Bowel Issues: Causes and Solutions for Soft Stools - Gastroenterology and Hepatology

Q: Bowel Issues: Causes and Solutions for Soft Stools

Dear Mr. <br>Jack： It is recommended that you return to the Department of Colorectal Surgery for follow-up to determine if further examinations are necessary. <br>Nantou Hospital cares about you. <br>Dr. <br>Tsai Jin-chi, Director of the Department of Hepatobiliary and Gastroente

Bowel issues

Hello, doctor.
A few years ago, due to stress and an irregular lifestyle, I started experiencing frequent unformed stools, sometimes feeling incomplete after bowel movements, going 3 to 4 times a day.
After turning 45, I began to pay more attention to my health.
Due to prolonged sitting at work and lack of exercise, I developed anal fissures.
Two years ago, I underwent a colonoscopy, which revealed two polyps measuring 0.2 and 0.3 mm, which were removed.
In April of this year, due to fecal occult blood, I promptly had another colonoscopy, which found a 0.4 mm polyp.
During the follow-up visit to discuss the report, in addition to the polyp removal, I was also diagnosed with hemorrhoids, which I now have to coexist with.
Typically, after breakfast, I go to the bathroom, but the amount varies.
However, I still often have unformed stools, sometimes even loose stools, and I am unsure of the cause.
My dietary habits include low meat and low oil intake, avoiding fried foods, and trying to eat vegetables and fruits for at least the past 10 years.
Recently, due to the ongoing soft stool issue, I started taking probiotics for maintenance, but it seems that my bowel problems have not improved.
I usually do not spend more than 3 to 5 minutes on the toilet, but I often feel like I haven't completely emptied my bowels, leading to situations where I go again after 5 to 30 minutes.
I also notice that the initial part of my stool is formed while the latter part is looser and not well-formed.
What could be the issue?

Jie Ke, 40~49 year old female. Ask Date: 2020/06/17

Dr. Cai Jinji reply Gastroenterology and Hepatology

Dear Mr.
Jack: It is recommended that you return to the Department of Colorectal Surgery for follow-up to determine if further examinations are necessary.
Nantou Hospital cares about you.
Dr.
Tsai Jin-chi, Director of the Department of Hepatobiliary and Gastroenterology, Nantou Hospital.

Reply Date: 2020/06/17

More Info

Understanding bowel issues, particularly soft stools, can be complex and multifaceted. Based on your description, several factors may contribute to your condition, including dietary habits, stress, and underlying gastrointestinal issues.

Causes of Soft Stools
1. Dietary Factors: Although you mentioned a diet low in meat and oil, and high in vegetables and fruits, it’s essential to consider the types of fiber you are consuming. There are two types of dietary fiber: soluble and insoluble. Soluble fiber, found in foods like oats, beans, and fruits, can help soften stools, while insoluble fiber, found in whole grains and vegetables, adds bulk. An imbalance in these fibers can lead to softer stools. Additionally, excessive intake of certain vegetables, especially those high in fructans (like onions and garlic) or sorbitol (found in some fruits), can cause gastrointestinal distress and lead to softer stools.

2. Hydration: Adequate hydration is crucial for maintaining stool consistency. Insufficient water intake can lead to dehydration, which may paradoxically cause softer stools as the body attempts to retain water.

3. Gut Health: The use of probiotics is generally beneficial for gut health, but the effectiveness can vary from person to person. If the probiotics you are taking do not contain the right strains for your specific needs, they may not yield the desired results. Additionally, if there is an underlying condition such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), these could also contribute to your symptoms.

4. Stress and Lifestyle: Chronic stress can significantly impact gut health, leading to changes in bowel habits. Stress can alter gut motility, leading to either diarrhea or constipation. Your sedentary lifestyle due to work may also contribute to these issues, as regular physical activity is known to promote healthy bowel function.

5. Previous Medical History: Your history of polyps and hemorrhoids may also play a role. While the removal of polyps is a positive step, the presence of hemorrhoids can lead to discomfort and changes in bowel habits. Additionally, if you have experienced any recent infections or changes in your gut flora, this could also lead to softer stools.

Solutions and Recommendations
1. Dietary Adjustments: Consider keeping a food diary to identify any specific foods that may be triggering your symptoms. Gradually introduce a variety of fiber sources to find a balance that works for you. You might also want to limit high-fructan and high-sorbitol foods if you suspect they are causing issues.

2. Hydration: Ensure you are drinking enough water throughout the day. A general guideline is to aim for at least 8 cups (64 ounces) of water daily, but this can vary based on individual needs and activity levels.

3. Regular Exercise: Incorporate regular physical activity into your routine. Even moderate exercise, such as walking or yoga, can significantly improve bowel function and reduce stress.

4. Stress Management: Engage in stress-reducing activities such as mindfulness, meditation, or yoga. These practices can help improve your overall well-being and may positively impact your gastrointestinal health.

5. Follow-Up with Healthcare Providers: Given your history of polyps and current symptoms, it’s essential to maintain regular follow-ups with your healthcare provider. Discuss your ongoing symptoms and consider further evaluation, such as stool tests or imaging studies, to rule out any underlying conditions.

6. Medication Review: If you are taking any medications or supplements, review them with your healthcare provider to ensure they are not contributing to your bowel issues.

In conclusion, soft stools can result from a combination of dietary, lifestyle, and medical factors. By making informed adjustments to your diet, increasing physical activity, managing stress, and maintaining open communication with your healthcare provider, you can work towards improving your bowel health and overall quality of life.

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