Q. I have ribbon-like stools with cramps. Is this a normal occurrence?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 09, 2020

Hello doctor,

I am a 32-year-old woman. I asked a question concerning my stools last week as well, as there was some visible mucus. Since then, the mucus is a lot less, and I was seen by a doctor who performed an anoscopy, which was expected. He told me not to worry. My stools usually are quite well-formed. Last night, however, for the first time, I had ribbon-like stools. The stools were very soft, and I had some cramps. Afterward, I had a little diarrhea. Should I be checked out again, or is this a normal occurrence when stools are soft? I also have some cramps. My white blood cells will always be slightly high. Due to an eye infection, I had one long and one short cycle of antibiotics to clear it up.

Thank you so much in advance.



Welcome to

Yes, I remember about the last time we had a conversation. Anoscopy was expected to be normal since it was only local irritation of the rectal lining due to local trauma, as we discussed last time. I hope you have avoided the rectal temp. I was monitoring afterward. The picture (attachment removed to protect patient identity) of stools you shared seems completely normal. And I assure you not to worry at all.

I might have explained to you that the stool form predominantly depends upon the food we take. I want to share a chart of normal stool form to help you understand how the stool form change from one to another while remaining completely normal. The chart is called the bristol stool chart; this ranges from 1 to 7. Both extremes are abnormal; however, stool score 2 to 6 is normal. So if we classify the form of your stools according to the chart, this is probably 4. And this is normal. You need not see the doctor in person again.

Thank you, doctor, for your reply.

The stools I shared were ones I passed on last week; they were indeed normal. The ones I had yesterday and I am worried about. I did not take a photo of it, but I will attach a photo of similar stools. Do I have to worry when this is a one-off occurrence, and my stools normally look like those I sent previously? Thank you again for your kind help. The attached photo is the one I found on the internet of stools, similar to the ones I had yesterday. Thank you.



Welcome back to

No problem, I am glad that I have been here helping you. You see, the picture (attachment removed to protect patient identity) you attached is more or less similar to the previous picture you attached. They are all normal forms of stools. You need not worry at all. For reference, kindly see the link I shared with you. Have a good day; cherish your life.

Thank you doctor.

I think my anxiety is getting the better of me (again). I cannot thank you enough for being so patient and kind to me. You have not only helped me with my questions but also with my fear of asking questions. Thank you so much. I was worried because they had a ribbon-like shape, and I read that it is associated with colon cancer. They were “flat.” Logically thinking, I think all of my stools would have to be that shape if there was a tumor in the way of their passage. Is this correct? I am adding another (final, so sorry to bother you again) photo I found online of similar stools with that ribbon-like shape, weirdly flat. I appreciate any help you can provide.

Kind regards.



Welcome back to

It is not weird at all. We all are human, and we are all frightened so easily. That is possibly our bad because God has given us a small heart indeed. Your concerns are very valid, and I feel happy when someone is wise enough to look at little changes in our health from normal. I did understand your history, plus stools findings, and finally, with the best of my knowledge, I am undoubtedly sure that you do not have any nasty or ominous thing to worry about. Literature available online is, although useful at times, sometimes misleading and not accurate. We physician often search over the internet and other similar forums, but the difference is that we know what to follow and what not to follow. At the same time, I advise my patients, who interpret the literature with the help of a physician who is an expert.

Hello doctor,

Thank you so much.

This really helped me.



Welcome back to

I have no problem at all you help you. You are welcome.


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