Incomplete Bowel Movements: Causes and Solutions

Bowel issues

Hello Doctor: I do not have constipation, my stools are not hard, and the color is normal.
I typically have a bowel movement once every morning, and I do not experience abdominal pain or bloating.
However, a few months ago, I started to feel like I wasn't completely emptying my bowels.
Initially, I didn't think much of it since I wasn't uncomfortable, but this sensation has become more pronounced recently.
The initial part of the bowel movement is relatively smooth, but towards the end, I feel like I cannot fully evacuate, even though there is still stool near the anus that I cannot pass.
Due to this incomplete evacuation, I often feel the urge to go throughout the day, but when I do try to use the restroom, I find it difficult to pass stool.
I have to wait until the next day when I have accumulated more stool and have a stronger urge to finally relieve myself.
I initially suspected that this might be due to my dietary changes last year when I was trying to gain weight and ended up eating too much.
However, I found that the term "stool retention" does not seem to exist in medical terminology.
Could you please advise me on what might be causing my condition? Should I see a gastroenterologist or a gastrointestinal surgeon? Thank you for taking the time to respond.

yt, 40~49 year old female. Ask Date: 2011/08/22

Dr. Ke Fangxu reply Surgery

This symptom is medically referred to as tenesmus, which is caused by the persistent rectal distension reflex.
If there is an object present in the rectum, it can trigger the urge to defecate, which is the mechanism of rectal evacuation.
The presence of feces, tumors, or even larger hemorrhoids in the rectum can lead to this condition.
Sometimes, heightened nerve sensitivity or constipation can also cause this issue.
Since you are over 40 years old, it is generally recommended to undergo a colonoscopy or sigmoidoscopy to rule out the possibility of rectal cancer.
Gastroenterology or colorectal surgery departments should provide these examination services.
If no abnormalities are found, increasing fiber intake should help improve this symptom.

Reply Date: 2011/08/22

More Info

Understanding incomplete bowel movements can be quite complex, as it involves various physiological and psychological factors. Based on your description, it seems you are experiencing a sensation of incomplete evacuation after bowel movements, despite having regular and normal stools. This condition can be frustrating and may lead to a cycle of frequent urges to defecate without the ability to fully relieve oneself.

Possible Causes
1. Rectal Sensitivity and Muscle Coordination: One of the primary reasons for the sensation of incomplete evacuation is related to the coordination of the pelvic floor muscles and the rectum. If these muscles do not relax properly during a bowel movement, it can lead to a feeling of fullness or the sensation that not all stool has been expelled. This can be exacerbated by anxiety or stress, which may affect muscle tension.

2. Dietary Factors: Although you mentioned that your stools are not hard and you do not experience constipation, dietary habits can still play a significant role. A diet low in fiber can lead to incomplete evacuation, as fiber helps to bulk up stool and promote regular bowel movements. If your diet has changed recently, it might be worth evaluating your fiber intake and ensuring you consume enough fruits, vegetables, and whole grains.

3. Irritable Bowel Syndrome (IBS): Your symptoms could also be indicative of IBS, a common gastrointestinal disorder characterized by symptoms like abdominal pain, bloating, and altered bowel habits. IBS can lead to feelings of incomplete evacuation, even when bowel movements appear normal. Stress and dietary changes often trigger or exacerbate IBS symptoms.

4. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function. If you are experiencing increased stress or anxiety, it may manifest as gastrointestinal symptoms, including the sensation of incomplete bowel movements.

5. Pelvic Floor Dysfunction: This condition occurs when the muscles of the pelvic floor do not function properly, which can lead to difficulties in bowel movements. This dysfunction can be due to various reasons, including previous surgeries, childbirth, or even chronic straining during bowel movements.

Recommendations
1. Dietary Adjustments: Ensure you are consuming a balanced diet rich in fiber. Aim for at least 25-30 grams of fiber per day. Incorporate foods like fruits, vegetables, legumes, and whole grains. Additionally, stay well-hydrated by drinking plenty of water throughout the day.

2. Regular Exercise: Physical activity can help stimulate bowel function and improve overall digestive health. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Mindfulness and Stress Management: Consider incorporating stress-reduction techniques such as yoga, meditation, or deep-breathing exercises. These practices can help relax the pelvic floor muscles and improve bowel function.

4. Scheduled Bowel Movements: Try to establish a regular schedule for bowel movements, even if you do not feel the urge. This can help train your body to recognize when it is time to go.

5. Consult a Specialist: Given your ongoing symptoms, it may be beneficial to consult a gastroenterologist. They can perform a thorough evaluation, which may include tests to assess bowel function and rule out any underlying conditions.
6. Pelvic Floor Therapy: If pelvic floor dysfunction is suspected, a referral to a physical therapist specializing in pelvic floor therapy may be helpful. They can provide exercises and techniques to improve muscle coordination and relaxation.

Conclusion
Your symptoms of incomplete bowel movements can stem from a variety of factors, including dietary habits, psychological stress, and potential pelvic floor dysfunction. By making dietary adjustments, managing stress, and consulting with a healthcare professional, you can work towards alleviating these symptoms. It is essential to address these concerns early to prevent further complications and improve your quality of life.

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