Changes in Bowel Movements and Gas: A Guide for Patients

Issues with bowel movements and flatulence?

I have been dealing with hemorrhoids for almost ten years, and it wasn't until the fourth year that I went to see a doctor.
The doctor said I was too late for treatment and that I have mixed hemorrhoids, along with a narrow anal canal, which causes anal fissures.
Generally, my hemorrhoids are not painful, but I do have issues with anal fissures.
Since developing hemorrhoids, my bowel movements have changed; they no longer come out in long shapes but rather in many small segments, which are also thinner.
To improve my constipation, I started training myself to use the bathroom every morning.
Now, I can go once every 1 to 2 days.
However, I've noticed that since I adjusted to a regular morning schedule for bowel movements, I tend to pass gas a lot in the evenings—it's loud and frequent, but almost odorless, unless I have a stomachache, in which case the gas has a smell.
I'm unsure if the changes in my stool becoming thinner and the increased flatulence are normal...
After researching online, I'm a bit worried...
I would appreciate your response.
Thank you.

Lu Lu, 20~29 year old female. Ask Date: 2016/10/10

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hemorrhoids may recur even after surgery, so they can accompany you for a lifetime.
Hemorrhoids can be treated by a colorectal surgeon.
For constipation issues, it is advisable to eat more fruits and vegetables and to reduce the intake of fried and spicy foods.
Excessive gas is often due to gastrointestinal bloating, and unpleasant odors are a result of fermentation, which generally indicates poor digestive function.

Reply Date: 2016/10/10

More Info

Understanding changes in bowel movements and gas can be quite complex, especially for patients with a history of conditions like hemorrhoids and anal fissures. Your experience with mixed hemorrhoids and the resulting anal fissures can certainly contribute to changes in your bowel habits and the characteristics of your stool.

Firstly, it’s important to understand that hemorrhoids can affect the shape and consistency of your stool. When you have hemorrhoids, especially if they are mixed (both internal and external), the discomfort or fear of pain during bowel movements can lead to changes in how you pass stool. This can result in smaller, more fragmented stools, as you might subconsciously alter your bowel habits to avoid pain. The fact that your stools are no longer in a long, cylindrical shape is not uncommon for individuals with hemorrhoids or anal fissures. The narrowing of the anal canal due to the presence of hemorrhoids can also contribute to this change.

Regarding your bowel movement frequency, training yourself to have a regular morning routine is a positive step. Regular bowel habits can help prevent constipation and reduce the strain during defecation, which is crucial for managing hemorrhoids and preventing further fissures. However, if you are experiencing bowel movements every 1-2 days, it’s essential to ensure that your stool is soft and easy to pass. Hard or dry stools can exacerbate your anal fissures and lead to pain.

The increased flatulence you are experiencing, especially if it is loud and frequent but mostly odorless, can be attributed to several factors. Changes in diet, the introduction of more fiber, or even the way you are swallowing air while eating can lead to increased gas production. It’s also worth noting that certain foods, particularly those high in fiber, can lead to increased gas as they are fermented in the intestines. If you notice that the gas is accompanied by pain or changes in your bowel habits, it might be worth discussing with your healthcare provider.

In terms of whether your symptoms are normal, it’s essential to consider the context. While changes in stool shape and increased gas can be common in individuals with hemorrhoids and fissures, persistent changes or new symptoms should always be evaluated by a healthcare professional. If you are experiencing significant discomfort, changes in your bowel habits, or any other concerning symptoms, it’s advisable to seek medical attention.

To manage your symptoms, consider the following recommendations:
1. Dietary Adjustments: Continue to consume a high-fiber diet, which includes fruits, vegetables, and whole grains. This can help soften your stool and promote regular bowel movements. However, be mindful of foods that may cause excessive gas, such as beans, lentils, and certain cruciferous vegetables.

2. Hydration: Ensure you are drinking plenty of water throughout the day. Adequate hydration is crucial for maintaining soft stools.

3. Regular Exercise: Physical activity can help stimulate bowel movements and reduce constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Avoid Straining: When you do have a bowel movement, try to relax and avoid straining, as this can worsen hemorrhoids and fissures.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and characteristics of your gas and stool. If you notice any concerning changes, consult your healthcare provider.

6. Consult a Specialist: If your symptoms persist or worsen, consider seeing a gastroenterologist or a colorectal specialist. They can provide a thorough evaluation and recommend appropriate treatments, which may include topical treatments for hemorrhoids or other interventions.

In conclusion, while some changes in bowel movements and gas can be normal, especially with a history of hemorrhoids and anal fissures, it’s essential to remain vigilant about any new or worsening symptoms. Regular follow-ups with your healthcare provider can help ensure that your condition is managed effectively and that any potential complications are addressed promptly.

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