Irregular Bowel Movements: Causes and Next Steps - Gastroenterology and Hepatology

It occurs regularly every 4 to 5 days?

Hello Doctor, since September of last year, I have noticed that my bowel movements follow a cycle of 4 to 5 days, alternating between formed, loose, mushy, and watery stools.
The next day, it returns to formed stools, and this pattern continues.
No matter how bland my diet is, I cannot return to normal.
I underwent a CT scan of the abdomen and an upper endoscopy in November, and a colonoscopy in December, all of which showed normal results.
However, my bowel habits have not improved.
Recently, I have been experiencing persistent dull pain in my upper abdomen, and bending over causes abdominal pain as well.
There is tenderness when I press near my stomach, and I have been experiencing diarrhea more frequently.
I would like to ask the doctor what further tests I can undergo, as my abdominal issues have not improved and it is affecting my mood.
Thank you for your help.

A-Zhen, 20~29 year old female. Ask Date: 2022/02/28

Dr. Chen Shidian reply Gastroenterology and Hepatology

Further observation or follow-up consultation may be necessary.

Reply Date: 2022/02/28

More Info

Understanding irregular bowel movements can be quite complex, especially when accompanied by other symptoms such as abdominal pain. Based on your description, it seems you've been experiencing a range of bowel movement consistencies, including formed, loose, and watery stools, cycling every few days. This inconsistency, coupled with abdominal discomfort, warrants a thorough evaluation.

Possible Causes of Irregular Bowel Movements
1. Dietary Factors: Changes in diet can significantly affect bowel habits. High fiber diets can lead to more formed stools, while low fiber or high-fat diets can result in looser stools. It's essential to assess your dietary intake, including fiber, hydration, and any recent changes.

2. Gut Motility Disorders: Conditions such as Irritable Bowel Syndrome (IBS) can cause alternating patterns of constipation and diarrhea. IBS is often triggered by stress, dietary changes, or gastrointestinal infections.

3. Infections or Inflammation: Gastrointestinal infections can lead to temporary changes in bowel habits. Chronic inflammation, such as in conditions like Crohn's disease or ulcerative colitis, can also cause irregularities.

4. Functional Gastrointestinal Disorders: These include conditions where the bowel appears normal upon examination but does not function correctly, leading to symptoms like yours.

5. Medication Side Effects: If you are taking any medications, they could be affecting your bowel movements. Certain medications can cause constipation, while others may lead to diarrhea.

6. Psychological Factors: Stress and anxiety can significantly impact gut health, leading to changes in bowel habits.

Next Steps for Evaluation
Given that you've already undergone imaging studies (CT scan, endoscopy, and colonoscopy) which returned normal results, here are some additional steps you might consider:
1. Dietary Review: Keep a food diary to track what you eat and how it correlates with your bowel movements. This can help identify any potential food intolerances or triggers.

2. Stool Tests: Consider asking your healthcare provider about stool tests to check for infections, parasites, or malabsorption issues.

3. Gastroenterology Referral: If you haven't already, consider seeing a gastroenterologist who specializes in functional gastrointestinal disorders. They can provide more targeted evaluations and management strategies.

4. Psychological Assessment: If stress or anxiety is suspected to be a contributing factor, a consultation with a mental health professional may be beneficial.

5. Probiotics and Fiber Supplements: Discuss with your doctor the potential benefits of probiotics or fiber supplements, which may help regulate bowel movements.

6. Follow-Up Imaging: If your abdominal pain persists, further imaging or tests may be warranted to rule out any underlying issues that were not identified in previous evaluations.

Conclusion
Irregular bowel movements can be distressing, especially when accompanied by abdominal pain. It’s crucial to continue working closely with your healthcare provider to explore all potential causes and treatment options. Keeping a detailed record of your symptoms, dietary habits, and any other changes in your health can provide valuable information for your healthcare team. Remember, managing stress and maintaining a balanced diet are essential components of gastrointestinal health. If symptoms persist or worsen, do not hesitate to seek further medical advice.

Similar Q&A

Understanding Irregular Bowel Movements: Causes and Solutions

Hello, doctor. I would like to ask about my bowel movements in recent years, which have not been very smooth and present three different situations. The first two situations are quite extreme. The first situation is diarrhea; the second situation is a complete lack of urge to def...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: Irregular bowel movements, occasional diarrhea, and often little or no urge to defecate are commonly caused by irritable bowel syndrome or gastrointestinal dysfunction. It is important to maintain good hygiene habits, consume a clean diet with non-greasy foods, and reduce ...

Understanding Constipation: Causes and Solutions for Digestive Health

I often do not have the urge to have a bowel movement, but I frequently pass gas. Sometimes, I go several days without a bowel movement. Is there something wrong with my body?

Dr. Lin Minghui reply Gastroenterology and Hepatology
Possible causes of irregular bowel movements: 1. Dietary factors: abnormal intake of fluids and fiber. 2. Functional gastrointestinal disorders, irritable bowel syndrome. 3. Structural issues in the pelvic region of the colon: hemorrhoids, pelvic floor dysfunction, rectal prolaps...

Understanding Recent Abdominal Pain and Irregular Bowel Movements: Causes and Solutions

The patient has been experiencing irregular bowel movements for over a month, with episodes of not having a bowel movement for 2 to 3 days, alternating with diarrhea (either loose or watery stools), and sometimes small, soft stools. There is a frequent sensation of incomplete eva...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Gas, stomach pain, are symptoms of the upper gastrointestinal tract, with chronic gastritis being the most common condition. It is advisable to avoid irritating foods, limit tea and coffee intake, and refrain from smoking and drinking alcohol. If there is no improvement, f...

Understanding Changes in Bowel Movements: Causes and Concerns

I have recently been experiencing irregular bowel movements. Initially, my stool was of normal size, but during the second time, it became much thinner and had a loose consistency similar to diarrhea. Additionally, I don't feel much sensation when passing stool. Could you pl...

Dr. Ke Fangxu reply Surgery
Based on your description, it seems more like Irritable Bowel Syndrome (IBS). It is recommended to start with a light diet and maintain a good daily routine. Spicy, irritating, and greasy foods should be avoided. If symptoms persist without improvement, you may consult a physicia...