Gastrointestinal Issues: Constipation and IBS Symptoms Explained

Gastrointestinal issues, bowel problems?

Hello, doctor.
In September of this year, I traveled to another city and experienced some difficulty using the toilet, resulting in 1-2 days without a bowel movement, which may have led to constipation.
After that, I started having bowel movements, but initially, the quantity was small, and the stools were often unformed.
I also experienced bloating, decreased appetite, and abdominal rumbling.
Additionally, the stools sank quickly to the bottom after being passed.
After a week of these symptoms, I consulted a traditional Chinese medicine practitioner who diagnosed me with autonomic nervous system dysfunction and irritable bowel syndrome.
After taking medication for 1-2 weeks, the bloating completely improved, my appetite returned, and the abdominal rumbling also improved, but the bowel movement issues persisted.
I have been observing these symptoms for nearly two months now.
Here is a summary of my bowel and gastrointestinal conditions over the past two months:
1.
I have bowel movements about 2-3 times a day.
The process is not completely smooth, but I am able to pass stools.
2.
The stool consistency is variable; sometimes it is soft, sometimes it is thin, sometimes it is thick and hard, sometimes it is long, sometimes it is short, and the color varies from yellow-brown to coffee-colored.
3.
The stools sink immediately to the bottom after being passed, and I can visibly see undigested food remnants.
4.
Recently, after some bowel movements, I noticed mucus (yellow-brown) on the toilet paper when wiping.
5.
There is no blood in the stools, no weight loss, no decreased appetite, no dizziness or anemia, and no fever.
6.
I may experience diarrhea about once every two weeks, accompanied by left lower abdominal pain, which improves after a bowel movement and does not cause further abdominal pain.
7.
Sometimes I feel air moving in my intestines, which prompts me to pass gas (odorless).
8.
Both my stools and gas are odorless.
I do not smoke or drink alcohol, I rarely eat out, and I exercise regularly.
Given that I have researched irritable bowel syndrome and found symptoms similar to those of colorectal cancer, enteritis, and polyps, I am quite concerned.
I would appreciate your advice on this matter.
Thank you.

Crispy, 20~29 year old female. Ask Date: 2021/10/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

It should be a short-term digestive/motility disorder (symptoms lasting over 6 months would be typical of irritable bowel syndrome).
A diet low in oil and dairy, along with medication management, should suffice.

Reply Date: 2021/10/27

More Info

Understanding gastrointestinal issues, particularly those related to constipation and Irritable Bowel Syndrome (IBS), can be quite complex, especially when symptoms overlap with other conditions. Based on the symptoms you've described, it seems that you are experiencing a range of gastrointestinal disturbances that are common in individuals with IBS, particularly after a period of constipation.

Firstly, it's important to recognize that IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and changes in bowel habits (which can include constipation, diarrhea, or alternating between the two). Your experience of irregular bowel movements, along with the presence of mucus in your stool and the sensation of incomplete evacuation, aligns with typical IBS symptoms.

The fact that you experienced constipation during your travels, followed by a return to more regular bowel movements, suggests that your gastrointestinal system may be sensitive to changes in routine, diet, and stress levels. Stress and anxiety can significantly impact gut function, leading to symptoms such as bloating and altered bowel habits. This is often referred to as the gut-brain axis, where emotional and psychological factors can influence gastrointestinal health.

Your observation of varying stool consistency—ranging from soft to hard, and the presence of undigested food particles—can also be indicative of IBS. In IBS, the digestive process can be disrupted, leading to incomplete digestion and absorption of nutrients, which may explain the undigested food remnants in your stool. The presence of mucus is not uncommon in IBS and can occur due to irritation in the intestines.

It's reassuring that you have not experienced alarming symptoms such as blood in your stool, significant weight loss, or fever, which are often red flags for more serious conditions like inflammatory bowel disease (IBD) or colorectal cancer. However, your concerns about the overlap of IBS symptoms with other gastrointestinal disorders are valid, and it’s wise to remain vigilant.

To manage your symptoms effectively, consider the following recommendations:
1. Dietary Adjustments: A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) may help alleviate symptoms. This involves reducing foods that are high in certain carbohydrates that can ferment in the gut and cause gas and bloating. Common high-FODMAP foods include certain fruits (like apples and pears), dairy products, wheat products, and legumes.

2. Regular Meal Patterns: Eating smaller, more frequent meals rather than large meals can help reduce the burden on your digestive system and may alleviate symptoms.

3. Hydration: Ensure you are drinking enough water, especially if you are experiencing constipation. Adequate hydration can help soften stool and promote regular bowel movements.

4. Physical Activity: Regular exercise can help stimulate bowel function and reduce stress, which may improve your overall gastrointestinal health.

5. Stress Management: Since stress can exacerbate IBS symptoms, consider incorporating relaxation techniques such as mindfulness, yoga, or meditation into your routine.

6. Follow-Up with Healthcare Providers: Continue to communicate with your healthcare provider about your symptoms. If your symptoms persist or worsen, further evaluation may be necessary to rule out other conditions.

In summary, while your symptoms are concerning, they are consistent with IBS, especially following a period of constipation. By making dietary and lifestyle adjustments, you may find relief from your symptoms. However, ongoing communication with your healthcare provider is essential to ensure that your condition is managed effectively and to rule out any other potential issues.

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