Urgency: Gastrointestinal Issues and Their Causes - Gastroenterology and Hepatology

urgent bowel movement

Hello Dr.
Tsai,
My wife wakes up every morning around 6 AM and takes our dog for a walk for about 30 to 40 minutes.
Frequently, as she is about to return home, she feels an urgent need to use the restroom (this occurs about twice every three days) and experiences abdominal cramping (below the navel).
Sometimes, shortly after having a bowel movement, she will feel abdominal pain again and has the urge to have another watery stool.
The color of her stool is olive green, and she usually has no other symptoms.
This situation has been ongoing for several months.

What are your thoughts and recommendations on this matter, Dr.
Tsai? Thank you!
Andy
January 11, 1996

andy, 40~49 year old female. Ask Date: 2007/01/11

Dr. Cai Yaozhou reply Gastroenterology and Hepatology

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by unexplained abdominal pain or discomfort associated with changes in bowel habits.
The term "functional" indicates that current examinations do not reveal any organic lesions.
The diagnostic criteria are based on the revised Rome II criteria established in 1999, which state that within a twelve-month period, there must be more than 12 weeks of abdominal pain or discomfort, accompanied by at least two of the following three features (the 12 weeks do not need to be consecutive, as long as the total is over 12 weeks):
1.
Symptoms are relieved by defecation.
2.
There is a change in the frequency of bowel movements when symptoms occur.
3.
There is a change in the form of the stool (either too soft or too hard).
Additionally, the following symptoms are not diagnostic criteria but the presence of more symptoms makes the diagnosis of IBS more certain:
- Abnormal bowel frequency (more than three times a day or less than three times a week)
- Abnormal stool form (too hard or watery)
- Abnormal defecation (straining, urgency, or feeling of incomplete evacuation)
- Passage of mucus
- Abdominal distension or bloating
The exact cause of IBS is currently unknown.
Some theories suggest it may be due to abnormal motility, hypersensitivity of the visceral nerves, issues with communication between the brain and gastrointestinal nerves, psychological or neurological factors, or dietary issues.
Due to the unknown etiology, there are no specific tests to confirm the diagnosis.
The diagnosis is primarily based on clinical symptoms and the exclusion of organic disease.
Signs of organic disease include weight loss, anemia, or blood in the stool, which warrant further investigation.
Treatment focuses on symptom management and avoiding irritant foods while reducing stress.
For patients primarily experiencing pain, antispasmodics may be used; for those with constipation, laxatives are recommended; and for patients with predominant diarrhea, antidiarrheal medications may be prescribed.
However, the effectiveness of these treatments can vary.

Reply Date: 2007/01/11

More Info

Dear Andy,
Thank you for reaching out with your concerns regarding your wife's gastrointestinal issues. Based on the symptoms you've described, it appears that she is experiencing a combination of urgency in bowel movements, abdominal pain, and changes in stool characteristics. Let's break down these symptoms and explore potential causes and recommendations.

Symptoms Overview
1. Urgency and Abdominal Pain: The fact that your wife feels an urgent need to use the restroom shortly after walking her dog suggests that her bowel is reacting strongly to physical activity or possibly to the timing of her meals. The abdominal pain, particularly located below the navel, could indicate irritation or inflammation in the intestines.

2. Frequent Loose Stools: The occurrence of watery stools, especially following the urgency, raises the possibility of a functional gastrointestinal disorder or an underlying condition such as irritable bowel syndrome (IBS) or even an infection.

3. Stool Color: The mention of "olive green" stools can be attributed to various factors, including dietary choices, bile production, or rapid transit through the intestines. Green stools are often seen when food moves too quickly through the digestive tract, which can happen in cases of diarrhea.

Possible Causes
1. Irritable Bowel Syndrome (IBS): This is a common functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). Stress, dietary factors, and physical activity can exacerbate symptoms.

2. Gastroenteritis: If there have been any recent changes in diet, exposure to contaminated food or water, or viral infections, gastroenteritis could be a potential cause. This condition typically presents with diarrhea, abdominal cramps, and sometimes fever.

3. Food Intolerances or Allergies: Certain foods may trigger gastrointestinal symptoms. Common culprits include lactose (found in dairy), gluten (found in wheat), and certain fermentable carbohydrates (FODMAPs). Keeping a food diary may help identify any correlations between food intake and symptoms.

4. Inflammatory Bowel Disease (IBD): Although less common, conditions like Crohn's disease or ulcerative colitis can cause similar symptoms. These conditions are characterized by chronic inflammation of the gastrointestinal tract and may require more extensive medical evaluation.

Recommendations
1. Medical Evaluation: It is crucial for your wife to consult a healthcare provider for a thorough evaluation. This may include a physical examination, stool tests, and possibly imaging studies or endoscopy to rule out any serious conditions.

2. Dietary Adjustments: Keeping a food diary can help identify any potential triggers. A diet low in FODMAPs may be beneficial if IBS is suspected. Additionally, ensuring adequate hydration and a balanced diet rich in fiber can support overall digestive health.

3. Stress Management: Since stress can exacerbate gastrointestinal symptoms, incorporating stress-reducing techniques such as yoga, meditation, or regular exercise may be helpful.

4. Regular Follow-ups: If symptoms persist or worsen, it is essential to maintain regular follow-ups with a healthcare provider to monitor her condition and adjust treatment as necessary.

In conclusion, while the symptoms your wife is experiencing can be concerning, many gastrointestinal issues are manageable with appropriate medical care and lifestyle adjustments. I encourage you to seek medical advice promptly to ensure a proper diagnosis and treatment plan.

Best wishes for your wife's health and well-being.

Sincerely,
Doctor Q&A Teams
Medical Expert

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