Both colon cancer and IBS can cause stools to come out like ribbons.

We’ve all heard that thin flat bowel movements are something to be concerned about.

Ribbon Shaped Poops from IBS vs. Colon Cancer: Appearance Comparison

Patients are often concerned about the frequency, shape and texture of their bowel movements,” says Dr. Brian Lacy, MD, of Dartmouth Hitchcock Med Center, who specializes in functional disorders of the gastrointestinal tract and author of “Making Sense of IBS.”

What is a normal stool?

“It is important to first understand what is considered normal with regard to stool frequency,” begins Dr. Lacy.

“A large study performed years ago in Britain determined that the average range of bowel movements is three per day to three per week.

“Stool form can also range from loose to firmer. This depends on a number of factors, including diet, stress, exercise and medications.

Ribbon-like stools can occur in younger patients and generally represent strong contractions of the colon flattening out the stool.

“In the absence of warning signs (low blood count, unintentional weight loss, evidence of blood in the stool or a family history of colon cancer in a first degree relative), the occasional occurrence of ribbon-like stools is usually nothing to be concerned about.

“However, in a patient who is older, or in a patient with warning signs as mentioned above, ribbon-like stools could mean something serious, such as a lesion in the colon.

“This should be discussed with your health care provider who can perform a careful abdominal and rectal exam and order tests as appropriate.”

Comparison of Appearance in the Toilet Bowl of Ribbon Stools from Colon Cancer and Those from Irritable Bowel Syndrome

“Spasm in the colon which can cause a ribbon like stool is common in IBS patients,” explains Dr. Lacy.

“But, the appearance may be the same as someone who has partial obstruction or who has colon cancer.

“However, someone with colon cancer likely has other symptoms (e.g., weight loss, anemia, blood in the stool).

“That is why those are considered warning signs and warrant evaluation and a colonoscopy.”

Dr. Lacy combines his love of science, medicine and people to uncover the causes of symptoms like stomach pain, gas, bloating, diarrhea, constipation and regurgitation. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/Juan Gaertner