Struggling with Incomplete Bowel Movements: Causes and Solutions

Inability to fully evacuate bowel movements?

Hello Doctor, I have been experiencing persistent issues with incomplete bowel movements.
I have a bowel movement in the morning, and then about an hour later, I feel the urge again, followed by another bowel movement around noon.
Sometimes, I feel a strange sensation in my anus.
The stool is typically long and shaped, but occasionally, I notice a small amount of mucus, although it's not a lot.
Recently, I've also been feeling a dull, nagging pain under my right rib cage; it's not severe but noticeable enough to be bothersome.
What should I do about this? My daily routine is quite normal, with regular meals and portion sizes.
I always drink a cup of soy milk after breakfast.
Is this considered normal? This situation is causing me some mental distress, and I'm worried that I might have some underlying health issue.

L, 20~29 year old female. Ask Date: 2012/02/05

Dr. Li Yongming reply Gastroenterology and Hepatology

Your symptoms may be more indicative of issues related to the anus or rectum.
It is recommended that you increase your fiber intake to enhance stool bulk and improve stool formation, which may help with more effective bowel movements.
If necessary, please consult a gastroenterologist or a colorectal surgeon for further examination.
The nerves located beneath the ribs can cause dull pain, and potential causes include pleuritis, chest wall issues, gastrointestinal problems, circulatory issues, or spinal nerve root problems.

Reply Date: 2012/02/05

More Info

Experiencing incomplete bowel movements can be quite distressing, and it’s important to understand the potential causes and solutions to address this issue effectively. Based on your description, it seems you are experiencing a combination of symptoms including frequent urges to defecate, the presence of mucus in your stool, and a vague discomfort in your right rib area.

Potential Causes
1. Irritable Bowel Syndrome (IBS): This is a common gastrointestinal disorder that can cause symptoms such as abdominal pain, bloating, and changes in bowel habits, including incomplete bowel movements. Stress and dietary changes can exacerbate IBS symptoms.

2. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to inflammation in the gastrointestinal tract, resulting in symptoms such as diarrhea, abdominal pain, and mucus in the stool. Given your history of mild colitis and the recent positive test for Clostridium difficile, it’s essential to consider these conditions.

3. Dietary Factors: Your diet plays a crucial role in bowel health. Consuming a high-fiber diet is generally recommended for regular bowel movements, but an abrupt increase in fiber or certain types of fiber can lead to bloating and discomfort. Additionally, if you are consuming a lot of dairy (like soy milk), it could contribute to gastrointestinal symptoms if you have lactose intolerance or a sensitivity to soy.

4. Anxiety and Stress: Psychological factors can significantly affect gastrointestinal function. Anxiety can lead to increased bowel motility or changes in bowel habits, which might explain the urgency and incomplete feeling.

5. Rectal Issues: Conditions such as hemorrhoids or anal fissures can cause discomfort during bowel movements and may lead to a sensation of incomplete evacuation.

Suggested Solutions
1. Dietary Adjustments: Consider keeping a food diary to identify any potential triggers. Gradually increase fiber intake if it’s low, focusing on soluble fiber (found in oats, fruits, and vegetables) while ensuring adequate hydration. If you suspect dairy or soy might be an issue, try eliminating them temporarily to see if symptoms improve.

2. Hydration: Ensure you are drinking enough water throughout the day, as dehydration can lead to harder stools and incomplete evacuation.

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

4. Stress Management: Incorporate stress-reducing techniques such as mindfulness, yoga, or meditation. These practices can help alleviate anxiety and improve gastrointestinal function.

5. Medical Evaluation: Given your symptoms and history, it’s crucial to follow up with your healthcare provider. They may recommend further testing, such as imaging studies or additional stool tests, to rule out any underlying conditions. If you have not already, discussing your symptoms with a gastroenterologist may provide more specialized insights.

6. Medication: If IBS or another functional gastrointestinal disorder is diagnosed, your doctor may prescribe medications to help manage symptoms.

Conclusion
While it’s understandable to feel anxious about your symptoms, many gastrointestinal issues can be managed effectively with the right approach. Keeping track of your symptoms, dietary habits, and stress levels can provide valuable information for your healthcare provider. It’s essential to communicate openly with your doctor about your concerns, especially regarding the discomfort in your rib area, as this could be related to gastrointestinal issues or other factors that require attention. Remember, you are not alone in this, and with the right support and management strategies, you can find relief from your symptoms.

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