Frequent Bowel Movements: Causes and Solutions - Gastroenterology and Hepatology

I have been wanting to have a bowel movement?

Over the past month, I have been having bowel movements more than three times a day.
Sometimes the stools are thin and short with some strands, and at times they are shapeless.
Shortly after finishing, I still feel the urge to go to the bathroom, and even when urinating, I feel the need to have a bowel movement.
After taking anti-diarrheal medication, I have about two bowel movements, but the stools are not always formed.
I have lost 3 kilograms in weight.
I have undergone a fecal occult blood test which was negative, and an upper gastrointestinal endoscopy showed the presence of Helicobacter pylori.
I have not yet taken medication to eradicate the Helicobacter pylori.
So far, I have visited three clinics and have been on medication for a month without improvement.
I would like to ask the doctor what the possible causes could be.
Could it be caused by Helicobacter pylori? Is there a need for further testing? Thank you!

N, 20~29 year old female. Ask Date: 2012/04/16

Dr. Li Yongming reply Gastroenterology and Hepatology

Hello, I will answer your inquiry in two parts.
First, the gastroscopy has revealed the presence of Helicobacter pylori, so I recommend that you undergo a triple therapy regimen to eradicate the Helicobacter pylori.
This bacterium has been shown to be highly associated with gastric cancer.

Second, regarding your abnormal bowel habits and changes in stool shape, along with weight loss, it is essential to rule out the possibility of colorectal tumors.
The physician at your clinic has arranged for a fecal occult blood test, which returned negative.
However, it is important to note that the fecal occult blood test can only detect colorectal cancer or polyps that are actively bleeding.
Research indicates that nearly half of colorectal cancer patients and 90% of patients with colorectal polyps may not be detected by this test.
Additionally, among those who test positive for fecal occult blood, only about 10% actually have colorectal cancer.
Therefore, I recommend that you visit a gastroenterologist for further evaluation and to arrange for a colonoscopy.

Reply Date: 2012/04/16

More Info

Frequent bowel movements, especially when accompanied by symptoms such as abdominal pain, bloating, and changes in stool consistency, can be quite distressing. Based on your description, it seems you are experiencing a range of gastrointestinal symptoms that could be indicative of several underlying conditions, including Irritable Bowel Syndrome (IBS), infections, or even stress-related gastrointestinal disturbances.

Irritable Bowel Syndrome is a common functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits, which can include diarrhea, constipation, or a mix of both. The fact that you are experiencing frequent bowel movements, sometimes with loose or poorly formed stools, aligns with the diarrhea-predominant subtype of IBS. Stress and anxiety are known triggers for IBS symptoms, and it appears that your symptoms may be exacerbated by emotional factors or lifestyle changes.

The presence of Helicobacter pylori (H. pylori) is another important consideration. This bacterium is associated with various gastrointestinal issues, including gastritis and peptic ulcers, but it is not typically linked directly to IBS or frequent bowel movements. However, if left untreated, H. pylori can lead to chronic gastrointestinal discomfort, which might indirectly affect bowel habits. It is advisable to follow up with your healthcare provider regarding treatment for H. pylori, as eradicating the infection may help improve your overall gastrointestinal health.

In your case, the fact that you have undergone stool tests and endoscopy, with negative results for serious conditions, is reassuring. However, persistent symptoms warrant further investigation. It may be beneficial to consider additional tests, such as a comprehensive stool analysis to check for infections, parasites, or malabsorption issues. Additionally, a food diary could help identify any dietary triggers that may be contributing to your symptoms.

Lifestyle modifications can also play a crucial role in managing your symptoms. Regular meal times, a balanced diet rich in fiber, and adequate hydration can help regulate bowel movements. Avoiding known irritants, such as caffeine, spicy foods, and artificial sweeteners, may also be beneficial. Stress management techniques, including mindfulness, yoga, or cognitive behavioral therapy, can help alleviate the psychological factors that may be exacerbating your gastrointestinal symptoms.

In summary, your symptoms may be indicative of IBS, potentially influenced by stress and dietary factors, alongside the presence of H. pylori. It is essential to address both the infection and the functional aspects of your gastrointestinal health. Consulting with a gastroenterologist for a tailored treatment plan, including medication for H. pylori and strategies for managing IBS, would be a prudent next step. Regular follow-ups and open communication with your healthcare provider will be key in navigating your symptoms and improving your quality of life.

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