Variations in Stool Shape: When to Seek Medical Advice

The stool consistency varies between thick and thin?

Hello, doctor.
My usual bowel habit is about twice a day, and I have maintained this for many years.
Since the beginning of this year, the characteristics of my daily bowel movements have changed somewhat.
The first bowel movement is usually normal in size, about the thickness of a ten-dollar coin, and is a complete long shape.
However, the second bowel movement is often divided into several segments and is only about the thickness of my thumb.
I would like to ask if this phenomenon is normal.

An, 20~29 year old female. Ask Date: 2022/04/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

As long as there is no blood present, further observation is acceptable, and it is recommended to increase the intake of fruits and vegetables for fiber.
If there are concerns, a fecal occult blood test can be performed.

Reply Date: 2022/04/03

More Info

When it comes to variations in stool shape and consistency, it’s important to understand that the gastrointestinal system can be quite sensitive to various factors, including diet, hydration, stress, and underlying health conditions. The fact that you have maintained a regular bowel habit of two times a day for years is a good sign of a healthy digestive system. However, changes in stool characteristics can sometimes indicate an underlying issue that may require medical attention.

In your case, you mentioned that your first bowel movement of the day remains normal in size and shape, resembling a typical healthy stool, while the second bowel movement is often fragmented and thinner, about the size of a thumb. This change can be concerning, especially if it persists over time.
Stool that is thinner than usual can sometimes indicate a narrowing of the intestinal passage, which could be due to several reasons, including but not limited to:
1. Dietary Changes: A sudden change in diet, particularly a decrease in fiber intake, can lead to changes in stool consistency. Fiber is crucial for maintaining healthy bowel movements, as it adds bulk to the stool and helps it pass more easily through the intestines.

2. Dehydration: Insufficient fluid intake can lead to harder stools and may affect the overall shape and consistency. Ensuring adequate hydration is essential for digestive health.

3. Stress and Anxiety: Psychological factors can also impact bowel habits. Stress can lead to changes in gut motility and may result in variations in stool shape and frequency.

4. Underlying Health Conditions: Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even more serious conditions like colorectal cancer can manifest as changes in stool shape. While it’s important not to jump to conclusions, persistent changes warrant further investigation.

Given that you have noticed these changes since the beginning of the year, it would be prudent to consult with a healthcare professional. They may recommend a thorough evaluation, which could include a physical examination, a review of your medical history, and possibly diagnostic tests such as stool analysis or imaging studies to rule out any serious conditions.

In general, you should seek medical advice if you experience any of the following alongside the changes in stool shape:
- Blood in the stool or black, tarry stools
- Unexplained weight loss
- Persistent abdominal pain or discomfort
- Changes in bowel habits that last more than a few weeks
- Diarrhea or constipation that does not resolve
In conclusion, while occasional variations in stool shape can be normal, persistent changes, especially if accompanied by other concerning symptoms, should be evaluated by a healthcare provider. Early intervention can help address any potential issues before they become more serious. Remember, your health is paramount, and it’s always better to err on the side of caution when it comes to changes in your body.

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