You’ve heard that colon cancer can cause ribbon stools, but IBS can also do this.
“Ribbon stools are not uncommonly seen with IBS, although excluding other causes, such as anatomic problems, inflammatory disease, etc., would be prudent,” says Michael Blume, MD, a gastroenterologist at MedStar Good Samaritan Hospital, Baltimore.
The exclusion process should also include colon cancer, even if you’ve had irritable bowel syndrome for years. IBS does not protect against colon cancer.
How does IBS lead to poops that are shaped like ribbons?
Dr. Blume says, “This usually occurs because if there is spasm in the colon, it may give one the sensation that there may be some obstruction and cause a change in the caliber of the stool.
“When one’s colon goes into spasm, as often occurs in IBS, the muscles in your large intestine constrict.
“Remember that you have muscles in your intestines, also, although they are somewhat different than the ones in your arms and legs that you voluntarily control.”
The type of muscle in your GI tract is called smooth muscle, and the muscle that enables you to bench press a barbell or comb your hair is called skeletal.
Dr. Blume says that when the intestinal muscles constrict, “they cause the diameter of your large intestine to become narrow, and when this occurs, one’s stools may appear narrow.”
It can still be unnerving, though, when you see ribbon stools in the toilet bowl, even if you’ve been diagnosed with IBS.
But if you’ve never had a colonoscopy yet have been diagnosed with IBS, you need to undergo a colonoscopy.
It’s not impossible for someone to hear, “You’re too young to have colon cancer, so you don’t need a colonoscopy; this looks like IBS. So don’t worry about the ribbon bowel movements.”
For a true diagnosis of IBS, all other possible causes of thin narrow stools — no matter how remote — should be ruled out.
Different causes have different treatments. Plus, people in their 20s can get colon cancer.
- 5.1% of U.S. colon cancer cases are in people 35-44.
- 2% are in people 20-34.
- 0.3% are under 20.
Source: The Surveillance Epidemiological and End Results Program
If all you have is IBS causing your long pencil stools, all it takes is a colonoscopy to set your mind at ease.
In practice for 25+ years, Dr. Blume treats over 65 conditions including abdominal pain, appetite loss, blood in stool, celiac disease, colon cancer, esophageal and liver disease, gas and IBS.
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.
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