Gastrointestinal Issues: Constipation, Pain, and Dietary Solutions

My digestive system is really troublesome!

Abnormal bowel movements, alternating between diarrhea and constipation, frequent abdominal pain with variable location, and intermittent severe pain that causes weakness in the legs, dizziness, pallor, profuse sweating, and coldness of the body are concerning symptoms.
Previously, the pain would subside after resting post-diarrhea, but recently, the pain has persisted for some time after bowel movements.
The school nurse suggested that this could be caused by constipation and bloating, but mentioned that it shouldn't typically cause pallor.
Is it really just simple bloating causing these symptoms?
I have noticed that I haven't had a bowel movement for several days, so I can accept the abdominal pain.
However, I often experience abdominal pain in various locations.
My diet is generally light, with minimal fried and cold foods, yet I still experience intermittent abdominal pain and even diarrhea.
Is this normal? I usually have poor digestion, eat little, but still feel bloated, and I have a habit of walking after meals.
Due to frequent constipation, I have tried various dietary remedies: sweet potatoes, bananas (various fruits that aid in bowel movements), honey tea, Yakult, yogurt, probiotics, and drinking a large glass of water in the morning, but I still feel like my gastrointestinal tract is inactive.
Only herbal remedies that promote gastrointestinal motility seem effective, but I worry about relying on them causing future health issues.
What should I do?
I have consulted a doctor about these issues, and due to my atopic dermatitis and other allergies, the doctor mentioned that individuals with allergic tendencies often have poor digestion.
The doctor frequently advises: "Exercise more, eat more vegetables, and drink more water." Based on this description, do you think that simply "exercising more, eating more vegetables, and drinking more water" will improve my condition? What could be the underlying disease? In the past, I noticed blood streaks on toilet paper once or twice during bowel movements, and recently it happened again.
A few days ago, I saw a bit of blood on the toilet paper and thought it might be related to my menstrual cycle, but after a day or two, there was no more bleeding.
Sometimes I suspect pain in the ovarian area; when I asked a nurse about it, she suggested it might be due to constipation.
However, since I noticed blood on the toilet paper a few days ago, I am a bit worried.
Could you please provide clarification?
I also heard a doctor on TV say that eating within two hours after exercising is most effective, but I saw you mention that one shouldn't eat after intense exercise.
What is the correct approach? Will eating protein and fats within two hours after exercise truly build muscle rather than fat? Thank you!

Yumi, 10~19 year old female. Ask Date: 2012/07/11

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello,
(1) If constipation leads to a localized bowel obstruction, the colon will typically attempt to push the stool forward.
However, if the stool is too hard, the colon must exert more effort than usual, which can result in excessive abdominal pain.
This may trigger a reflex from the autonomic nervous system, potentially causing symptoms such as weakness in the legs, dizziness, pallor, cold sweats, and a cold body.

(2) The presence of pain in non-fixed locations can be explained by the accumulation of retained stool in various parts of the colon.
Prolonged retention can lead to excessive bacterial growth, which may trigger diarrhea.

(3) As you are concerned, it is not advisable to use either traditional or Western medicine for extended periods.
You have made significant efforts in your diet, and you should continue to maintain that.
"Exercise more, eat more vegetables, and drink more water" is indeed the best remedy for softening stool.
However, it is essential to ensure adequate hydration, not just with a large glass of water in the morning, but rather a total of 1500cc to 2000cc daily.
In hot weather, when fluid loss may increase, it is even more important to drink enough water.
Additionally, developing a habit of regular daily bowel movements (even when there is no urge) is crucial, as prolonged stool retention in the colon can lead to excessive water absorption, resulting in hard stools that are difficult to pass.

(4) The presence of blood on toilet paper can indeed be caused by constipation, as hard stools can increase pressure in the rectum, impairing venous return.
If combined with prolonged sitting without movement, this can lead to the development of varicose veins, commonly known as hemorrhoids.
Hard stools passing through these engorged veins and mucosal capillaries can result in bleeding.

(5) The reason for not eating immediately after vigorous exercise is that during exercise, blood flow is predominantly directed to the muscles in the limbs, reducing blood flow to the gastrointestinal tract.
If one eats right after exercising, insufficient blood flow to the gastrointestinal system may lead to indigestion.
The body utilizes energy in the following order: glucose, followed by lipids, and finally proteins.
Glucose is the first to be consumed during exercise, and only after glucose is depleted does the body start burning fat.
Protein is typically burned only in extreme energy deficiency situations, such as prolonged starvation.
Consuming protein after exercise will result in its digestion into amino acids, which does not directly replenish the glucose expended during exercise.
Converting amino acids into stored lipids (fat) is more complex than utilizing glucose.
Therefore, this may be the theoretical basis for the recommendation.

Changhua Hospital cares about your health.

Dr.
Tsai An-shun

Reply Date: 2012/07/11

More Info

Understanding gastrointestinal issues can be quite complex, especially when symptoms like constipation, abdominal pain, and dietary concerns are involved. Based on your description, it seems you are experiencing a range of gastrointestinal symptoms that could be linked to several factors, including diet, lifestyle, and possibly underlying medical conditions.

Firstly, the symptoms you describe—irregular bowel movements, abdominal pain, and the presence of blood on toilet paper—are concerning and warrant further investigation. The fact that you experience pain that can lead to dizziness and cold sweats suggests that your body is reacting strongly to whatever is happening in your gastrointestinal tract. While the school nurse suggested that your symptoms might be due to constipation and bloating, the presence of blood is a red flag that should not be ignored.

Blood in the stool or on toilet paper can be caused by several issues, including hemorrhoids, anal fissures, or more serious conditions like inflammatory bowel disease (IBD) or even colorectal cancer. Given your history of gastrointestinal issues and the fact that you have experienced blood on toilet paper, it would be prudent to consult a gastroenterologist for a thorough evaluation. They may recommend diagnostic tests such as a colonoscopy to rule out any serious conditions.

Regarding your dietary habits, you mentioned that you eat a light diet and avoid fried and cold foods, which is generally good practice for digestive health. However, it’s important to ensure that your diet is also rich in fiber, which can help promote regular bowel movements. Foods high in fiber include fruits, vegetables, whole grains, and legumes. You mentioned trying various foods like sweet potatoes and bananas, which are good, but you might also want to consider incorporating more leafy greens and whole grains into your meals.

Hydration is another critical factor in maintaining gastrointestinal health. Drinking plenty of water can help soften stool and promote regular bowel movements. The advice you received about "more exercise, more vegetables, and more water" is sound. Regular physical activity can stimulate intestinal function and help alleviate constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

You also expressed concerns about relying on herbal remedies to stimulate bowel movements. While some herbal treatments can be effective, it’s essential to use them judiciously. Over-reliance on laxatives or herbal remedies can lead to dependency, where your bowel becomes less responsive to natural stimuli. It’s best to use these remedies as a short-term solution while working on long-term dietary and lifestyle changes.

As for the timing of meals around exercise, the advice can vary. Generally, it’s recommended to wait at least 30 minutes to an hour after vigorous exercise before eating, as your body is still in a recovery state. However, consuming a balanced meal with protein and healthy fats after exercise can aid in muscle recovery and overall health. The notion that eating protein after exercise leads to muscle gain rather than fat gain is based on the principle that muscle repair and growth occur when the body has the necessary nutrients available.

In summary, while dietary changes and lifestyle modifications can significantly improve your gastrointestinal health, it’s crucial to address the concerning symptoms you’ve described, particularly the blood in your stool. Consulting with a healthcare professional for a comprehensive evaluation is the best course of action. They can provide tailored advice based on your specific situation and help you develop a plan that addresses both your gastrointestinal symptoms and overall health.

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