Differential Diagnosis for Floating Stool
- Single most likely diagnosis
- Malabsorption (e.g., celiac disease, pancreatic insufficiency): Floating stool is often associated with malabsorption of fats, which can lead to an increase in gas production and a decrease in stool density, causing it to float.
- Other Likely diagnoses
- Gastrointestinal infection (e.g., giardiasis): Certain infections can lead to malabsorption and gas production, resulting in floating stool.
- Lactose intolerance or other carbohydrate malabsorption: Undigested carbohydrates can be fermented by colonic bacteria, producing gas and leading to floating stool.
- Small intestine bacterial overgrowth (SIBO): Excessive bacterial growth in the small intestine can lead to malabsorption and gas production.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intestinal obstruction or ileus: Although less common, floating stool can be a sign of an underlying obstruction or ileus, which requires prompt medical attention.
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause malabsorption, diarrhea, and floating stool, and require timely diagnosis and treatment.
- Rare diagnoses
- Whipple's disease: A rare bacterial infection that can cause malabsorption and floating stool.
- Short bowel syndrome: A condition characterized by a significant loss of intestinal tissue, leading to malabsorption and potentially floating stool.
- Carcinoid syndrome: A rare condition caused by a neuroendocrine tumor, which can lead to diarrhea and floating stool due to the production of vasoactive peptides.