What You Need To Know about Crohn's Disease Poop

Medically reviewed by Kumkum Sarkar Patel, MD

Crohn's disease is a type of inflammatory bowel disease (IBD) that causes inflammation in the digestive tract. This inflammation can affect any part of the digestive tract—from the mouth to the anus—but most commonly involves the small intestine and large intestine (colon).

The symptoms you experience can depend on which part of the gastrointestinal tract is inflamed. A common symptom of Crohn's disease is a change in stool (poop). 

Normal stools are typically brown, shaped like a sausage or snake, and easy to pass. Crohn's disease poop can look and smell different. You might also experience a change in bowel movements, including needing to poop more often.

What Does Crohn's Disease Poop Look Like?

Crohn's disease cycles between periods of remission, where symptoms are minimal or absent, and flare-ups, where inflammation returns and bowel problems worsen. Especially during flare-ups, Crohn's disease can lead to changes in the texture and color of poop. Even poop's smell can change.

Texture

Crohn's' disease poop might be looser than normal poop. The poop can get looser over time for two reasons. One, inflammation in the small intestine makes it harder for the small intestine to absorb nutrients. Two, the large intestine is unable to efficiently absorb water. Your poop might not just become loose and watery (diarrhea), it can sometimes be entirely liquid.

Crohn's disease can also make it difficult for your intestines to absorb fat from the food you eat. Instead, the fat is released through your poop, making the poop loose and oily.

Chronic inflammation sometimes causes strictures, which are areas of narrowing in the intestines from scarring. Narrowed intestines can make it difficult for stool to move through the intestines, leading to constipation. If you are constipated, your poop might be small, hard, and pebble-like.

Color

Stool is usually brown, but Crohn's disease can cause variations in your poop color.

Inflammation can lead to ulcers (open sores) on the intestinal lining, which can cause bleeding from the gastrointestinal (GI) tract. The blood can get mixed into your poop, making your poop look different shades of red or even black.

The color of the blood in your poop can depend on where in the GI tract the bleed is. Bright or dark red streaks or spots of blood in your poop usually mean the bleeding is lower in your GI tract. Stools that appear black and tarry typically mean the bleed is further up in your GI tract.

Inflammation and ulcers also increase mucus production in the digestive tract, leading to yellow or whitish-colored mucus in or surrounding your poop.

Many people with Crohn's disease have difficulty digesting certain foods and nutrients. This can cause your poop to have various colors, depending on what you eat. You may notice bits of undigested food in your poop. For example, your poop may appear green if you ate green vegetables that pass through your digestive tract too quickly. If you have difficulty absorbing fats, your poop may look pale-colored.

Smell

All poop has a smell, which is primarily from the breakdown of food by bacteria in the intestines. In Crohn's disease, an inability for the intestines to properly absorb fat from the food you eat can also affect the smell. In people who have fat malabsorption, stools may be foul-smelling.

How Does Crohn's Disease Affect Your Pooping Habits?

Crohn's disease can affect more than just the way your poop appears and smells. It can also have a significant impact on your bathroom habits. Here are some of the ways your bowel movements might change.

Urgency

Bowel movement urgency—the sudden and immediate need to poop—is a part of life for many people with Crohn's disease. This symptom can be stressful. People who have an urgent need to go to the bathroom report that it impacts their daily activities, including work, school, and socializing.

Frequency

Someone without Crohn's disease may poop anywhere from three times a day to three times a week. If you have Crohn's disease, you might be pooping more or less than that.

In Crohn's disease, it is common to poop more than three times a day. Inflammation in the digestive tract disrupts the normal absorption of foods, fluids, and nutrients, which can lead to diarrhea (having loose, watery stools three or more times a day).

While less common than diarrhea, people with Crohn's disease can also experience constipation (having fewer than three bowel movements a week). Narrowing of the intestines from the buildup of scar tissue can make it harder to poop and cause constipation.

Incomplete Bowel Movements

With Crohn's disease, you might have the sensation of incomplete bowel movements, which is known as tenesmus. This feels like you still need to empty your bowels, even if you've just pooped.

Chronic inflammation can cause narrowing of the intestines and affect the function of the muscles that help move stool through your GI tract. On top of feeling like you need to poop even if there is nothing left to expel, tenesmus can cause abdominal cramping.

Fecal Incontinence

Inflammation associated with Crohn's disease can sometimes damage or impair the muscles and nerves around the rectum and anus, which are responsible for controlling bowel movements. This can lead to fecal incontinence, or the accidental leakage of stool before you can get to a toilet.

Treatment

If your poop has changed in appearance or frequency, it might be a sign your Crohn's disease has flared. Your healthcare provider may need to make changes in your treatment plan to address the flare, which will improve your poop and bowel movements.

While you are in a flare, managing abnormal bowel movements can be frustrating and disruptive to your daily life. Fortunately, there are ways to manage poop issues and improve your comfort and quality of life.

At-Home Management

Healthy lifestyle modifications are an important aspect of managing Crohn's disease. Adopting certain habits can help you manage and reduce the impact of symptoms on your daily life: 

• Make dietary changes: Some people find that certain foods worsen their Crohn's symptoms. A food diary can help you identify foods that may trigger symptoms. Carbonated beverages, popcorn, nuts, vegetable skins, and other high-fiber foods may impact inflammation and symptoms, so you may consider limiting those. Aim to eat several small meals throughout the day rather than three bigger meals.

• Stay hydrated: When you have frequent diarrhea, dehydration is a risk because your body loses too much fluid. Drink plenty of fluids throughout the day to help maintain stool consistency and prevent dehydration.

• Be prepared: Being prepared for poop emergencies can provide peace of mind when the urge to poop comes on suddenly when you're not at home. Keep a well-stocked bag of supplies, including toilet paper, wet wipes, hand sanitizer, air freshener, a spare change of clothes, and a large freezer bag to store soiled clothes, and carry your bag with you when at school, work, or social events.
  

Medical Treatments

Most people with Crohn's disease require lifelong medical treatment. Your healthcare provider will develop a treatment plan to help control inflammation and reduce symptoms and their impact on your quality of life. With proper treatment, many people with Crohn's disease experience periods of little to no symptoms (remission).

A cornerstone of Crohn's disease treatment is medication. Your healthcare provider will likely prescribe medications to control inflammation, reduce the frequency and severity of symptoms, and promote more regular bowel movements.

Many people with Crohn's disease will eventually require surgery to remove the affected sections of their digestive tract. Some people opt for surgery when their symptoms are too much to manage or prescription medications are no longer effective in managing the disease. Others need surgery when they develop complications, such as intestinal obstruction (blockage) or bleeding.

How Can Poop Help in Making a Diagnosis?

Your poop can provide clues for your healthcare provider in the process of diagnosing Crohn's disease. When you visit your healthcare provider, they might ask about the physical characteristics of your poop to determine if it shows signs of intestinal inflammation, such as blood or mucus in your stool. They will also probably ask about your bowel movement habits, such as how often you need to go.

Your poop itself can be tested as part of diagnosing Crohn's disease. A calprotectin stool test measures the levels of a protein called calprotectin in your poop. A small amount of calprotectin in the stool is normal, but high levels signal inflammation in your intestines.

When you have inflammation, your immune system sends neutrophils (white blood cells) to the intestines. The neutrophils release calprotectin, which mixes into your stool. Therefore, high calprotectin levels is a sign there is intestinal inflammation.

When To See a Healthcare Provider

See a healthcare provider if you notice any changes to your poop that seem to stick around. You should also schedule a visit if you have any other symptoms of Crohn's disease, such as:

• Abdominal pain and cramping

• Persistent diarrhea

• Rectal bleeding

• Urgent need to make bowel movements

• Sensations of incomplete bowel movements 
  

People with Crohn's disease require regular check-ups with a healthcare provider to maintain remission and treat symptom flare-ups. Crohn's disease can also lead to complications that require prompt medical attention. See your healthcare provider as soon as possible if you have Crohn's disease and develop:

• Rectal bleeding with blood clots in your stool

• Constant abdominal or rectal pain

• Fever

• Heavy diarrhea

• Persistent constipation

• Nausea and vomiting

• Pus discharge or leaking from your anus

• A swollen, tender lump at the edge of your anus 
  

A Quick Review

Crohn's disease is a chronic inflammatory bowel disease that can change the way your poop looks and smells. Crohn's disease poop may be loose and watery if you have diarrhea or hard and small if you have constipation. Your poop may appear oily or pale. It may also have blood or mucus in it. Sometimes, Crohn's disease poop is foul-smelling.

Besides a change in the poop itself, Crohn's disease may also cause changes in your bowel movement habits, such as having to poop more often.

While your poop alone isn't enough to diagnose Crohn's disease, it can provide important clues about your digestive health since changes in poop may be a sign there is inflammation somewhere in your intestines. If you experience any concerning changes in your poop, consider seeing a healthcare provider. They can take steps to make a diagnosis. If you've already been diagnosed with Crohn's disease, they can discuss treatment plan changes.

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