Bowel Movement Changes: When to Seek Medical Advice

Bowel issues

Hello, doctor.
In my twenties, I used to have bowel movements every two to three days, sometimes even every three to four days.
Now, I typically have a bowel movement every one to two days, although I still experience occasional constipation, going two to three days without a bowel movement.
I've noticed that in the past few months, there are times when I have two bowel movements in one day (this might happen once a week or once every two weeks).
When I have two bowel movements in one day, the first one is usually small, pellet-like stools, while the second one is more formed, resembling a log.
Should I be concerned about having two bowel movements in one day? As a breast cancer survivor, I tend to worry a lot about any changes in my body.
Thank you for your help!

Yu, 30~39 year old female. Ask Date: 2020/11/12

Dr. Chen Shidian reply Gastroenterology and Hepatology

There shouldn't be any issues; if you're concerned, you can test for occult blood in the stool.

Reply Date: 2020/11/12

More Info

Understanding changes in bowel movements can be a source of concern, especially for individuals with a history of serious health conditions like breast cancer. It’s important to recognize that bowel habits can vary significantly from person to person and can be influenced by a variety of factors, including diet, hydration, physical activity, and stress levels.

In your case, you mentioned that your bowel movements have changed over time, from having a bowel movement every two to three days in your twenties to now experiencing daily bowel movements, sometimes even twice a day. The consistency of your stools also varies, with the first bowel movement being pellet-like and the second being more formed.

When to Seek Medical Advice
1. Consistency and Frequency: While it’s common for bowel habits to change, it’s essential to monitor the consistency and frequency of your stools. The Bristol Stool Scale is a useful tool for categorizing stool types. Pellet-like stools (Type 1) can indicate constipation, while well-formed stools (Type 3 or 4) are generally considered normal. If you notice a persistent change in your stool consistency or frequency, it may warrant further investigation.

2. Accompanying Symptoms: Pay attention to any accompanying symptoms such as abdominal pain, bloating, changes in appetite, weight loss, or blood in your stool. These symptoms can indicate underlying issues that may require medical attention.

3. History of Cancer: Given your history as a breast cancer patient, it’s crucial to be vigilant about any changes in your body. Cancer and its treatments can affect gastrointestinal function, and new symptoms should always be discussed with your healthcare provider.

4. Duration of Changes: If the changes in your bowel habits persist for more than a few weeks, or if you experience significant discomfort or distress, it’s advisable to consult your physician. They may recommend tests such as a colonoscopy or imaging studies to rule out any serious conditions.

Recommendations for Management
1. Dietary Adjustments: Consider increasing your fiber intake through fruits, vegetables, whole grains, and legumes. Fiber can help regulate bowel movements and improve stool consistency. Additionally, staying well-hydrated is crucial for maintaining healthy bowel function.

2. Physical Activity: Regular exercise can promote healthy digestion and bowel regularity. Aim for at least 150 minutes of moderate aerobic activity each week, along with strength training exercises.

3. Stress Management: Stress can significantly impact bowel habits. Techniques such as mindfulness, yoga, or meditation can help manage stress levels and improve gastrointestinal health.

4. Medication Review: If you are taking medications for your cancer treatment or other health conditions, review them with your healthcare provider. Some medications can affect bowel function, leading to constipation or diarrhea.

5. Regular Check-ups: Regular follow-ups with your oncologist or primary care physician are essential for monitoring your overall health, including gastrointestinal function. They can provide personalized advice based on your medical history and current health status.

In conclusion, while occasional changes in bowel habits can be normal, it’s essential to remain vigilant, especially with your medical history. If you have any concerns or if the changes persist, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and peace of mind are paramount, and proactive management is key to maintaining your well-being.

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