Constipation and Loose Stools: A Gastrointestinal Perspective

Constipation with soft stools?

I've been struggling with bowel issues for a long time, and I don't know when it started.
During my menstrual period, my bowel movements become very infrequent for about a week, and it feels like my intestines hardly move at all.
If I do have a bowel movement, it's mostly watery.
As my period comes to an end, my bowel movements gradually return to normal, but they still aren't well-formed.
I feel that after my period, my intestinal motility increases significantly.
When I feel the urge to go (which is usually in the morning), I rush to the bathroom and it takes about 2 seconds to finish.
The stools are very soft, oddly shaped, and not formed.
Observing the toilet, I see various shapes floating, none of which are well-formed, and then I don't feel the urge anymore (although I do feel like I haven't completely emptied my bowels).
I’m unsure what this means, but it has been abnormal for a long time.
I only have these strange stools, so my questions are about the constipation during my menstrual period and the soft stools I experience otherwise.
Regarding my weight, whenever I start to experience constipation, I only eat one meal a day, and I have lost two kilograms so far.
I'm not sure if that is significant.

FION, 20~29 year old female. Ask Date: 2011/01/01

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, experiencing constipation during menstruation while usually having soft stools can be common.
Some individuals have sensitive gastrointestinal systems, leading to alternating constipation and diarrhea, especially under stress or with irregular eating habits, which can alter gut function.
Based on your situation, it may be a case of irritable bowel syndrome (IBS).
During menstruation, it's important to maintain a positive mood and increase your intake of water and fiber to see if it helps alleviate constipation.
If you experience severe diarrhea, weight loss, blood in the stool, or persistent constipation, it is advisable to consult a physician for further examination.
Wishing you good health, Dr.
Lin Ming-Hui, Taoyuan Health Bureau.

Reply Date: 2011/01/01

More Info

Understanding gastrointestinal issues, particularly constipation and loose stools, can be quite complex, especially when they are influenced by factors such as hormonal changes during menstruation. Your experience of having reduced bowel movements during your menstrual cycle, followed by softer stools afterward, is not uncommon and can be attributed to several physiological and hormonal factors.

During menstruation, many women experience changes in bowel habits due to fluctuations in hormone levels, particularly estrogen and progesterone. Progesterone, which rises during the luteal phase of the menstrual cycle, can slow down gastrointestinal motility, leading to constipation. This is likely why you notice a significant decrease in stool frequency and consistency during your period. Once menstruation ends, the decrease in progesterone can lead to a resumption of normal bowel function, which may explain the increase in stool frequency and the softer consistency you experience.

The fact that you describe your stools as "very soft" and not well-formed suggests that you might be experiencing a form of functional bowel disorder, such as irritable bowel syndrome (IBS). IBS can manifest as alternating patterns of constipation and diarrhea, often triggered by stress, dietary changes, or hormonal fluctuations. The sensation of incomplete evacuation you mentioned, along with the varying shapes and consistencies of your stools, further supports this possibility.

It's also important to consider dietary factors. If you are eating less during times of constipation, this can lead to a cycle where your body is not receiving enough fiber, which is essential for forming well-structured stools. A diet low in fiber can contribute to both constipation and the formation of loose stools when your body compensates for the lack of bulk. Incorporating more fiber-rich foods, such as fruits, vegetables, whole grains, and legumes, can help regulate your bowel movements.

Additionally, hydration plays a crucial role in bowel health. Insufficient fluid intake can exacerbate constipation, leading to harder stools that are difficult to pass. Conversely, when you experience loose stools, it may indicate that your body is not absorbing water properly or that there is an underlying issue affecting your gut health.

Given your symptoms and the impact they have on your quality of life, it would be beneficial to consult with a gastroenterologist. They can provide a thorough evaluation, which may include dietary assessments, stool tests, and possibly imaging studies to rule out any underlying conditions. They may also recommend lifestyle modifications, such as regular physical activity, stress management techniques, and possibly probiotics, which can help balance gut flora and improve bowel regularity.

In summary, your experience of alternating between constipation and loose stools, particularly in relation to your menstrual cycle, is likely influenced by hormonal changes, dietary factors, and possibly an underlying functional bowel disorder. Addressing these issues through dietary changes, hydration, and professional medical advice can help you achieve more regular and comfortable bowel movements.

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