Digestive Discomfort: Causes and Solutions for Constipation and Diarrhea

Gastrointestinal discomfort?

Hello, Doctor: I have been suffering from chronic constipation for many years.
However, I have not improved because I dislike drinking water.
Since the summer vacation began, I have been experiencing diarrhea almost every day, or I have difficulty passing stools, requiring significant effort to do so.
Sometimes, I feel like there is still stool left in my abdomen that I cannot expel, which is very uncomfortable.
Recently, I have been eating very little because I always feel bloated and unable to eat much.
Moreover, less than half an hour after eating, I rush to the bathroom and have diarrhea continuously.
I feel like eating is equivalent to not eating at all.
My mother suggested I take Zhenglu pills (dark brown), but they are very foul-smelling and difficult to swallow; as soon as they reach my throat, I vomit them all out, and it tastes bitter by the end.
I also feel pain when I have a bowel movement.
My stomach feels strange all day, and I can't find a comfortable position whether sitting or standing.
Additionally, the abdominal pain has been occurring more frequently.
I have had hemorrhoids in the past, and it seems that the old issue has flared up again.
I have managed to push it back in, but it doesn't seem to help much.
Although it is an external hemorrhoid, it doesn't hurt now (it used to).
Furthermore, taking oral medications has been ineffective.
Could you please tell me what is wrong with my body? Do I need to see a doctor? If so, will I need to undergo an endoscopy or colonoscopy? I have been dealing with these issues for a long time because I do not want to take medication; every time I take medicine, I feel nauseous.

Xiao Ying, 10~19 year old female. Ask Date: 2005/07/27

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Hello, I would like to know if you are experiencing any symptoms such as fever, weight loss, or blood in your stool.
If none of these symptoms are present, it may be irritable bowel syndrome.
However, if you have any of the aforementioned symptoms, or if your abdominal discomfort is worsening, it is important to seek medical evaluation.
Please pay attention to your diet; avoid overeating and also refrain from going long periods without food.
Be mindful of any foods that may cause particular discomfort (such as dairy products, watermelon, pineapple, etc.).
Increase your intake of fruits and vegetables, and try to establish a regular bowel habit.
Additionally, engage in physical activity and maintain a relaxed state of mind.
If there is no improvement, I recommend consulting a physician for further assessment.
Sincerely, Dr.
Yuan Hong-Dao, Internal Medicine.

Reply Date: 2005/07/27

More Info

Digestive discomfort, particularly issues like constipation and diarrhea, can be quite distressing and often indicate underlying gastrointestinal problems. Based on your description, it seems you are experiencing a combination of chronic constipation, episodes of diarrhea, abdominal bloating, and possibly a recurrence of hemorrhoids. Let's break down these symptoms and explore potential causes and solutions.

Understanding Your Symptoms
1. Chronic Constipation: This condition is often characterized by infrequent bowel movements, difficulty passing stools, and a sensation of incomplete evacuation. In your case, it appears that your reluctance to drink water has contributed to this issue, as adequate hydration is crucial for softening stool and promoting regular bowel movements.

2. Diarrhea: The sudden shift to frequent diarrhea can be alarming, especially if it follows a long period of constipation. This could be due to several factors, including dietary changes, stress, or even an infection. The fact that you experience diarrhea shortly after eating may suggest a gastrointestinal disturbance, such as food intolerance or irritable bowel syndrome (IBS).

3. Abdominal Bloating and Pain: Bloating often accompanies both constipation and diarrhea. It can be caused by the buildup of gas in the intestines, which may result from certain foods or digestive issues. The pain you describe, especially if it is worsening, could indicate a more serious underlying condition that warrants further investigation.

4. Hemorrhoids: The history of hemorrhoids, particularly if they are external, can cause discomfort during bowel movements, especially if you are straining to pass hard stools. While you mentioned that they are not currently painful, the recurrence of symptoms suggests that the underlying issues with bowel movements need to be addressed.

Recommendations
1. Hydration: Increasing your water intake is essential. Aim for at least 8-10 glasses of water daily. This can help soften your stool and reduce the risk of constipation. If plain water is unappealing, consider herbal teas or flavored water.

2. Dietary Adjustments: Incorporate more fiber-rich foods into your diet, such as fruits, vegetables, whole grains, and legumes. Fiber helps regulate bowel movements and can alleviate both constipation and diarrhea. Gradually increase your fiber intake to avoid gas and bloating.

3. Regular Exercise: Physical activity can stimulate bowel function and help manage symptoms of constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Avoid Trigger Foods: Pay attention to foods that may exacerbate your symptoms. Common culprits include dairy products, high-fat foods, and certain artificial sweeteners. Keeping a food diary can help identify triggers.

5. Medications: While you mentioned reluctance to take medications, it may be beneficial to discuss options with a healthcare provider. Laxatives, stool softeners, or medications for diarrhea may provide relief. If you have a history of hemorrhoids, topical treatments may also help.

6. Consult a Healthcare Provider: Given the persistence and severity of your symptoms, it is advisable to consult a gastroenterologist. They may recommend diagnostic tests such as an endoscopy or colonoscopy to rule out any serious conditions, especially since you have a history of digestive issues.

7. Mental Health Considerations: Stress and anxiety can significantly impact digestive health. If you feel that stress is a contributing factor, consider stress-reduction techniques such as mindfulness, yoga, or counseling.

Conclusion
Your symptoms of chronic constipation, diarrhea, abdominal discomfort, and the recurrence of hemorrhoids suggest a complex interplay of dietary habits, hydration status, and possibly underlying gastrointestinal conditions. While lifestyle modifications can significantly improve your situation, professional medical advice is crucial to rule out any serious issues and to develop a tailored treatment plan. Don't hesitate to seek help; your health is worth it.

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