Irregular Bowel Movements: Causes and Concerns - Gastroenterology and Hepatology

Bowel Movements and Gastrointestinal Issues

Hello, Doctor: I have a habit of using the restroom in the morning, but my bowel movements are quite irregular.
I notice three different types of stools.
The first type is unformed, but it is not like diarrhea; the stool does not mix with water, yet it sinks to the bottom without any shape.
The second type is thin stools (and in small amounts), but they are not pencil-thin; they are about half the thickness of normal stools.
The third type is normal stools that occasionally appear (about 1-2 times a month), and they are usually a solid, healthy-looking shape, but sometimes they appear fluffy, and when I flush, they break apart.
Additionally, if I have fewer bowel movements for a few days (the second type or no bowel movement), I start to experience mild abdominal pain, frequent gurgling sounds in my stomach, and increased flatulence, followed by more intense pain and then diarrhea.
After the diarrhea, the abdominal pain subsides.
This cycle has been repeating for a year and a half.
Doctor, could you please tell me what might be going on? Could it be colon cancer? Thank you for taking the time to respond.

Xiao Ming, 10~19 year old female. Ask Date: 2020/02/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may just be irritable bowel syndrome; if you're concerned, you should see a doctor and get a stool occult blood test.

Reply Date: 2020/02/05

More Info

It sounds like you are experiencing a range of gastrointestinal symptoms that can be concerning and disruptive to your daily life. Based on your description, you have irregular bowel movements characterized by three different types of stool consistency, along with abdominal pain and changes in bowel habits. Let's break down your symptoms and explore potential causes, as well as when it might be necessary to seek medical attention.

Understanding Your Symptoms
1. Irregular Stool Consistency:
- The first type of stool you describe sounds like it may be a sign of incomplete digestion or a change in gut motility. This can occur due to various factors, including diet, hydration levels, and stress.

- The second type, which is thin and small, could indicate a narrowing of the bowel, which can sometimes be associated with conditions like irritable bowel syndrome (IBS) or even more serious conditions like strictures or tumors.

- The occasional normal stool is a positive sign, but the fact that it appears "hairy" and breaks apart easily could suggest that it is not being formed properly due to a lack of fiber or hydration.

2. Abdominal Pain and Bloating:
- The abdominal pain you experience after a few days of irregular bowel movements could be due to increased gas production and intestinal cramping. This is common in individuals with IBS or other functional gastrointestinal disorders.

- The cycle of constipation followed by diarrhea (often referred to as "diarrhea-predominant IBS") is a recognized pattern in IBS, where the bowel alternates between different states of motility.

3. Concerns About Serious Conditions:
- Your concern about colon cancer is understandable, especially given the changes in your bowel habits. While your symptoms could be indicative of IBS or another functional disorder, it is essential to rule out any serious conditions, particularly if you have a family history of gastrointestinal diseases or if you notice any alarming symptoms such as significant weight loss, blood in your stool, or persistent changes in your bowel habits.

When to Seek Medical Attention
Given that your symptoms have persisted for over a year and are causing you discomfort, it is advisable to consult with a healthcare professional, particularly a gastroenterologist. They can perform a thorough evaluation, which may include:
- Medical History and Physical Examination: Discussing your symptoms in detail, including any dietary habits, stress levels, and family history of gastrointestinal diseases.

- Diagnostic Tests: Depending on your symptoms, tests such as a colonoscopy, stool tests, or imaging studies may be recommended to rule out any underlying conditions.

- Dietary Assessment: A registered dietitian can help assess your diet and suggest modifications to increase fiber intake and hydration, which may help improve your bowel regularity.

Conclusion
In summary, while your symptoms may be indicative of a functional gastrointestinal disorder like IBS, it is crucial to seek medical advice to rule out any serious conditions, including colorectal cancer. Early intervention can lead to better management of your symptoms and improve your quality of life. Make sure to document your symptoms, including their frequency and any associated factors, to provide your healthcare provider with a comprehensive overview during your visit.

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