Changes in Stool Size: When to Seek Medical Advice - Gastroenterology and Hepatology

It feels like my stool has become thinner?

I generally have a bowel movement every morning, and I consume a lot of dietary fiber and drink plenty of water.
However, for the past month, I've been experiencing some constipation and have to strain to pass stool.
Additionally, I feel a strange sensation in my anus, as if something is stuck, and I have the urge to defecate when sitting down.
The symptoms lessen when I walk, but this has only been happening for three days.
Ever since I started eating sweet potatoes for breakfast three weeks ago, my bowel movements have been very smooth, taking less than a minute.
However, the width of my stool is not normal, which concerns me.
On days when I consume more meat, my stool tends to be even thinner, which confuses me.
Although I consulted a doctor who diagnosed me with irritable bowel syndrome, the medication hasn't shown significant effects, and my stool remains narrow, about slightly thicker than a marker.
I would like to ask the doctor what the normal width of healthy stool should be, as I haven't seen any wide stools in over a month.

Mao Laoshi, 20~29 year old female. Ask Date: 2019/02/07

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Basically, if the narrowing of stools is related to colorectal cancer, there are two points to consider.
First, the change in stool caliber does not occur suddenly; it typically takes several months.
Second, once the stools become narrow, they will not return to a normal size; they will only continue to become thinner.

Reply Date: 2019/02/07

More Info

Understanding changes in stool size and consistency can be a source of concern for many individuals, especially when accompanied by symptoms such as constipation or discomfort. Based on your description, it seems that you have been experiencing a few notable changes in your bowel habits, particularly after incorporating sweet potatoes into your diet. Let's break down the factors at play and when it might be necessary to seek further medical advice.

Firstly, it's important to recognize that stool size and shape can vary significantly based on diet, hydration, and overall gastrointestinal health. A healthy stool is typically well-formed, smooth, and can vary in size, but it should generally be about the width of a banana or a bit thicker. If your stools are consistently narrower than this, it could be indicative of a few potential issues.

The fact that you mentioned experiencing a sensation of something being "stuck" in your rectum, along with the need to strain during bowel movements, raises a few flags. This could suggest the presence of a blockage or narrowing in the rectal area, which might be caused by various factors, including hemorrhoids, anal fissures, or even more serious conditions such as rectal polyps or tumors. While these conditions are not common, they should not be overlooked, especially if you notice persistent changes in your bowel habits.

Your mention of a diagnosis of irritable bowel syndrome (IBS) is also relevant. IBS can lead to a variety of symptoms, including changes in stool consistency and frequency, abdominal pain, and discomfort. However, IBS typically does not cause significant changes in stool width. If your symptoms are not improving with standard treatments for IBS, it may be worth discussing with your healthcare provider whether further investigation is warranted.

In terms of dietary influences, sweet potatoes are high in fiber, which can help promote regular bowel movements. However, if you are experiencing a change in stool width after increasing your intake of certain foods, it may be beneficial to keep a food diary to identify any correlations between your diet and bowel habits. Additionally, consuming a diet high in meat can sometimes lead to harder, narrower stools, as meat is lower in fiber compared to plant-based foods.

Given that you have been experiencing these symptoms for over a month, and considering the changes in stool size and the sensation of blockage, it would be advisable to seek further medical evaluation. A healthcare professional may recommend additional tests, such as a colonoscopy, to rule out any structural abnormalities or other underlying conditions that could be contributing to your symptoms.

In summary, while changes in stool size can be influenced by diet and lifestyle, persistent changes, especially those accompanied by discomfort or other symptoms, should not be ignored. It is essential to communicate openly with your healthcare provider about your concerns and to advocate for further evaluation if necessary. Maintaining a balanced diet, staying hydrated, and monitoring your symptoms closely will also be beneficial in managing your gastrointestinal health.

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