Liquid Stool During Menstruation: When to Seek Medical Advice

Passing gas with watery stools?

Hello Dr.
Chen, I have my period these past two days.
Usually, I experience constipation before my period, and after it starts, I tend to have diarrhea.
After exercising today (which is not part of my usual routine), I noticed some watery stool coming out when I passed gas.
I have a history of anal fissures and hemorrhoids; it started with an anal fissure, then I went to see a doctor for hemorrhoids.
The last time I visited for the fissure, the doctor found hemorrhoids and performed a ligation procedure.
Since then, I haven't had a follow-up appointment, but I accidentally wiped too hard while using the restroom and experienced some bleeding.
I've only been applying the ointment the doctor prescribed.
Should I see a doctor for the watery stool during this period of diarrhea? In the past, I've had a few instances of this, but it was only a small amount.
This time, I even used three pieces of toilet paper and two wet wipes...
I hope you can provide some guidance, thank you, Dr.
Chen.

Chen, 20~29 year old female. Ask Date: 2023/02/12

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can observe for a few more days, and if there is no improvement, seek medical attention.

Reply Date: 2023/02/12

More Info

Experiencing liquid stool during menstruation can be concerning, especially for someone with a history of anal fissures and hemorrhoids. It’s not uncommon for women to experience changes in bowel habits during their menstrual cycle due to hormonal fluctuations. The increase in prostaglandins, which help the uterus contract, can also lead to increased intestinal motility, resulting in diarrhea for some women.

In your case, the fact that you have a history of anal fissures and hemorrhoids adds another layer of complexity. The presence of liquid stool, especially if it is accompanied by a significant amount of blood or if you experience severe pain, warrants medical attention. Here are some considerations to help you decide whether to seek medical advice:
1. Duration and Severity: If the diarrhea persists for more than a couple of days or is severe, it’s advisable to consult a healthcare provider. Persistent diarrhea can lead to dehydration, especially during menstruation when fluid loss can already be a concern.

2. Presence of Blood: You mentioned that you have experienced bleeding previously. If you notice blood in your stool or if the liquid stool is accompanied by significant pain, it is crucial to seek medical attention. This could indicate a flare-up of your anal fissure or another underlying issue.

3. Dehydration Symptoms: Watch for signs of dehydration, such as excessive thirst, dry mouth, reduced urine output, or dizziness. If you experience any of these symptoms, it’s important to seek medical care.

4. Diet and Activity Changes: Since you mentioned that you exercised for the first time in a while, consider whether any dietary changes or the intensity of your activity could have contributed to your symptoms. Sometimes, sudden changes in diet or physical activity can lead to gastrointestinal upset.

5. Underlying Conditions: Given your history of gastrointestinal issues, it’s essential to consider whether there may be an underlying condition that needs to be addressed. Conditions such as irritable bowel syndrome (IBS) can be exacerbated by hormonal changes during menstruation.

6. Consultation with a Specialist: If your symptoms do not improve or if you have ongoing concerns, consider consulting a gastroenterologist. They can provide a more thorough evaluation and may recommend tests to rule out any underlying conditions.

In summary, while it is not uncommon to experience changes in bowel habits during menstruation, the presence of liquid stool, especially in the context of your medical history, should be monitored closely. If you experience any concerning symptoms such as prolonged diarrhea, blood in your stool, or signs of dehydration, it is advisable to seek medical attention promptly. Your health and comfort are paramount, and a healthcare provider can help determine the best course of action based on your specific situation.

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