Irregular Bowel Movements: IBS or Something More Serious?

Sometimes bowel movements are normal, while other times there is diarrhea?

Hello doctor, I am 20 years old, 186 cm tall, and weigh about 80 kg.
My weight has not decreased; in fact, it has increased.
I would like to ask about my recent bowel movements, which are sometimes ribbon-like but often have a shiny surface with a mucus-like substance.
Other times, the stool is loose and contains remnants of vegetables that break apart upon contact.
Additionally, I sometimes hear loud bowel sounds after having a bowel movement or while lying down to sleep.
I have been taking probiotics, but I feel there has been no improvement.
This situation has been ongoing for about six months, with fluctuations in severity.
Could this be irritable bowel syndrome or colon cancer?

Hao, 20~29 year old female. Ask Date: 2024/03/28

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is not colorectal cancer; it is just a variation in digestive motility.
A normal diet of fruits and vegetables is recommended, and further observation is advised.

Reply Date: 2024/03/28

More Info

Based on your description, it seems you are experiencing symptoms that could be associated with Irritable Bowel Syndrome (IBS), but it is essential to consider other potential causes as well. IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and irregular bowel movements, which can manifest as diarrhea, constipation, or alternating between the two. The presence of mucus in your stool and the inconsistency in the shape and consistency of your bowel movements are common features of IBS.

The fact that you have noticed a shiny, mucus-like substance in your stool can be concerning, but it is not uncommon in IBS. Mucus can be produced by the intestines as a response to irritation or inflammation, which can occur in IBS. However, the presence of mucus alone does not indicate a more serious condition like colorectal cancer, especially in the absence of other alarming symptoms such as significant weight loss, blood in the stool, or severe abdominal pain.

Your symptoms have persisted for about six months, which is a significant duration. While IBS can be chronic and fluctuate in severity, it is crucial to rule out other conditions, especially if you are experiencing changes in bowel habits. Conditions such as inflammatory bowel disease (IBD), infections, or even colorectal cancer can present with similar symptoms. Given your age and the absence of alarming symptoms, the likelihood of colorectal cancer is relatively low, but it is not impossible, and a thorough evaluation is warranted.

You mentioned that you have been taking probiotics without noticeable improvement. Probiotics can be beneficial for some individuals with IBS, but they do not work for everyone. It may take time to find the right strain or dosage that works for you, or you may need to explore other dietary changes or medications.

In terms of management, dietary modifications can play a significant role in alleviating IBS symptoms. A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has shown effectiveness in many patients with IBS. This involves reducing foods that are high in certain carbohydrates that can ferment in the gut and lead to gas, bloating, and diarrhea.

Additionally, stress management techniques, such as cognitive-behavioral therapy, mindfulness, or relaxation exercises, can help reduce the impact of stress on your gastrointestinal symptoms. Stress is a known trigger for IBS flare-ups, and addressing it can lead to significant improvements in your overall well-being.

If your symptoms persist or worsen, it is advisable to consult a gastroenterologist for further evaluation. They may recommend tests such as a colonoscopy or imaging studies to rule out other conditions. It is essential to have an open dialogue with your healthcare provider about your symptoms, concerns, and any changes you notice in your bowel habits.

In summary, while your symptoms are suggestive of IBS, it is crucial to rule out other potential causes. A comprehensive approach that includes dietary changes, stress management, and possibly medication can help manage your symptoms effectively. Regular follow-ups with your healthcare provider will ensure that any changes in your condition are monitored and addressed promptly.

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