Approximately one-half of all patients with irritable bowel syndrome (IBS) complain of mucus discharge with stools, so the first thought with yellow mucus in your “poop” is IBS. There are other things to consider as well so it’s worth a checkup to help rule out other worrisome causes.

Steps you should take if you have mucus in your stools:

1) “Alarm” symptoms like rectal bleeding, abdominal pain at night, weight loss or laboratory abnormalities such as anemia will likely prompt a quick referral to sigmoidoscopy or colonoscopy.

2) Start with your primary care doctor so they can get a history from you and perform a physical exam.

3) Routine laboratory studies (complete blood count, chemistries) can be done and are normal in IBS.

4) If you have mucus and diarrhea, stool cultures should be done to rule out a gastrointestinal infection (campylobacter, salmonella, shigella, Clostridium difficile, etc) especially if you have had recent travel.

5) Celiac disease (Gluten sensitivity): Screening for celiac disease can be done with blood tests (serum IgA antibody and tissue transglutaminase) and adults who meet criteria for IBS are four times as likely to have Celiac disease.

6) Lactose intolerance should be considered so you should modify your diet and your doctor may consider Lactose breath testing.

7) If the above testing is unrevealing and you have persistent symptoms and/or diarrhea flexible sigmoidoscopy (or colonoscopy) and biopsy should be done.

8) This workup should help rule out organic disease in 95% of patients and if this workup is negative, IBS is more likely. DS has an active and informed IBS community available to answer questions and provide support.

To those patients with IBS, jump in and tell us your experience.

Dr O.