Incomplete Bowel Movements: Causes and Solutions

Incomplete bowel evacuation?

Hello, I have had poor lifestyle habits and a fondness for fried foods, which led to discomfort in my stomach and diarrhea last year.
After undergoing an endoscopy, I was diagnosed with gastroesophageal reflux disease (GERD) and gastritis.
A stool occult blood test returned normal results.
After my doctor prescribed medication, those issues resolved.
However, a few months later, I suddenly experienced increased sensitivity in my intestines, with a lot of gas and gurgling sounds.
Not long after, I found myself passing gas frequently, sometimes multiple times a day, which continued for several days.
I also had a sensation of urgency to have a bowel movement, but felt incomplete after defecating.
Typically, I have the most bowel movements in the morning, and afterward, it tends to be sporadic.
I often feel as though I need to pass stool.
I am wondering if this could be a sign of rectal dysfunction.
I do not experience any abdominal pain or cramping.
I even purchased a stool occult blood test kit from a pharmacy, and the results were normal as well.
However, I have noticed that after wiping, there has been some blood, which I am unsure if it is related to hemorrhoids causing the sensation of urgency.
When I consulted my doctor, they only mentioned that it was related to lifestyle and dietary habits and did not prescribe any medication.
The doctor also suggested that if I was still concerned, I could undergo a colonoscopy.
Do you think that is necessary? I usually feel the urge to defecate more when lying down, and it tends to disappear when sitting.
The urge also diminishes temporarily after passing gas.

Lin Tongxue, 20~29 year old female. Ask Date: 2017/04/04

Dr. Ke Fangxu reply Surgery

This situation is likely due to swollen hemorrhoids, which are often caused by prolonged straining during bowel movements.
It is recommended to avoid constipation during this period and to limit the time spent on the toilet to no more than ten minutes.
Warm sitz baths may also help alleviate symptoms.
You can purchase hemorrhoid suppositories at the pharmacy for relief, but it's best not to use stool softeners indiscriminately.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2017/04/04

More Info

Understanding incomplete bowel movements can be a complex issue, often involving a combination of physiological, dietary, and psychological factors. Based on your description, it seems you are experiencing a range of symptoms that could be linked to several underlying causes, including dietary habits, gastrointestinal motility issues, and possibly even stress or anxiety.

Potential Causes of Incomplete Bowel Movements
1. Dietary Factors: Your history of consuming a diet high in fried foods may have contributed to your gastrointestinal issues. A diet lacking in fiber can lead to constipation and incomplete bowel movements. Fiber is essential for adding bulk to the stool and promoting regular bowel movements. It is recommended to increase your intake of fruits, vegetables, whole grains, and legumes, which can help improve bowel function.

2. Gastrointestinal Motility: The sensation of incomplete evacuation could be linked to altered bowel motility. Conditions such as irritable bowel syndrome (IBS) can cause symptoms like gas, bloating, and a feeling of incomplete evacuation. This condition is often exacerbated by stress and dietary choices. The "gurgling" sounds you hear may indicate increased bowel activity, which can be a normal response to certain foods or stress.

3. Rectal Sensitivity: The feeling of needing to pass stool even after a bowel movement may be related to rectal sensitivity or issues such as rectal prolapse or hemorrhoids. Hemorrhoids can cause discomfort and bleeding during bowel movements, which may lead to a heightened awareness of bowel sensations.

4. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function. The mind-gut connection is well-documented, and stress can lead to increased bowel activity or altered sensations in the gastrointestinal tract. If you find that your symptoms worsen during stressful periods, this could be a contributing factor.

Recommendations for Management
1. Dietary Adjustments: Focus on a high-fiber diet to promote regular bowel movements. Aim for at least 25-30 grams of fiber per day. Incorporate foods like oats, beans, lentils, fruits, and vegetables. Additionally, ensure you are drinking enough water, as hydration is crucial for digestive health.

2. Regular Exercise: Physical activity can stimulate bowel function and help alleviate symptoms of constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Establish a Routine: Try to establish a regular bowel routine by setting aside time each day for bowel movements, ideally after meals when the gastrocolic reflex is strongest. This can help train your body to have more regular bowel movements.

4. Stress Management: Consider incorporating stress-reduction techniques such as mindfulness, yoga, or meditation into your daily routine. These practices can help alleviate anxiety and improve overall gastrointestinal function.

5. Medical Evaluation: Given your concerns about rectal bleeding and the sensation of incomplete evacuation, it may be prudent to follow up with a healthcare provider. A colonoscopy can be a valuable tool for ruling out any serious conditions, especially if you have a family history of gastrointestinal diseases or if your symptoms persist despite lifestyle changes.

Conclusion
In summary, the sensation of incomplete bowel movements can stem from various factors, including dietary habits, gastrointestinal motility issues, and psychological stress. By making dietary adjustments, increasing physical activity, and managing stress, you may find relief from your symptoms. However, if your symptoms persist or worsen, seeking further medical evaluation is advisable to rule out any underlying conditions. Remember, maintaining open communication with your healthcare provider is essential for addressing your concerns effectively.

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