Gastrointestinal Issues: Insights on Bowel Health and Diet

Q: Gastrointestinal Issues: Insights on Bowel Health and Diet

Hello Mr. <br>Hsiao： You reported that your bowel habits and frequency have been unstable recently, and you are concerned about the risk of cancer? The risk of colorectal cancer is usually associated with age, a diet high in red meat, smoking, a family history of polyps, and a fa

Gastrointestinal issues

Hello, doctor.
Due to the lockdown caused by the pandemic, since October, I have been experiencing bowel movements 2-3 times a week.
The first one is usually normal (Bristol Stool Type 4), while the second one is diarrhea (Bristol Stool Types 5-6).
This occurs between the morning and noon, while the afternoons and evenings are normal.
I usually work at a gym, where I can reach several thousand steps daily, and I train four times a week.
During the lockdown, I have maintained my exercise routine at home, but my total daily activity may be less than one-third of what it used to be.
The stress from work and concerns about my gastrointestinal health have added to my anxiety, and my sleep quality has not been as good as before.

Since early November, I have tried a low FODMAP diet, and my condition has improved significantly.
Over the past month, I have only experienced the same issue for 1-2 days in one week (first normal, second diarrhea), while the other three weeks have been normal (one formed stool per day).
Recently, starting in early December, my stool patterns and frequency have become a bit unstable again.
In the first week, I had 2-3 days with two bowel movements (first formed, second diarrhea), while on other days, I had one bowel movement that was normal in the first half and loose in the second half.

Currently, I have not noticed any blood in my stool (none on the toilet paper or in the stool), nor do I experience abdominal pain, cramping, or other discomforting symptoms, aside from occasional burping and flatulence.
My appetite is normal, but I have intentionally been eating lighter than before, with my total daily caloric intake being about 25% lower than usual to reduce digestive burden.
As a result, since October, my weight has decreased from 77.5 kg to 74.6 kg (approximately 0.25 kg per week).

My usual diet is high in protein; although I consume a lot of fruits and vegetables, I also eat a significant amount of meat.
In July 2014, at the age of 24, I had a colonoscopy, which was normal with no polyps or ulcers, only hemorrhoids.
There is no family history of colorectal cancer.
Due to my concerns, I have scheduled a colonoscopy for this month, but I still feel anxious about it.
Therefore, I would like to ask for your advice, doctor.
Thank you.

Xiao Jian, 30~39 year old female. Ask Date: 2021/12/04

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Hello Mr.
Hsiao: You reported that your bowel habits and frequency have been unstable recently, and you are concerned about the risk of cancer? The risk of colorectal cancer is usually associated with age, a diet high in red meat, smoking, a family history of polyps, and a family history of colorectal cancer.
If your colonoscopy did not reveal any tumors and your bowel habits do not affect your daily life, it is advisable not to worry excessively.
It is recommended to follow up regularly at the gastroenterology clinic.
Thank you for your inquiry!

Reply Date: 2021/12/04

More Info

Understanding gastrointestinal issues can be quite complex, especially when symptoms fluctuate and vary in intensity. Based on your description, it seems you are experiencing a combination of normal bowel movements and episodes of diarrhea, particularly after your first bowel movement of the day. This pattern can be indicative of several underlying factors, including dietary changes, stress, and possibly an irritable bowel syndrome (IBS) or other functional gastrointestinal disorders.

Gastrointestinal Health and Diet
1. Bowel Movement Patterns: The Bristol Stool Scale categorizes stool types from 1 (hard lumps) to 7 (liquid). Your report of having a type 4 stool followed by type 5-6 suggests that while you are generally maintaining a healthy bowel movement, there are instances of loose stools that could be linked to dietary choices or stress. The fact that your first bowel movement is normal and the second is loose may indicate a rapid transit time through the intestines, which can be influenced by various factors, including anxiety or dietary triggers.

2. Dietary Considerations: You mentioned adopting a low FODMAP diet, which is often recommended for individuals with IBS. This diet helps reduce certain carbohydrates that can ferment in the gut, leading to gas, bloating, and diarrhea. It’s great to hear that you’ve noticed improvements with this dietary change. However, it’s essential to ensure that your diet remains balanced and includes adequate fiber, vitamins, and minerals. Since you have reduced your caloric intake, be cautious about potential nutrient deficiencies, especially if your diet is heavily protein-focused.

3. Stress and Lifestyle: The pandemic has undoubtedly increased stress levels for many individuals, which can significantly impact gastrointestinal health. Stress can exacerbate symptoms of IBS and lead to changes in bowel habits. Maintaining a regular exercise routine, as you have been doing, is beneficial for both physical and mental health. However, if your overall activity level has decreased, it might contribute to your gastrointestinal symptoms. Consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises to help manage stress.

4. Hydration and Fiber: Ensure you are drinking enough water, as hydration is crucial for digestive health. Additionally, while you are consuming more vegetables and fruits, ensure you are getting enough soluble and insoluble fiber to help regulate your bowel movements. Foods rich in soluble fiber, such as oats, bananas, and apples, can help manage diarrhea, while insoluble fiber from whole grains and vegetables can help with constipation.

5. Monitoring Symptoms: Since you have scheduled a colonoscopy, it’s a prudent step to rule out any serious underlying conditions, especially given your history of hemorrhoids. While your previous colonoscopy was normal, changes in bowel habits warrant further investigation. Keep a detailed diary of your symptoms, dietary intake, and any stressors to discuss with your healthcare provider. This information can be invaluable in diagnosing any potential issues.

6. Consultation with a Specialist: If your symptoms persist or worsen, or if you experience any new symptoms such as abdominal pain, significant weight loss, or changes in appetite, it would be wise to consult a gastroenterologist. They may recommend additional tests or dietary adjustments tailored to your specific needs.

Conclusion
In summary, your gastrointestinal symptoms appear to be manageable with dietary adjustments and stress management techniques. The upcoming colonoscopy will provide further insights into your bowel health. Continue to monitor your symptoms, maintain a balanced diet, and prioritize your mental well-being. If you have any concerns or if your symptoms change, don’t hesitate to reach out to your healthcare provider for further evaluation and support.

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