Changes in Bowel Habits: What You Need to Know - Gastroenterology and Hepatology

Bowel movement issues

Hello Doctor, I have recently noticed changes in my bowel habits.
I usually have a bowel movement around noon and again in the evening, but lately, the amount has decreased.
The stools are neither thick nor thin, but they are shorter in length compared to before, when I would have larger stools.
I'm not sure what's going on.
I am an athlete and exercise daily.
Recently, I have been experiencing either very small stools or just one larger one, but not as substantial as before.
It's not diarrhea, as the shape is still visible.
Previously, I would use several wipes to clean myself thoroughly after a bowel movement, sometimes even causing minor bleeding from wiping too much.
Now, I only need to use 3 or 4 wipes, and I feel clean.
However, my abdomen feels noticeably bloated, and I'm worried about what might be wrong.
I've been drinking more water and eating fruit with my meals, hoping it would help, but it hasn't improved, which makes me anxious.
Last night, I felt like I could have a large bowel movement, but it turned out to be many small pieces instead, which is frustrating.
I tend to spend a long time on the toilet, often looking at my phone.
When I'm at home, I wash my bottom with body wash after using the toilet to ensure cleanliness.
I would like to ask the doctor what might be causing this issue and how I can improve it quickly.

luó mào, 10~19 year old female. Ask Date: 2021/05/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

As long as there is only a change in the shape of the stool without any bleeding or weight loss, it can be monitored further.

Reply Date: 2021/05/08

More Info

It's great that you're taking the time to understand your bowel habits and seeking advice on how to improve them. Changes in bowel habits can be concerning, especially when they deviate from what is considered normal for you. Based on your description, it seems like you are experiencing a few different issues: a change in the size and consistency of your stools, abdominal bloating, and some discomfort during bowel movements.

Firstly, it's important to recognize that bowel habits can vary widely from person to person, and what is normal for one individual may not be for another. However, there are some general guidelines that can help you assess whether your bowel habits are within a healthy range. The Bristol Stool Chart is a useful tool that categorizes stool types from 1 (hard lumps) to 7 (liquid). Ideally, you want your stools to be in the range of types 3 to 5, which are considered normal and healthy.

From your description, it sounds like your stools have become smaller and more fragmented, which can be indicative of a few potential issues. One common cause of changes in stool size and consistency is dietary fiber intake. Fiber is crucial for maintaining healthy bowel movements, as it adds bulk to the stool and helps it pass more easily through the intestines. Since you mentioned that you are eating fruits and drinking more water, it might be beneficial to assess the overall fiber content of your diet. Aim for a variety of fiber sources, including whole grains, legumes, fruits, and vegetables. The recommended daily intake of fiber is about 25 grams for women and 38 grams for men.

Another factor to consider is your hydration status. While you mentioned that you are drinking more water, it's essential to ensure that you are adequately hydrated throughout the day. Dehydration can lead to harder stools, making them more difficult to pass. A good rule of thumb is to drink enough water so that your urine is light yellow in color.

You also mentioned experiencing abdominal bloating and discomfort, which could be related to several factors, including diet, stress, or even the way you are sitting on the toilet. Spending a long time on the toilet, especially while distracted by your phone, can sometimes lead to straining and may contribute to discomfort. It might be helpful to limit the time you spend on the toilet and to focus on relaxing your body during bowel movements.

If you are experiencing pain or bleeding during bowel movements, it's essential to consult a healthcare professional. While occasional discomfort can be normal, persistent pain or bleeding should not be ignored, as it could indicate an underlying issue that needs to be addressed.

In summary, here are some steps you can take to improve your bowel habits:
1. Increase Fiber Intake: Aim for a variety of fiber-rich foods, including fruits, vegetables, whole grains, and legumes.

2. Stay Hydrated: Ensure you are drinking enough water throughout the day to keep your stools soft.

3. Limit Time on the Toilet: Try to avoid spending excessive time on the toilet, as this can lead to straining.

4. Monitor Your Diet: Pay attention to any foods that may be causing bloating or discomfort and consider keeping a food diary to identify patterns.

5. Consult a Healthcare Professional: If your symptoms persist or worsen, seek medical advice to rule out any underlying conditions.

Remember, it's never too late to make positive changes to your diet and lifestyle. By being proactive about your health, you can improve your bowel habits and overall well-being.

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