Increased Bowel Movements After Fistula Surgery: Is It IBS?

Increased frequency of bowel movements after fistula surgery?

Hello doctor, since I had my fistula surgery in January, I have been having bowel movements 3 to 4 times a day, and sometimes up to 6 times.
I don’t experience any abdominal pain, but I do feel the urge to go.
My stools are shaped like logs and are yellow or brown (about the diameter of a one-dollar coin).
Aside from the first bowel movement in the morning, the amount for the rest of the day is not much, usually about 1 to 3 logs.
Sometimes I feel the urge to have a bowel movement, but it turns out to be just gas, and I feel much better after passing it.
I don’t feel bloated after meals, but I do burp frequently.
Could this be irritable bowel syndrome? Do I need to undergo further examination?

jinmu, 30~39 year old female. Ask Date: 2023/03/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely irritable bowel syndrome.
You may return to the original surgeon's outpatient clinic or visit a family medicine or gastroenterology clinic.

Reply Date: 2023/03/09

More Info

Increased bowel movements following a surgical procedure, such as fistula surgery, can indeed raise concerns about potential underlying conditions, including Irritable Bowel Syndrome (IBS). However, it is essential to consider various factors before jumping to conclusions.

Firstly, it is not uncommon for patients to experience changes in bowel habits after surgery. The gastrointestinal (GI) tract is sensitive to various factors, including stress, dietary changes, and the physical trauma of surgery itself. In your case, the increase in bowel movements to 3-6 times a day, along with the sensation of urgency and the presence of gas, could be attributed to several factors related to your recent surgery.

IBS is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits, including diarrhea and constipation. The symptoms you describe—frequent bowel movements, a feeling of urgency, and the sensation of needing to pass gas—could align with IBS, particularly if they persist over time and are accompanied by discomfort or distress. However, the absence of abdominal pain and the nature of your stools (described as thin and well-formed) may suggest that your symptoms could also be a temporary reaction to the surgical procedure rather than a chronic condition like IBS.

It is also important to consider the role of diet and lifestyle in your current symptoms. After surgery, dietary changes are often necessary, and certain foods may exacerbate bowel irregularities. For instance, high-fiber foods, dairy products, or fatty foods can lead to increased gas production and altered bowel habits. Keeping a food diary to track your intake and any corresponding changes in bowel habits may provide valuable insights.

Additionally, the psychological aspect of undergoing surgery can also impact bowel function. Stress and anxiety can lead to increased gut motility, resulting in more frequent bowel movements. If you are experiencing any anxiety related to your surgery or recovery, addressing these feelings may help alleviate some of your gastrointestinal symptoms.

Regarding the need for further evaluation, it may be prudent to consult with your healthcare provider. They can perform a thorough assessment, including a review of your medical history, a physical examination, and possibly some diagnostic tests if deemed necessary. Tests such as stool studies, blood tests, or imaging studies may help rule out other conditions that could be contributing to your symptoms, such as infections or inflammatory bowel disease.

In summary, while your symptoms may suggest IBS, they could also be a temporary response to the surgical procedure. Monitoring your symptoms, maintaining a balanced diet, and managing stress levels are essential steps you can take. However, consulting with your healthcare provider for a comprehensive evaluation is crucial to determine the best course of action and to rule out any other potential issues.

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