Bowel Issues: Causes and Solutions for Constipation - Surgery

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Bowel issues


Hello, Doctor.
I would like to ask about some recent issues I've been experiencing.
I've been having difficulty with bowel movements; my stools have been harder, and I've noticed a little blood when wiping.
Recently, when I try to go, the stools are not much and are long and thin, with a darker color similar to diarrhea.
I find myself needing to wipe many times before feeling clean, and afterward, I experience a burning sensation around the anus.
I'm worried about possibly damaging the area from excessive wiping.
Could this indicate a gastrointestinal issue? Should I consider taking probiotics or yogurt to help with digestion? I'm particularly concerned about hemorrhoids, as I've been trying to eat more fruits and drink more water.
I'm unsure what else I can do to make my bowel movements more regular.
Thank you for your response, Doctor.

vivi, 40~49 year old female. Ask Date: 2018/09/27

Dr. Ke Fangxu reply Surgery


This situation is likely due to hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing the intake of dietary fiber and probiotics can also be beneficial.
Warm sitz baths may help alleviate symptoms, and you can purchase hemorrhoid suppositories at the pharmacy.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2018/09/27

More Info


Understanding bowel issues, particularly constipation, can be quite complex, as they often involve a combination of dietary, lifestyle, and physiological factors. Based on your description, it seems you are experiencing a range of symptoms that could be indicative of constipation, possibly exacerbated by dietary habits and stress.

Constipation is typically defined as having fewer than three bowel movements per week, and it can be characterized by hard, dry stools that are difficult to pass. The symptoms you mentioned, such as hard stools, blood during wiping, and a feeling of incomplete evacuation, are common indicators of constipation. The presence of blood can be particularly concerning, as it may suggest irritation or injury to the anal area, possibly due to straining or passing hard stools.

The fact that your stools are described as "thin and long" could indicate that your bowel is not functioning optimally. This can happen when there is a lack of fiber in the diet, insufficient hydration, or even due to stress and anxiety, which can affect gut motility. Additionally, the "spicy" sensation you feel around the anus may be a result of irritation from hard stools or excessive wiping, which can lead to anal fissures or hemorrhoids.

To address your concerns, here are several strategies you can consider:
1. Dietary Adjustments: Increasing your intake of dietary fiber is crucial. Aim for a variety of fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up the stool and makes it easier to pass. The recommended daily intake of fiber is about 25 grams for women and 38 grams for men.
2. Hydration: Drinking plenty of water is essential for preventing constipation. Aim for at least 8-10 cups of water per day. Proper hydration helps soften the stool, making it easier to pass.

3. Probiotics: Incorporating probiotics into your diet, such as yogurt or fermented foods, can help promote a healthy gut microbiome. This can improve digestion and may alleviate some symptoms of constipation.

4. Regular Exercise: Physical activity can stimulate bowel movements. Aim for at least 30 minutes of moderate exercise most days of the week.

5. Routine: Establishing a regular bowel routine can help. Try to set aside time each day to sit on the toilet, even if you don’t feel the urge to go. This can help train your body to have regular bowel movements.

6. Stress Management: Since stress can significantly impact gut health, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your daily routine.

7. Over-the-Counter Remedies: If dietary changes do not improve your symptoms, you might consider over-the-counter laxatives or stool softeners. However, these should be used sparingly and not as a long-term solution.

8. Medical Evaluation: If your symptoms persist, worsen, or if you notice significant blood in your stool, it is essential to consult a healthcare professional. They may recommend further evaluation to rule out conditions such as hemorrhoids, anal fissures, or more serious gastrointestinal issues.

In conclusion, while your symptoms may be indicative of constipation, it is essential to approach this issue holistically, considering both dietary and lifestyle factors. By making some adjustments and monitoring your symptoms, you can often find relief. However, do not hesitate to seek medical advice if your symptoms do not improve or if you have any concerns about your health.

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