Irregular Bowel Movements: Causes and Solutions - Gastroenterology and Hepatology

What should I do if I have irregular bowel movements?

Hello, doctor.
I apologize for bothering you during your busy schedule.
I am 31 years old, and since childhood, my bowel movements have not been very regular; sometimes I go every two days, and other times I have a bowel movement every day.
I drink almost enough fluids daily, eat little meat, consume plenty of fruits and vegetables, and also drink probiotic beverages.
However, I noticed about six months ago that after each bowel movement, my anus feels swollen, as if it is congested from straining.
This swelling subsides after a couple of days, but it happens again with the next bowel movement.
Is this hemorrhoids? Additionally, in the past week or two, I have been trying to lose weight and have been pushing myself to go to the bathroom every day to ensure regular bowel movements.
However, the more I try, the more difficult it becomes.
Sometimes I feel the urge to go, but when I get to the bathroom, I can't seem to pass anything.
The stools I have been passing in the last two weeks are mostly thin (about the width of a pinky to a middle finger, and they are mostly yellow in color).
Since I am trying to lose weight, I have been eating half portions for all three meals.
Could this affect the amount I am able to pass? Do I need to go to the hospital for an examination? Thank you.

Lan, 30~39 year old female. Ask Date: 2007/03/19

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
"Hemorrhoids" can protrude due to straining during bowel movements, and some hemorrhoids can be pushed back in.
2.
Diet and emotions can affect bowel habits and frequency; a reduced food intake can impact stool volume.
It is recommended to maintain good habits of drinking water and consuming plenty of fruits and vegetables, and to establish a routine of daily bowel movements, with a tendency to have easier bowel movements after breakfast.
3.
If there are difficulties or pain during bowel movements, one should consult a colorectal surgeon or a gastroenterologist for examination and treatment.

Reply Date: 2007/03/19

More Info

Irregular bowel movements can be a common concern for many individuals, and understanding the underlying causes and potential solutions is essential for maintaining digestive health. Based on your description, it appears that you have been experiencing a range of symptoms, including infrequent bowel movements, a sensation of swelling in the anal area after defecation, and difficulty passing stool, particularly when trying to establish a daily routine for bowel movements.

Firstly, the irregularity in your bowel habits—sometimes going two days without a bowel movement and other times having daily movements—can be attributed to several factors. These may include dietary habits, hydration levels, physical activity, and even stress. While you mentioned that you consume adequate fluids and a diet rich in fruits and vegetables, it’s important to ensure that your fiber intake is sufficient. Fiber plays a crucial role in promoting regular bowel movements by adding bulk to the stool and facilitating its passage through the intestines. If your diet is low in fiber, it could contribute to harder stools and difficulty in passing them.

The sensation of swelling or engorgement in the anal area after bowel movements is concerning and may indeed indicate the presence of hemorrhoids (commonly referred to as piles). Hemorrhoids can occur due to increased pressure in the rectal area, often caused by straining during bowel movements, prolonged sitting, or even constipation. The fact that you experience this swelling after each bowel movement suggests that your body may be reacting to the strain, leading to temporary inflammation and discomfort. It’s essential to address this issue to prevent further complications, such as thrombosed hemorrhoids or anal fissures.

Your recent attempts to establish a daily bowel routine, while well-intentioned, may be counterproductive if they lead to increased straining or anxiety about bowel movements. The pressure to have a bowel movement every day can create a cycle of stress that makes it even more difficult to pass stool. Instead of forcing yourself to go daily, it may be more beneficial to listen to your body and allow for natural urges to guide your bowel habits. If you find that you are experiencing difficulty passing stool, consider incorporating gentle abdominal massage, relaxation techniques, or even over-the-counter stool softeners to ease the process.

Regarding your dietary changes aimed at weight loss, it’s crucial to ensure that you are not overly restricting your caloric intake, as this can lead to inadequate nutrition and insufficient stool bulk. Reducing portion sizes significantly can result in less food being available for digestion, which may lead to smaller, harder stools that are more challenging to pass. Instead of drastically cutting your meals, consider focusing on nutrient-dense foods that are high in fiber, such as whole grains, legumes, fruits, and vegetables, while still allowing for adequate caloric intake.

In terms of medical evaluation, if your symptoms persist or worsen, it would be advisable to consult with a healthcare provider. They can perform a thorough assessment, including a physical examination and possibly diagnostic tests, to rule out any underlying conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or other gastrointestinal disorders. Additionally, they can provide tailored recommendations based on your specific health needs.

In summary, addressing irregular bowel movements involves a multifaceted approach that includes dietary adjustments, hydration, and potentially medical evaluation. By focusing on a balanced diet rich in fiber, listening to your body’s natural cues, and seeking professional guidance when necessary, you can work towards achieving more regular and comfortable bowel habits.

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