Weekly Diarrhea: Causes and Solutions for Digestive Health

Diarrhea once a week?

Hello Doctor: Since I had diarrhea after drinking yogurt two months ago, my bowel movements have been softer for the past two months.
Recently, I have been experiencing diarrhea once a week for the past month (with watery stools), and it occurs at the same time, lasting for 2 to 3 consecutive times.
Before the diarrhea, I feel a slight pain in my abdomen, and I can sense bowel sounds and movement.
The next day, I experience some constipation, but by the second day, my bowel movements return to normal.
I usually do not have abdominal pain or blood in my stools.
Sometimes, I feel bowel sounds and movement in my abdomen.
I have visited a clinic and seen a doctor at a medical center, as well as consulted a traditional Chinese medicine practitioner.
They all seem to suggest irritable bowel syndrome and have prescribed anti-inflammatory medications.
While I am on medication, my condition is normal, but as soon as I stop taking the medication, I experience diarrhea again the next day or within 2 to 3 days.
I was considering whether I need to undergo a colonoscopy.
I had one three years ago, during which a 0.4 cm polyp was removed.
In mid-December 2020, I had another colonoscopy, where three small polyps (the largest being 0.4 cm) were also removed.
The doctor at the medical center mentioned that there shouldn't be any issues within 2 to 3 years after a colonoscopy, and the clinic doctor also believes that another one is unnecessary.
Additionally, my bowel habits are about twice a day, sometimes three times.
The stool color is usually yellow or brown, and during diarrhea, it is yellow.
Furthermore, I typically do not pass gas, only before having a bowel movement.
I am unsure of the cause of these symptoms, and it has been quite distressing.
Could you please help clarify this for me? Thank you.

Gordon Hong, 50~59 year old female. Ask Date: 2021/10/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely a case of abnormal gastrointestinal motility (irritable bowel syndrome), which can be managed with dietary adjustments, lifestyle changes, and medication.

Reply Date: 2021/10/08

More Info

Understanding the causes of recurrent diarrhea, especially when it occurs weekly, can be quite complex. Based on your description, it seems that you are experiencing a pattern of diarrhea that is accompanied by mild abdominal discomfort and a sensation of bowel movement without significant pain or blood in the stool. This pattern, along with your history of gastrointestinal issues, suggests a few potential underlying causes.

One of the most common reasons for recurrent diarrhea, especially after consuming certain foods like yogurt, could be related to food intolerances or sensitivities. Lactose intolerance, for instance, is a condition where the body cannot properly digest lactose, a sugar found in milk and dairy products. If you experienced diarrhea after consuming yogurt, it might indicate that your body is having difficulty processing lactose, leading to gastrointestinal symptoms.
Another possibility is Irritable Bowel Syndrome (IBS), which is characterized by a combination of symptoms including abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). IBS can be triggered by various factors, including stress, certain foods, and hormonal changes. The fact that your symptoms improve with medication but recur after stopping suggests that there may be a functional component to your digestive issues, which is typical of IBS.

Additionally, your history of polyps and previous colonoscopies raises the question of whether there could be any underlying structural issues, although your doctors have indicated that your colonoscopy results are normal for the time being. It’s important to note that while polyps can be a concern, the recurrence of diarrhea in the absence of other alarming symptoms (like blood in the stool or severe pain) is less likely to be related to polyps.

In terms of management, it’s crucial to maintain a food diary to identify any potential triggers for your diarrhea. This can help you pinpoint specific foods that may be causing your symptoms. Additionally, consider dietary adjustments, such as reducing lactose-containing foods if you suspect lactose intolerance, or following a low-FODMAP diet, which has been shown to help many individuals with IBS.

Hydration is also key, especially when experiencing diarrhea. Ensure you are drinking plenty of fluids to prevent dehydration. Electrolyte solutions can be beneficial if diarrhea persists.

Since you mentioned that your symptoms improve with medication, it may be worth discussing with your healthcare provider the possibility of a long-term management plan that includes dietary changes, stress management techniques, and possibly a maintenance medication that can help manage your symptoms more effectively.

Lastly, if your symptoms continue or worsen, or if you develop new symptoms such as significant weight loss, persistent abdominal pain, or changes in your stool color or consistency, it would be prudent to seek further evaluation, potentially including repeat imaging or more specialized gastrointestinal testing.

In summary, while your symptoms are concerning and warrant attention, they may be manageable through lifestyle and dietary modifications, along with appropriate medical treatment. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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