Abdominal Discomfort: Alternating Diarrhea and Constipation

Q: Abdominal Discomfort: Alternating Diarrhea and Constipation

Hello： According to your description, being overweight and having poor dietary habits, along with discomfort in the left abdomen, if it is in the upper left abdomen, may indicate gastric issues. <br>The limited abdominal space, if occupied by intra-abdominal fat, can compress the

Abdominal discomfort with alternating diarrhea and constipation?

Hello, Doctor.
I have had poor dietary habits and been overweight.
Since February, I have suddenly experienced left abdominal pain (which seems to be cramping pain), and then gastrointestinal issues began.
Initially, I had intermittent pain in the left abdomen, and in the past month, I have also experienced intermittent pain in the upper and right abdomen, which is mild and varies in location.
There is some discomfort around the umbilical area, but it is minimal, and there is no pain upon palpation.
I have also experienced diarrhea and constipation; during diarrhea, my stools were yellow-brown, soft, watery, and sometimes only mucus.
I have had a sensation of incomplete evacuation and tenesmus, and my anus has felt uncomfortable.
In the past two days, during constipation, my stools were dry, pellet-like, and very dark green, with a small amount of mucus.
Visually, I only see mucus and no blood.
I have also felt bloated, experienced borborygmi, belching, acid reflux, and throat discomfort.
I tried eating only plain rice porridge daily, and I lost 20 pounds, but my gastrointestinal issues persist.
After returning to a normal diet, my weight has remained stable, and I have no other physical problems.
In May, a physician performed an abdominal examination and a digital rectal exam, finding no significant issues.
On June 1, I had an abdominal ultrasound, which showed only mild fatty liver with no abnormalities.
On June 18, a stool test was normal (but I am unclear about what tests were conducted aside from culture).
I will undergo a colonoscopy at the end of this month and an upper endoscopy next month.
Doctor, what could be the possible issues in my case? Additionally, I am a bit worried about my recent dark green stools.
I have intentionally eaten more vegetables in the past two to three days; could this be the reason? Thank you, Doctor.

Kam, 20~29 year old female. Ask Date: 2012/07/04

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: According to your description, being overweight and having poor dietary habits, along with discomfort in the left abdomen, if it is in the upper left abdomen, may indicate gastric issues.
The limited abdominal space, if occupied by intra-abdominal fat, can compress the normal functioning of the stomach, leading to gastroesophageal reflux (belching, acid reflux, and throat discomfort) and indigestion.
As for the variable location of abdominal pain, it may be due to irregular bowel movements, with excessive fecal matter causing localized bloating or paralytic obstruction.
Constipation and irregular bowel movements may also lead to bacterial overgrowth, resulting in diarrhea.
Additionally, alternating diarrhea and constipation, mucus in stools, urgency, and discomfort in the anal area may suggest irritable bowel syndrome.
It is recommended to relax, manage psychological stress, consume more fruits and vegetables, and increase fluid intake.
Awaiting endoscopy to rule out organic issues, the remaining steps may involve increasing physical activity, maintaining an ideal weight, avoiding rapid weight loss, and focusing on a balanced diet.
Dark green stools, if there are concerns about gastrointestinal bleeding, may require a stool occult blood test to confirm any bleeding.
However, if it does not persist, it may be influenced by diet, and there is no need for excessive worry.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2012/07/04

More Info

Understanding abdominal discomfort, particularly when it involves alternating diarrhea and constipation, can be quite complex and may indicate various underlying issues. Based on the symptoms you've described, including intermittent left abdominal pain, changes in bowel habits, and the presence of mucus in your stool, it is essential to consider several potential causes.

Firstly, the alternating patterns of diarrhea and constipation, along with the abdominal pain, could suggest a condition known as Irritable Bowel Syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and changes in bowel habits. Stress, dietary choices, and lifestyle factors often exacerbate IBS symptoms. Given your history of poor dietary habits and recent weight loss, it is possible that these factors have contributed to your gastrointestinal distress.

The presence of mucus in your stool and the deep green color may also be noteworthy. Green stools can result from several factors, including the consumption of certain foods, such as leafy greens or foods with green coloring, and can also occur when food moves too quickly through the intestines, preventing bile from breaking down completely. The fact that you have been consuming more vegetables recently could indeed contribute to this change in stool color. However, if the green stools persist or are accompanied by other concerning symptoms, it would be advisable to discuss this with your healthcare provider.

Additionally, the discomfort in your throat, along with symptoms of acid reflux, may indicate gastroesophageal reflux disease (GERD). This condition can often coexist with IBS and can lead to symptoms such as heartburn, regurgitation, and throat discomfort. The gastrointestinal tract is interconnected, and issues in one area can influence symptoms in another.

Your recent abdominal ultrasound showing mild fatty liver is also relevant. While fatty liver itself may not directly cause your gastrointestinal symptoms, it can be associated with metabolic syndrome, which includes obesity, insulin resistance, and dyslipidemia. These conditions can further complicate gastrointestinal health and may contribute to symptoms like bloating and discomfort.

Given that you have already undergone several tests, including abdominal ultrasound and stool tests, and are scheduled for a colonoscopy and endoscopy, you are on the right track to rule out more serious conditions. These procedures will help evaluate the health of your gastrointestinal tract more thoroughly and can identify any abnormalities such as polyps, inflammation, or other pathologies.

In the meantime, managing your symptoms through dietary modifications may be beneficial. A diet high in fiber can help regulate bowel movements, but it is essential to introduce fiber gradually to avoid exacerbating bloating or discomfort. Staying hydrated and avoiding trigger foods that may worsen your symptoms (such as high-fat or spicy foods) can also be helpful.

If your symptoms persist or worsen, or if you experience additional concerning symptoms such as significant weight loss, persistent abdominal pain, or blood in your stool, it is crucial to seek further medical evaluation promptly. Your healthcare provider may consider additional diagnostic tests or referrals to specialists, such as a gastroenterologist, to ensure a comprehensive approach to your gastrointestinal health.

In summary, while your symptoms may suggest conditions like IBS or GERD, the upcoming diagnostic procedures will provide more clarity. It is essential to maintain open communication with your healthcare provider and to follow up on any new or worsening symptoms.

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