Digestive Health: When to See a Gastroenterologist - Gastroenterology and Hepatology

Bowel movement questions

Since childhood, I have had a tendency to experience diarrhea.
I have experienced every type of stool according to the Bristol Stool Chart.
I used to love eating meat, but later switched to a diet primarily consisting of vegetables and some fiber supplements that can be mixed with water for health reasons.
However, recently, for over two weeks, I have been unable to identify my stool type according to the Bristol classification.
Currently, my stool is soft, segmented, about the length of a thumb or index finger, roughly the thickness of two fingers, with about four or five pieces.
It is not smooth and appears to have jagged edges.
The color varies from light to dark brown, and sometimes it contains remnants of food I previously ate, including red bits (I think I had carrots before) and green bits.
There are also occasional black bits mixed in.
Most of the time, the stool is formed, but when flushed, it disintegrates (is this normal?).
Additionally, I am not sure about the frequency of flatulence; it occurs about once or twice a day, sometimes in succession, but it is not foul-smelling, just a bit noisy.
Lastly, I drink more than 2000 cc of water daily.
I generally enjoy drinking water, but sometimes I still feel thirsty even after drinking.
Which specialty should I consult for this?

Xiao Yuan, 30~39 year old female. Ask Date: 2020/06/01

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 30-year-old female with questions about bowel movements.
She has a tendency towards diarrhea but has recently described her stools as types 2 and 3 on the Bristol Stool Chart, with multiple soft stools.
She usually consumes fiber and experiences flatulence.
She drinks enough fluids, and it is generally advised to maintain adequate hydration and fiber intake to promote healthy bowel habits.
It's important to pay attention to eating habits, avoiding eating too quickly, not talking while eating, and reducing the intake of carbonated beverages, sweets, and gas-producing foods to alleviate bloating.
She often experiences dry mouth, so it's essential to ensure adequate fluid intake.
When taking fiber supplements, it is important to increase water intake.
Some medications can cause dry mouth.
Dry mouth can also be associated with certain metabolic disorders and autoimmune diseases.
If abnormal stools, bloating, and dry mouth persist, it is recommended to consult a family physician, internist, or gastroenterologist.
Wishing you peace and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/06/01

More Info

When it comes to digestive health, understanding when to see a gastroenterologist is crucial, especially if you have a history of gastrointestinal issues. Based on your description, it seems you have been experiencing a range of symptoms related to your bowel movements and overall digestive function.
Firstly, let’s break down your symptoms. You mentioned that you have a history of diarrhea and have recently altered your diet to include more vegetables and fiber supplements. Your stool characteristics, as described, suggest a mix of normal and abnormal findings. The Bristol Stool Chart is a useful tool for categorizing stool types, and while you’ve indicated that your stool doesn’t fit neatly into one category, it’s important to note that variations can occur based on diet, hydration, and other factors.

The fact that your stool is often soft, segmented, and occasionally contains food remnants could indicate a few things. It may suggest that your digestive system is not fully breaking down food, which can happen for various reasons, including insufficient digestive enzymes or rapid transit time through the intestines. The presence of different colors and textures in your stool, such as green or red remnants, could be linked to the foods you consume, like carrots, which can impart a reddish hue, or leafy greens, which can cause greenish stools.

You also mentioned that you drink over 2000cc of water daily, which is generally a good practice for maintaining hydration and supporting digestive health. However, if you still feel thirsty, it could be a sign of an underlying issue, such as diabetes or another metabolic condition, which warrants further investigation.

Given your symptoms—irregular bowel habits, changes in stool appearance, and persistent thirst—it would be advisable to consult a gastroenterologist. They specialize in diagnosing and treating conditions related to the gastrointestinal tract, including the esophagus, stomach, intestines, liver, and pancreas.
During your visit, the gastroenterologist may conduct a thorough evaluation, including a detailed medical history and physical examination. They might recommend tests such as blood work, stool analysis, or imaging studies to rule out conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or malabsorption syndromes.
Additionally, if you experience any alarming symptoms such as significant weight loss, persistent abdominal pain, blood in your stool, or changes in appetite, it is crucial to seek medical attention promptly. These could be signs of more serious conditions that require immediate intervention.

In summary, while some variations in bowel habits can be normal, your ongoing symptoms and changes in stool characteristics suggest that it would be prudent to see a gastroenterologist. They can provide a comprehensive assessment and guide you toward appropriate treatment options, ensuring that your digestive health is managed effectively. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek help when needed.

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