Answers
Loose motions for weeks, or mucus in stool: what does it mean?
Short answer
Loose motions lasting more than four weeks are chronic diarrhoea, and they need a cause found. Common causes are IBS, lactose intolerance, long-standing infections such as giardia or amoeba, celiac disease, medicines, thyroid problems, and inflammatory bowel disease. Some mucus in stool is common with IBS, but mucus with blood, weight loss or night-time motions needs tests.
Common causes
- IBS with diarrhoea: urgency and loose motions, often with stress, without blood or weight loss
- Lactose intolerance or celiac disease
- Infections such as giardia, amoeba or, in India, intestinal TB
- Medicines, including some diabetes medicines, antacids with magnesium and antibiotics
- Ulcerative colitis, Crohn's disease or microscopic colitis
- Thyroid overactivity, pancreas problems, or diarrhoea after gallbladder removal
About mucus
The bowel normally makes some mucus. Visible mucus is common in IBS and after infections. Mucus with blood, pain, fever or loose motions that wake you at night suggests inflammation, such as colitis, and needs a colonoscopy.
Tests
- Blood tests: blood counts, thyroid, celiac antibody, inflammation markers
- Stool tests: microscopy for parasites, and calprotectin to look for inflammation
- Colonoscopy with biopsies, which also finds microscopic colitis and TB
- Sometimes an upper endoscopy, breath tests or a CT scan
Warning signs
See a doctor soon for blood in the stool, weight loss, motions that wake you at night, fever, anaemia, symptoms starting after age 45 to 50, or a family history of bowel cancer or IBD. Drink ORS to avoid dehydration while the cause is being found.
Diet while the cause is being found
Eat more
- ORS, coconut water, chaas and soups to replace fluid
- Light food: khichdi, curd rice, idli, banana, boiled potato
- Soluble fibre such as isabgol, which can firm loose stools
Cut down
- Milk, if loose motions worsen after it
- Sugar-free sweets with sorbitol, and very sweet drinks
- Fried, very spicy food and alcohol
Good to know
- Keep a short food and symptom diary to show your doctor.
- Do not cut out many foods at once before tests, especially wheat, as it can hide celiac disease.
Common questions
Can stress cause loose motions for months?
Yes, in IBS, stress can trigger urgency and loose motions. But other causes should be ruled out first, especially if there are warning signs.
Is mucus in stool always a sign of disease?
No. Small amounts are normal, and more is common in IBS. Mucus with blood or pain needs tests.
Will I need a colonoscopy?
Often, if loose motions last more than a few weeks, especially with blood, weight loss or age over 45. It allows biopsies that find conditions not seen by eye.