— Arlene, Florida Since fat is lighter than water, floating stools are most commonly an indication of a high fat content in the stool. Floating stools can occur normally depending on the fat content of the diet we ingest; each of us has only a certain amount of capacity to digest fats. However, any condition that impairs fat absorption may lead to more floating stools due to high fat content. These conditions include celiac disease, bacterial overgrowth, and chronic pancreatitis. While pancreatic cancer can develop in people with chronic pancreatitis, floating stools would be an unusual way for this disease to present. If you have seen a recent increase in the number of passed stools that float, you may want to see your doctor to measure the amount of fat actually present in your stools. If this is high, he should perform tests to see if you have any of the common causes of fat malabsorption, such as those noted above. Q2. What are the possible reasons for passing mucus in your bowel movements? — Arthur, Ohio Mucus normally lines the large intestine and is a normal component of bowel contents. While most people do not notice the passage of small amounts of mucus, certain conditions lead to increased mucus passage with bowel movements. Of these, irritable bowel syndrome (IBS), which affects approximately 15 percent of the U.S. population, can be accompanied by visible mucus along with other symptoms of abdominal bloating and changes in the frequency of bowel movements. The inflammatory bowel diseases ulcerative colitis and Crohn’s disease, bacterial infections, anal fissures, and the very uncommon condition called solitary rectal ulcer syndrome are also frequently associated with visible mucus. The mucus itself is not harmful, but I would recommend consulting your physician if you note an increase of mucus with your bowel movements. Q3. I noticed a little bit of blood in my stool; should I worry now or wait and see if it continues? I have a history of hemorrhoids. — Crystal, Tennessee While hemorrhoids are by far the most common cause of bright red blood in the stool, you should see your doctor if this is the first time that you’ve noticed blood. Hemorrhoids that bleed are often the result of swollen blood vessels inside the rectum, so you may not be able to detect them when you are wiping. Hemorrhoids are very common during and after pregnancy, and in people who are constipated or have liver disease or any condition that increases pressure in the abdomen, or who engage in an activity such as weight lifting. Nevertheless, bleeding may represent something more serious, so you should see your doctor to find out whether you need further testing. Q4. I have had bleeding from hemorrhoids and anal fissures for four years because of constipation. What do you think is the best treatment for this condition? Hemorrhoids, remarkably common in Western countries, are swollen blood vessels in the area of the anus. They are typically associated with conditions that increase abdominal pressure, including constipation, pregnancy, heavy weight lifting, and even obesity. Anal fissures (small tears in the anal verge) are less common but are associated with the same conditions. The best way to treat your hemorrhoids and fissures is to treat your constipation. If routine measures such as increasing fluid intake, engaging in aerobic exercise, and increasing dietary fiber are not sufficient, you should see a gastroenterologist to consider medications such as lactulose or Miralax (now available over the counter). If this does not improve the bleeding, you may need to have your hemorrhoids surgically treated. Learn more in the Everyday Health Digestive Health Center.
