Digestive Issues: Constipation and Gut Health Concerns

The sensation of gastrointestinal motility is not as good as before, the urge to defecate has decreased, and bowel movements require more effort. I have experienced constipation for the past two days?

Hello Doctor: I would like to ask you some questions.
Previously, I was on a low-carb diet, so I only consumed starchy foods like pumpkin and sweet potatoes, avoiding white rice and noodles.
As a result, my stools were often unformed.
However, after I stopped the low-carb diet, my stools returned to normal.
I have been eating normally for the past 1-2 years, but I occasionally experience constipation and bloating, with a frequent sensation of gas in my intestines.
Recently, over the past 2-3 months, I have felt that my gastrointestinal motility is not as good as before; my urge to defecate has decreased, and I need to exert more effort to pass stools, often feeling that my bowel movements are incomplete.
Sometimes, I have 2-3 bowel movements a day, but the amount is small, and I often feel some bloating (though not severe).
Compared to my younger days, my urge to defecate feels weaker, and I need to exert more effort to have a bowel movement.
In mid-October of this year, I traveled abroad for 10 days.
During that time, I experienced constipation, but I have been back for a month now, and I have been having daily bowel movements, although the amount feels less, and I still need to exert more effort.
Over the past two weeks, I have had a few days where my stool volume was normal, and I could pass it without much effort.
Last Saturday (11/18), my bowel movement was very normal, but on 11/19, I suddenly became constipated and could hardly pass any stool all day, until the evening when I passed some harder stools.
Today, 11/21, I have been having regular bowel movements, but I am still in a state of constipation.
Reflecting on my diet over the past few days, on 11/17 (Friday) around 7 PM, I ate some bread, and on 11/18 (Saturday) at 11 AM, I had a normal bowel movement.
After that, I ate again around 5-6 PM, having sweet potato leaves and noodle soup, and I only drank the soup.
Later, around 9 PM, I ate stinky tofu.
On 11/19, I woke up around 11 AM and had bread, coffee, and milk, and I also ate in the evening.
Since then, I have been eating as usual, mainly focusing on noodle dishes.
Doctor, I would like to ask if my situation indicates intestinal aging or irritable bowel syndrome (IBS)? Is IBS hereditary? My mother also has IBS and her gastrointestinal health is not very good.
Thank you for your help, Doctor!

Jia Jia, 40~49 year old female. Ask Date: 2023/11/21

Dr. Yang Zhichao reply Gastroenterology and Hepatology

You can visit the gastroenterology and hepatobiliary department for evaluation and examination.

Reply Date: 2023/11/21

More Info

Understanding digestive issues, particularly constipation and gut health, can be quite complex, especially when considering factors like diet, lifestyle, and individual health history. Based on your description, it seems you are experiencing a combination of symptoms that may be indicative of several underlying issues.

Firstly, the fact that you previously followed a low-carb diet and experienced changes in your bowel movements suggests that dietary fiber plays a crucial role in your digestive health. When you reduced your intake of starchy foods, you likely decreased your fiber intake, which can lead to harder stools and constipation. Fiber is essential for adding bulk to the stool and promoting regular bowel movements. It is also important for maintaining a healthy gut microbiome, which can influence overall digestive health.

Your recent experience of needing to exert more effort during bowel movements, along with the sensation of incomplete evacuation, could be signs of functional constipation. This condition is characterized by infrequent bowel movements, hard stools, and difficulty passing stools. It can be exacerbated by dietary choices, hydration levels, and even stress. The fact that you mentioned feeling bloated and having a reduced urge to defecate may also suggest that your gut motility is not functioning optimally.

Regarding your question about whether these symptoms could be related to gut aging or irritable bowel syndrome (IBS), it is possible. As we age, our digestive system can undergo changes that may affect motility and the overall efficiency of digestion. IBS, on the other hand, is a functional gastrointestinal disorder that can manifest as a combination of symptoms, including abdominal pain, bloating, and altered bowel habits (constipation or diarrhea). While IBS can have a genetic component, it is not strictly hereditary. However, if your mother has IBS, it may suggest a predisposition in your family.

Your recent dietary habits, particularly the increased consumption of pasta and other carbohydrate-rich foods, may also be contributing to your symptoms. High-carb diets, especially those low in fiber, can lead to digestive discomfort and constipation. It is essential to ensure that your diet includes adequate fiber from fruits, vegetables, whole grains, and legumes to support healthy bowel function.

In terms of managing your symptoms, here are some recommendations:
1. Increase Fiber Intake: Aim to incorporate a variety of fiber-rich foods into your diet. Soluble fiber (found in oats, beans, and fruits) can help soften stools, while insoluble fiber (found in whole grains and vegetables) adds bulk.

2. Stay Hydrated: Drinking plenty of water is crucial for preventing constipation. Aim for at least 8 cups of water daily, and consider increasing this amount if you are consuming more fiber.

3. Regular Physical Activity: Engaging in regular exercise can help stimulate bowel movements and improve gut motility. Aim for at least 150 minutes of moderate-intensity exercise each week.

4. Monitor Stress Levels: Stress can significantly impact gut health and may exacerbate symptoms of IBS. Consider incorporating stress-reducing practices such as mindfulness, yoga, or meditation into your routine.

5. Consult a Healthcare Professional: If your symptoms persist or worsen, it is advisable to consult a gastroenterologist. They can perform necessary evaluations, such as imaging or endoscopy, to rule out any underlying conditions.

In conclusion, your symptoms may be related to a combination of dietary choices, lifestyle factors, and possibly genetic predisposition. By making mindful adjustments to your diet and lifestyle, you can improve your digestive health and alleviate symptoms. If concerns persist, seeking professional medical advice is essential for appropriate management and care.

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