop include the following:

Dietary issues and dehydration

A diet high in processed foods and fats and insufficient fluid intake can affect stool formation and lead to a flat or ribbon-like appearance. Common nutritional problems that might cause flat or ribbon-like poop include not drinking enough water, eating a lot of processed food, not getting adequate dietary fiber, and irregular eating habits.

Bowel obstruction and other colorectal conditions

Various lesions that affect the colon and rectum can result in flat stools, including polyps, hemorrhoids, inflammatory bowel disease, diverticulitis, and anal fissures. Tumors are a more serious cause of flat, ribbon-like stools. If your flat stools persist, it is essential to visit your doctor to rule out a tumor in the intestine.

Colorectal cancer is also a concern. Symptoms may include abdominal pain, blood in or on your stool, unexplained weight loss, and bowel changes that can consist of both constipation and diarrhea.

Structural issues

Physical changes or structural abnormalities in the gut can change the shape of your poop.

Structural problems can include tumors outside the GI tract that compress the gut, GI tumors, an enlarged prostate gland in men, pelvic floor issues, and post-surgical changes.

What flat poop may mean based on appearance, consistency, or another symptom or condition

There are a few conditions that can be the cause of your flat poop. For example, people with hemorrhoids may have flat poop due to their hemorrhoids obstructing the rectum and anus. Here are a few situations and the reasons they may cause flat poop:

• Flat poop after being constipated: This can indicate a temporary bowel irritation or a spasm after a bout of constipation.
• Flat poop when you have IBS: Flat poop is typical during IBS flares due to altered gut motility and muscle spasms in the intestine.
• Flat poop when you have hemorrhoids: Flat poop may occur due to pressure from swollen hemorrhoids affecting stool shape.
• Flat poop while pregnant: Flat poop can result from hormonal changes in pregnancy and pressure in the gut from compression by the growing fetus.

Read our guides on different types of stool, stool colors, and healthy vs. unhealthy stool for more.

When to see a doctor about flat poop

Changes in your stool shape can sometimes signal serious health conditions that require medical attention. You can catch potential problems early and improve your health outcome by knowing alarm symptoms when you have flat poop and when to seek professional advice.

You should see a doctor if:

• Flat stools persist for more than two weeks
• You experience unexplained weight loss
• There's a change in bowel habits
• You notice increasing fatigue
• You have persistent abdominal pain
• There's blood in your stool
• You have unexplained weight loss

You should go to the emergency room if:

• You experience severe abdominal pain
• You have persistent vomiting
• There's significant rectal bleeding
• You develop a high fever
• You experience severe weakness or dizziness

Questions to ask your doctor about flat poop

Having a list of questions for your doctor can help you make the most of your appointment. Below are questions you may want to ask if you are seeing your doctor for flat, ribbon-like poop.

• What tests should be conducted to determine the underlying cause?
• Could this be related to any medications I'm taking?
• What dietary changes would you recommend?
• Should I be concerned about colon cancer?

How to stop or treat flat poop

Flat stools often resolve on their own without treatment. If you frequently experience flat stools, you should see your doctor. Depending on the cause, your doctor may suggest dietary changes, lifestyle changes, or medication. The following treatment options may alleviate your symptoms:

Hydration

Dehydration is a common cause of flat poop. Be sure you are drinking at least six to eight cups (eight ounces) of water daily. If you have trouble drinking 64 ounces daily, try infusing fresh fruit or sipping herbal tea.

Staying well-hydrated is one of the most important ways to relieve constipation. Adequate hydration keeps stool soft and eases its passage through the colon to the rectum.

Increase fiber intake

Soluble fiber, which can be digested, helps keep you regular. The body cannot digest insoluble fiber, which can nevertheless be helpful for regular bowel movements.

Foods that are high in fiber add bulk to stool, making the stool easier to pass. Good fiber sources include fruits, vegetables, whole grains, and legumes (beans, lentils, and chia or flax seeds).

Get moving

Physical activity is a natural way to stimulate bowel movements. Even light exercise (like walking or gentle stretching) can help get your digestive system working. Try to move around at least a little every day.

Try the squatting position

Squatting while you poop can help straighten your lower intestine and rectum, making it easier to pass bowel movements. You can do this by placing a small stool under your feet to elevate your knees.

Massage your abdomen

Gently massage your tummy clockwise to stimulate peristalsis, the contractions of muscles surrounding the intestine. Peristalsis moves partially digested food through the gut. Use light pressure and circular motions to massage the abdomen. Focus on your lower abdomen.

Foods that can help with constipation

Several foods can help with constipation. Let's look at a few popular choices:

Prunes

Prunes are natural laxatives that are high in fiber and sorbitol. Sorbitol is a natural sugar alcohol with a mild laxative effect. Fiber draws water into the stool and gives it form, making it easier to pass.

Kiwi

Kiwi fruit is rich in fiber, vitamins, and actinidin, an enzyme that can aid digestion by breaking down proteins in food.

Oats

Soluble fiber is plentiful in oats. Soluble and insoluble fiber can help soften stool and promote regular bowel movements.

Spinach

Spinach is packed with fiber, magnesium, and vitamin C, which can help stimulate bowel function.

Chia seeds

Chia seeds are packed with soluble fiber. They can absorb water and add bulk to stool.

Drinks that can help with constipation

Certain beverages, like the ones below, may also help by increasing hydration or directly stimulating the gastrointestinal tract.

Warm lemon water

Lemon juice is acidic, which can help stimulate bowel movements. Warm temperatures can also help relax the intestines.

Prune juice

Prune juice contains a high amount of sorbitol, making it a natural laxative. Sorbitol is hard to digest, so it draws water into the intestines and facilitates regular bowel movements.

Coffee

Caffeine in coffee is as a mild stimulant, helping to stimulate contractions in the intestines and promote bowel movements.

Herbal teas

Certain herbal teas, such as ginger, peppermint, or fennel, can have a gentle laxative effect and help soothe the digestive system. Caffeine in tea is a mild stimulant in the GI tract.

Over-the-counter remedies for constipation

Over-the-counter medications can be helpful for persistent constipation or symptoms that don’t respond to dietary changes.

Fiber supplements

Fiber supplements, such as psyllium, methylcellulose, or polyethylene glycol, can help add bulk to stool, promoting regular bowel movements.

Stimulant laxatives

Stimulant laxatives, such as senna or cascara, increase the contractions of the intestinal muscles to encourage bowel movements.

Osmotic laxatives

Like magnesium and lactulose, osmotic laxatives draw water into the intestines to soften stool and help get bowels moving.

Stool softeners

Stool softeners (docusate is a popular one) increase the water in the stool, which eases its passage to the rectum.

How to prevent flat poop

Preventing future episodes of flat poop can be as simple as making some key lifestyle changes. Understanding how your lifestyle choices can affect your poop and overall bowel health can make a big difference in managing thin stools. Here's how to maintain healthy habits:

Good nutrition

Eating well plays a crucial role in maintaining a healthy digestive system. You should avoid processed foods and eat a well-balanced diet. Include 25-30 grams of fiber daily in your diet. High-fiber foods include fruits, vegetables, and whole grains. Drink plenty of water during the day to remain hydrated.

Regular exercise

Physical activity supports healthy digestion in several ways. It increases blood flow to your intestines and can contract your intestinal muscles, helping you pass healthy stools. It doesn’t matter whether you swim, walk, or dance.

Moving around will help you stay regular. Core-strengthening exercises can also help improve your digestion. Reducing stress through activities like yoga and gentle stretching is a good idea. Maintaining a healthy weight by regularly exercising will also benefit your digestion.

Healthy bathroom habits

Good bathroom habits can make a big difference in your bowel health. Don’t ignore the natural urge to have a bowel movement, as this can disrupt your regular digestive pattern.

Take enough time for bowel movements, and don’t rush. It helps to establish regular timing for bathroom visits. Using good toileting posture can also be helpful. If you elevate your feet with a stool or have a low toilet, you straighten out the rectum and can quickly empty your bowels.

Frequently asked questions: flat poop

Understanding common concerns about flat stools can help you better manage your digestive health and know when to seek medical attention. Some of the most frequently asked questions about flat poop are answered below.

Can stress cause flat poop?

Yes, stress can affect digestive function and change stool shape. Stress-induced muscle tension and altered gut motility can temporarily result in flat or ribbon-like stools.

Is flat poop a sign of cancer?

While flat stools can be a warning sign of colorectal cancer, many other less serious conditions can cause this symptom. However, persistent flat stools could be a cause for concern. If you have persistent flat poop, see your doctor promptly, especially if you are having other symptoms like abdominal pain or weight loss.

What if you've been experiencing flat poop for months or years?

You should make an appointment with your doctor if you have any chronic changes in your bowel movements. There may be an underlying condition that should be treated. Irritable bowel syndrome can result in flat poop.

Flat poop wrap-up

While flat stools can be worrying, you can manage this condition by understanding the causes of flat poop and knowing when to seek medical care. Most cases can be resolved through lifestyle modifications and proper medical care when necessary. Early intervention is critical when dealing with persistent changes in bowel habits.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

Bellini, Massimo, et al. "Chronic Constipation: Is a Nutritional Approach Reasonable?" Nutrients vol. 13,10 3386. 26 Sep. 2021, doi:10.3390/nu13103386, https://pmc.ncbi.nlm.nih.gov/articles/PMC8538724/.

Elshami, Mohamedraed, et al. "Awareness of colorectal cancer signs and symptoms: a national cross-sectional study from Palestine." BMC Public Health vol. 22,1 866. 30 Apr. 2022, doi:10.1186/s12889-022-13285-8, https://pmc.ncbi.nlm.nih.gov/articles/PMC9063349/.

National Institute of Diabetes and Digestive and Kidney Diseases. “Prostate enlargement (benign prostatic hyperplasia).” September 2014, https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia.

Thompson W. Alarm symptoms: a cause for alarm? International Foundation for Functional Gastrointestinal Disorders, https://iffgd.org/gi-disorders/symptoms-causes/alarm-symptoms/.

U.S. Department of Agriculture and U.S. Department of Health and Human Services. 9th Edition. December 2020. Available at DietaryGuidelines.gov. (n.d.). Dietary Guidelines for Americans, 2020-2025. Home | Dietary Guidelines for Americans. Retrieved November 4, 2024, https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf.

Centers for Disease Control and Prevention. (2024, January 16). Testing and diagnosis for giardia infection. Giardia. https://www.cdc.gov/giardia/testing/index.html.

Constipation. (2018, May 1). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/all-content.

Definition & facts for celiac disease. (2020, October 1). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/definition-facts.