Sudden Changes in Bowel Habits: When to Seek Further Gastrointestinal Evaluation

Sudden changes in bowel habits with no abnormalities found upon examination?

Hello, doctor.
I have a bowel movement once a day.
Since the end of January this year, I have noticed that my stool has become softer and wetter than before.
Previously, my stools were more formed, resembling a cylindrical shape with slight cracks on the surface, and I could clean myself with a wet wipe.
Now, however, they resemble a banana shape, smooth on the surface, and I cannot clean myself properly with just a wet wipe (though this situation does not occur every day).
A week ago, I had blood tests and stool tests, both of which showed no abnormalities, but I have not undergone a colonoscopy or endoscopy.
I initially suspected lactose intolerance, but considering I have been consuming dairy products for years, I wonder why my bowel habits would change so suddenly.
I have tried to hold my bowel movement for two days, which did help the earlier part of the stool return to its previous shape, but the latter part remains soft and wet.
My diet is generally balanced, and I supplement my workouts with whey protein, but I do not actively consume dairy products.
I am unsure whether this is due to rapid intestinal motility, malabsorption, or other factors.
This issue has persisted until now, and I would like to know if I should make any changes or undergo further testing.
Thank you, doctor!

Xiao Li, 20~29 year old female. Ask Date: 2024/04/26

Dr. Luo Yining reply Gastroenterology and Hepatology

According to the Bristol Stool Scale, stool can be classified into seven types, with types three and four being the ideal stool forms.
Type three stool is sausage-shaped but has cracks on the surface (similar to the bowel habits you described in the past), while your current bowel habit resembles type four: smooth and like a sausage or snake, which is the easiest shape to pass.
Both of these stool types are considered ideal.
If there are no symptoms such as weight loss, loss of appetite, blood in the stool or changes in color, persistent diarrhea or constipation, or unexplained anemia, there should be no need for excessive concern.
However, if any of the above symptoms occur, it is advisable to consult a gastroenterologist.

Reply Date: 2024/04/26

More Info

Sudden changes in bowel habits can often be a source of concern, and it's important to understand the potential implications of these changes. Based on your description, it seems that you have noticed a shift in the consistency of your stools, which have become softer and more banana-shaped, compared to your previous normal bowel movements that were more solid and well-formed. This change, especially if it has persisted for several weeks, warrants further evaluation.

Firstly, it is essential to recognize that changes in bowel habits can be influenced by a variety of factors, including diet, stress, hydration levels, and underlying gastrointestinal conditions. In your case, you mentioned that your diet is generally balanced and that you engage in regular exercise, which are both positive factors for maintaining healthy bowel function. However, the introduction of whey protein and any changes in your overall dietary patterns could potentially impact your gastrointestinal health. For instance, whey protein can sometimes lead to gastrointestinal discomfort or changes in bowel habits, especially if consumed in large quantities or if your body is not accustomed to it.

Additionally, you expressed concern about lactose intolerance. While it is possible for lactose intolerance to develop at any age, it typically presents with symptoms such as bloating, gas, and diarrhea after consuming dairy products. Since you have been consuming dairy for some time without issues, it may be less likely that this is the sole cause of your recent changes in bowel habits. However, if you suspect lactose intolerance, you might consider temporarily eliminating dairy from your diet to see if your symptoms improve.

Another possibility is that your bowel movements are being affected by changes in gut motility. If your intestines are moving too quickly, this can lead to softer stools as there is less time for water to be absorbed from the stool in the colon. This can occur due to stress, dietary changes, or even infections. Conversely, if your intestines are not moving enough, it can lead to constipation and harder stools. The fact that you have experienced variations in your bowel habits, including a return to more normal stools when delaying bowel movements, suggests that motility may indeed be a factor.

Given that you have already undergone blood tests and stool tests without any abnormalities, it may be prudent to consider further evaluation if your symptoms persist or worsen. A colonoscopy could be beneficial, especially if you have a family history of gastrointestinal issues or if you experience additional symptoms such as abdominal pain, weight loss, or blood in your stool. A gastroenterologist can provide a thorough assessment and may recommend additional tests based on your specific symptoms and medical history.

In the meantime, you might consider keeping a food diary to track your dietary intake and any associated changes in your bowel habits. This can help identify any potential triggers or patterns. Additionally, focusing on hydration, fiber intake, and stress management techniques can also support healthy bowel function.

In summary, while occasional changes in bowel habits can be normal, persistent changes warrant further investigation. Monitoring your symptoms, considering dietary adjustments, and consulting with a healthcare professional for a comprehensive evaluation will help ensure that any underlying issues are addressed appropriately.

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