Concerned About Undigested Pills in Stool?

It's a very common but embarrassing inquiry. Patients who see medication in their stool might wonder if it means something wrong with her digestion. If you are taking medications for high blood pressure, diabetes, or even for colon cancer pain, it is disconcerting to see them where they don't belong—in your toilet.

Sometimes It's Easily Explained

Seeing unabsorbed medications in your stool does not necessarily mean that there is anything wrong with your colon or digestion. Pharmaceutical companies make many different types of medication coatings from extended-release coatings to cellulose capsules. In most cases, the body is absorbing the medications as it should and expelling the shell of the medication.

Long-acting or extended-release capsules have a special outer coating designed to be absorbed slowly. While the medication may be released, the shell may remain intact and be refilled with liquids from your intestinal tract.

It's similar to the digestion of corn kernels—your body digests the inner grain of corn, but the tough, fibrous husk is expelled. The liquids and waste from your body refill the corn husk—and likewise some medication "husks"—making them appear full and unabsorbed.

There is a simple way to determine if this is the case. If the medications are working or doing what they are prescribed to do, then you are most likely just seeing the empty capsule in your stool. For instance, if you are taking medications for diabetes and your blood sugar remains within a normal range, there is a good chance the medications are getting absorbed properly. When in doubt, talk to your doctor about your concerns. He or she can tell you if this is fairly normal or expected with the specific medication you are taking or prescribe an alternate for you.

Absorption Concerns

In rare cases, there is a legitimate reason to have a concern if you see medications in your bowel movement. If the medications are moving through your system too fast or not being absorbed appropriately, there is a chance that you will see the whole tablet or capsule in the toilet. Most commonly this would occur if you have diarrhea, as the intestinal contents are dumped rapidly into your colon. There are many causes of diarrhea, some of which are fairly common including:

  • Gastrointestinal viruses
  • Food intolerances
  • Lactose intolerance
  • Irritable bowel syndrome
  • Inflammatory bowel disease
  • Celiac disease
  • Crohn's disease
  • New prescriptions

Some of the aforementioned conditions, such as lactose intolerance, IBD, Crohn's, celiac, and AIDS can also result in malabsorption.

If you have problems properly absorbing the medications during periods of severe inflammation and flare-ups, do not delay and talk to your doctor. He or she can prescribe medications to help reduce inflammation and slow down your gastrointestinal system. If you are not absorbing your medications properly then there is a very good chance you are also not retaining necessary nutrients from your food, either.

Read the Medication Pamphlet

Although it is unlikely that taking a medication in the wrong way could cause you to expel it unabsorbed, it is possible. Those pages of information with the tiny print may seem daunting, but there is a sound purpose behind the medication pamphlets you receive with a new prescription. Medications work in a very specific way in your body and some of them come with special rules for proper absorption. For instance, certain medications:

  • Cannot be taken at the same time.
  • Should be administered on an empty (or full) stomach.
  • Should not be taken with specific supplements, such as vitamins.
  • Can not be taken with certain juices, such as grapefruit juice.

If you've already tossed the pamphlet or this is a medication you've been taking for a long time, your pharmacist will be happy to reprint the information for you.

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Article Sources

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  • National Cancer Institute. (n.d.). Diarrhea.

  • National Digestive Diseases Information Clearinghouse. (n.d.). What I Need to Know About Celiac Disease.