Can floating stools and fatigue signify a digestive problem?

Question

Hello doctor,

For the past month, my stool has been floating. It is in normal color. I have no other problems or pains except for a little fatigue. I had an abdominal ultrasound, which was normal. The amylase, lipase, and bilirubin tests, as well as ALT and AST, are normal. Should I be worried, and do I need any other tests and checks?

Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Thank you for sharing these details. Here is a breakdown of your situation:

Floating stools are usually caused by increased gas content in the stool, which can occur from:

Dietary factors: High fiber intake, carbonated drinks, or eating more fats than usual.
Malabsorption: If your stool is also greasy or foul-smelling, this might indicate fat malabsorption (steatorrhea), as seen in conditions like pancreatic insufficiency (though normal amylase and lipase make this less likely), celiac disease, and small intestine issues (like bacterial overgrowth).

However, if your stool is normal in color, not oily or greasy, and you have no weight loss, diarrhea, or other GI (gastrointestinal) symptoms, it is usually benign.

Tests: Normal amylase, lipase, bilirubin, ALT (alanine aminotransferase), AST (aspartate aminotransferase), and a normal abdominal ultrasound suggest that there is no significant liver, bile duct, or pancreas disease at play.

Fatigue: Mild fatigue can have many causes that are not necessarily related to your GI tract. Stress, poor sleep, or minor infections can cause it.

The next steps you can follow are:

Reassurance: In most cases, a floating stool alone is not worrisome.
Diet review: Consider your diet. Taking increased fiber or fats can cause this.
Monitor symptoms: Watch for new symptoms like weight loss, persistent diarrhea, pale, greasy, foul-smelling stools, severe fatigue, and abdominal pain.
Celiac disease check: If you have a family history or symptoms like bloating, diarrhea, or weight loss, you might consider checking for celiac disease (anti-tTG (tissue transglutaminase) antibodies or EMA (anti-endomysial) antibodies).

Right now, with normal tests and no significant symptoms, you likely do not need any further testing. If symptoms persist or worsen, or if you develop new issues (like weight loss or diarrhea), see your doctor for additional workup, which might include:

Stool fat analysis.
Celiac screening.
Microscopy for parasites (if you had travel or dietary changes).
Blood tests for anemia or thyroid issues (if fatigue persists).

I hope this helps you.

Thank you.