Constipation and Gastrointestinal Issues: A Comprehensive Guide

Bowel issues and gastrointestinal problems?

Date of onset: Early May to present
Symptoms: Constipation, thin stools
Weight: 42.2 kg
I started experiencing constipation about a month ago, and while it has improved somewhat, I still have some symptoms of constipation (taking 5 to 10 minutes or more to have a bowel movement).
I can go 2 to 3 days without a bowel movement and feel no urge, although my abdomen is not distended.
When I do go to the bathroom, I can pass a normal amount of stool.
I would like to consult a doctor regarding the following specifics:
1.
Out of 10 bowel movements, about 9 require some straining, even maximum effort, to pass.
The stools are often too hard to expel, but I have been straining less recently.
2.
There is no bloating in the lower abdomen, but I experience slight difficulty passing gas.
There is no blood in the stool or streaks of blood; the stools are all a normal brown color.
A very small number of larger stools have slight black spots (very few), and there are no soft stools.
Occasionally, after a bowel movement, there is mucus or brown translucent gel-like material on the toilet paper (mostly from the rectum feeling the high temperature of the stool).
The stools almost always sink to the bottom of the toilet, and I experience bloating in the upper abdomen along with frequent burping.
3.
The stools vary in thickness.
In the last 10 bowel movements, there was: 1 instance of strong urge with no constipation feeling, very smooth (normal thickness, 3 pieces); 1 instance of constipation with mushy stools; and 8 instances of soft stools that were warm and had to be pushed out hard, resulting in thin, elongated shapes (the thinnest being the diameter of a finger).
4.
There is no obvious distension in the abdomen.
I can feel a long, cord-like structure in the sigmoid colon area (covering the entire sigmoid colon region).
This does not disappear before or after a bowel movement, and pressing does not create an urge to defecate, with no significant pain.
5.
For the past month, I have had to exert effort to have a bowel movement, which has also caused me to forcefully empty my bladder.
I now have a persistent discomfort near the sigmoid colon, kidneys, and prostate (which was not present in the two weeks prior to this issue).
Dietary habits: High intake of oils (salad oil), no fried foods, high sugar intake, low meat/fruit, high vegetables/eggs/grains, and low fluid intake.

Lifestyle: Occasionally irregular routine, no alcohol consumption, smoking, little exercise, and moderate to low sleep quality.
I have not had a stool test or colonoscopy in recent years.
In February, I had an upper endoscopy, which confirmed a duodenal ulcer and Helicobacter pylori infection, for which I took strong antibiotics for two weeks.
Regarding what I did before these symptoms occurred: The only difference was that I went running two days prior, which caused severe cramping pain in the lower left abdomen (as I usually do not exercise).
There were no other unusual activities.
What should I do now, doctor?

Bai, 20~29 year old female. Ask Date: 2019/06/08

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Eat more fruits and vegetables, stay adequately hydrated, avoid fried and spicy foods, and seek medical attention from a gastroenterologist if necessary.

Reply Date: 2019/06/08

More Info

Understanding gastrointestinal issues, particularly constipation, can be quite complex, especially when accompanied by other symptoms. Based on the information provided, it appears you are experiencing a combination of constipation, changes in stool consistency, and some discomfort in the abdominal region. Let's break down your symptoms and discuss potential management strategies.

Symptoms Overview
1. Constipation: You mentioned experiencing constipation for about a month, with infrequent bowel movements (every 2-3 days) and difficulty passing stools. This is characterized by the need to exert significant effort to have a bowel movement, which can be frustrating and uncomfortable.

2. Stool Characteristics: Your stool varies in consistency, with some being normal and others being hard or even resembling a "thin pencil." The presence of mucus or semi-transparent gel-like substances on the toilet paper can indicate irritation in the rectal area, which may occur due to straining.

3. Abdominal Discomfort: Although you do not report significant bloating, you do mention a feeling of discomfort in the lower abdomen, particularly around the sigmoid colon area. This could be related to the straining and the nature of your bowel movements.

4. Diet and Lifestyle Factors: Your diet appears to be high in oils and sugars, with low intake of fruits and vegetables. Additionally, you noted low hydration levels and irregular physical activity, which are significant contributors to constipation.

Potential Causes
Given your history of a duodenal ulcer and Helicobacter pylori infection, it’s important to consider how these conditions might interact with your gastrointestinal symptoms. Stress, dietary habits, and lifestyle choices can exacerbate gastrointestinal issues. The recent increase in physical activity may also have contributed to your symptoms, especially if your body is not accustomed to it.

Management Strategies
1. Dietary Adjustments:
- Increase Fiber Intake: Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stool and promote regular bowel movements. Consider foods like oats, beans, apples, and leafy greens.

- Hydration: Increase your water intake to at least 8-10 glasses a day. Proper hydration is crucial for softening stool and facilitating easier passage.

- Limit Processed Foods: Reduce your intake of high-sugar and high-fat processed foods, which can contribute to constipation.

2. Regular Physical Activity:
- Incorporate regular exercise into your routine. Even simple activities like walking can stimulate bowel function and help alleviate constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Establish a Routine:
- Try to set a regular 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. Over-the-Counter Remedies:
- If dietary changes are insufficient, consider using over-the-counter laxatives or stool softeners as a temporary measure. However, consult with a healthcare provider before starting any new medication.

5. Stress Management:
- Since stress can exacerbate gastrointestinal symptoms, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your daily routine.

6. Follow-Up with Healthcare Provider:
- Given your history of gastrointestinal issues, it’s essential to maintain regular follow-ups with your healthcare provider. They may recommend further evaluation, such as a colonoscopy, especially since you have not had one in several years.

Conclusion
In summary, your symptoms suggest a combination of functional gastrointestinal issues, likely exacerbated by dietary and lifestyle factors. By making dietary adjustments, increasing physical activity, and establishing a regular bowel routine, you can significantly improve your symptoms. However, it is crucial to stay in touch with your healthcare provider to monitor your condition and make any necessary adjustments to your treatment plan. If symptoms persist or worsen, further investigation may be warranted to rule out any underlying conditions.

Similar Q&A

How to Effectively Manage Chronic Constipation and Digestive Issues

Hello Doctor: I have been experiencing long-term constipation issues, having a bowel movement every two to three days, or sometimes even longer. Occasionally, I also have diarrhea, and during bowel movements, I feel a tearing sensation in my anus, sometimes accompanied by slight ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, constipation is a common issue among women, often related to poor gastrointestinal motility and can also be influenced by menstrual flow. It is recommended to use stool softeners and increase your intake of fruits, vegetables, and fiber, along with drinking plenty of water...

Dealing with Constipation: Tips for Gastrointestinal Health

I'm sorry, doctor. Currently, I can only sit while using the toilet, but since mid-June, I have been experiencing difficulty with bowel movements. I visited a colorectal surgeon who prescribed a laxative for me, but after taking it last night before bed, there was no improve...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Constipation requires identifying the underlying causes, such as excessive intake of greasy foods, insufficient hydration and fiber intake, hard stools, and difficulty in bowel movements. Inadequate physical activity can affect intestinal motility. Dysregulation of the autonomic ...

Understanding Constipation: Causes and Solutions for Digestive Health

Hello. I have recently experienced a decrease in stool volume and unformed stools for almost two weeks. I have since increased my intake of fruits, vegetables, and fluids, as well as enzymes, but the problem persists. What could this condition be, and how can it be resolved?

Dr. Lin Minghui reply Gastroenterology and Hepatology
1. Maintaining good lifestyle habits is important. Increase fiber intake to 20-30 grams per day along with adequate hydration. Establish regular bowel habits and engage in moderate exercise consistently to improve bowel issues. 2. If stool volume is low and not well-formed, it is...

Understanding Gastrointestinal Issues: Managing Stress and Digestive Health

Hello, doctor... Recently, I've been experiencing a lot of academic pressure, but I'm eating regular meals and including vegetables in my diet. However, I haven't been drinking enough water and haven't been exercising much. Since the start of the semester, I&#...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Increase your intake of fruits and vegetables, take a walk after meals, reduce prolonged sitting, and observe the results. If necessary, consider having a laxative on hand.