Digestive Issues: From Diarrhea to Constipation - Gastroenterology and Hepatology

Bowel movement issues

I used to have daily bowel movements without paying attention to the appearance of my stool.
Last week, after possibly consuming spoiled food, I experienced severe diarrhea, to the point where it was more than urination.
After taking medication similar to loperamide, the diarrhea stopped.
However, in the following days, I experienced loud and frequent bowel sounds, and I went two days without a bowel movement.
I felt the urge to defecate but could only pass gas.
Later, I noticed symptoms resembling an impending menstrual period, but my period did not come, and it shouldn't be due at this time.
Over the past two days, my stools have been thinner.
What could be the issue? (I have been following a ketogenic diet and have been losing weight.)

Bu, 20~29 year old female. Ask Date: 2020/03/28

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Ms.
BU, your symptoms are likely a post-gastroenteritis condition.
Please monitor your situation for a few days, and if your bowel movements do not return to normal, please visit the gastroenterology department at the internal medicine clinic.
Thank you for your inquiry, and Changhua Hospital cares about your health.

Reply Date: 2020/03/28

More Info

Digestive issues can be quite complex and may arise from various factors, including dietary changes, infections, and underlying health conditions. Based on your description, it seems you have experienced a significant shift in your bowel habits, transitioning from regular daily bowel movements to experiencing diarrhea followed by constipation. This pattern can be indicative of several potential issues.

Initially, the diarrhea you experienced after consuming possibly spoiled food suggests an acute gastrointestinal disturbance, likely due to foodborne pathogens. Common culprits include bacteria such as Salmonella, E. coli, or viruses like norovirus. Diarrhea is the body's way of expelling harmful substances, and it can lead to dehydration if fluid loss is significant. The use of medications like loperamide (similar to Pepto-Bismol) can help manage diarrhea, but it’s essential to ensure that the cause of diarrhea is not an infection that requires further medical attention.

After the diarrhea subsided, you mentioned experiencing loud bowel sounds and a feeling of incomplete evacuation, which can be signs of constipation. Constipation can occur for various reasons, including dehydration, dietary changes (such as the introduction of a ketogenic diet), and changes in gut motility. The ketogenic diet, which is low in carbohydrates and high in fats, can lead to changes in bowel habits, particularly if fiber intake is insufficient. It's crucial to ensure adequate hydration and consider incorporating fiber-rich foods or supplements to help maintain regular bowel movements.

The fact that you experienced a delay in menstruation could also be related to stress on your body from dietary changes or gastrointestinal distress. Stress, whether physical or emotional, can impact hormonal balance and menstrual cycles. If your menstrual cycle is irregular or delayed, it may be worth consulting a healthcare provider to rule out any underlying issues.

The presence of thin stools can indicate several things, including dietary changes or potential issues with the colon. Narrow stools can sometimes be a sign of an obstruction or other gastrointestinal issues, so if this persists, it would be advisable to seek medical evaluation.

In summary, your symptoms suggest a possible acute gastrointestinal disturbance followed by constipation, likely exacerbated by dietary changes and possibly stress. Here are some recommendations to help manage your symptoms:
1. Stay Hydrated: Ensure you are drinking plenty of fluids, especially if you have experienced diarrhea. Electrolyte solutions can also be beneficial.

2. Dietary Adjustments: If you are on a ketogenic diet, consider incorporating more fiber-rich foods or supplements to help with bowel regularity. Foods like avocados, nuts, and seeds can be good options.

3. Monitor Symptoms: Keep track of your bowel habits, dietary intake, and any other symptoms you may experience. This information can be helpful for healthcare providers if you need to seek further evaluation.

4. Consult a Healthcare Provider: If your symptoms persist, worsen, or if you experience additional concerning symptoms (such as severe abdominal pain, blood in stool, or prolonged constipation), it is essential to consult a healthcare professional for a thorough evaluation.

Digestive health is vital for overall well-being, and addressing any issues early can help prevent more significant problems down the line.

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