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Stools - floating

Definition

Stools that float are usually due to poor absorption (malabsorption) of nutrients or excessive gas (flatus).

Alternative Names

Floating stools

Considerations

Floating stools are seen in a variety of different situations. Most are diet-related, or occur during a gastrointestinal infection. A change in diet can lead to an increase in the amount of gas produced by the bacteria found in the (healthy) gastrointestinal tract.

Acute gastrointestinal (GI) infections also can result in increased gas in the intestines, due to rapid movement of food through the GI tract. One wrong idea is that floating stools are caused by an increase in the fat content of the stool. In fact, it is increased gas in the stool that makes it less dense and allows it to float.

Increased levels of nutrients in the stool that have not been absorbed by the GI tract supply the normal bacteria that live in the gut. These bacteria, in turn, produce more gas. This results in more gas-rich stools that float.

Common Causes

Dietary changes, diarrhea, and malabsorption can cause floating stools. Most causes are harmless and the floating stools will go away by themselves when the infection ends or the normal bacteria in the GI tract adjust to the changes in the diet.

Home Care

Floating stools alone do not indicate an illness or problem, and they do not require home care. If a change in diet has caused problems, try to find and eliminate the offending food.

Call your health care provider if

It is important to discuss a change in stool characteristics with a doctor if it continues for more than a couple of weeks. If blood, fever, or dizziness accompanies these changes, consult a doctor immediately.

What to expect at your health care provider's office

A health care provider will normally take a family history and disease history, and will perform a physical examination.

A stool sample and blood tests may be requested. In most cases, however, these tests will not be needed.

You may be asked the following medical history questions:

• When did you first notice the floating stools?
• Does it happen all the time or from time to time?
• What is your basic diet?
• Does a change in your diet change your stools?
• Do you have other symptoms?
• Are the stools foul smelling?
• Are the stools an abnormal color (especially pale or clay-colored stools)?

Treatment depends on the specific diagnosis. Strictly follow your health care provider's instructions, including diet recommendations.

References

Bailey J. FPIN's Clinical Inquiries: Effective management of flatulence. Am Fam Physician. 2009;79:1098-1100.

Ohge H, Levitt MD. Intestinal gas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier;2006: chap 10.