High Water Content in Stool: Is It Irritable Bowel Syndrome? - Gastroenterology and Hepatology

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Difficulty in bowel movements, with high water content in the stool and gas?


Doctor, I have had gastrointestinal issues since childhood.
When my diet is poor, I tend to experience bloating, and when it gets worse, excessive stomach acid leads to gastric ulcers.
In the past, although I was constipated (having bowel movements once or twice a week), the stools were usually complete and of significant volume.
However, starting in March of this year, even though I drink about 2000cc of water daily, I find myself wanting to have a bowel movement every 2 to 3 days.
The stools are now very watery, and at times, I experience diarrhea with a lot of gas, and I notice a somewhat "yellow foamy" consistency (throughout this process, I do not feel pain and there is no blood in my stools).
In May, my doctor prescribed magnesium and probiotics, which helped firm up my stools (lower water content), but after stopping the medication, I returned to having high-water-content stools.
I would like to know if these symptoms could be considered a form of irritable bowel syndrome (IBS)? If I want to undergo some tests, what would you recommend? Would a regular ultrasound be sufficient, or would blood tests or a painless colonoscopy be necessary?

Li Tongxue, 20~29 year old female. Ask Date: 2013/08/22

Dr. Cai Anshun reply Gastroenterology and Hepatology


Hello: Irritable bowel syndrome (IBS) must meet the following criteria: In the past 6 months, there should be at least 12 weeks or more of abdominal discomfort, with recurrent symptoms including: abdominal pain or bloating that improves after a bowel movement; changes in bowel frequency, such as constipation (fewer than 3 times a week) or diarrhea (more than 3 times a day); changes in stool form (hard lumps, loose stools, or watery stools); changes in the process of defecation (straining, urgency, or feeling of incomplete evacuation); and presence of mucus in the stool.
Based on your description, gastrointestinal functional issues should be prioritized.
Start with changes in dietary and lifestyle habits, including increased water intake, more fruits and vegetables, and increased physical activity.
Recommended tests may include a routine stool examination.
If there is no significant improvement with medication or lifestyle changes, a colonoscopy may be considered (a sigmoidoscopy examines only the rectum and has limited diagnostic value).
However, the purpose of a colonoscopy is to rule out organic diseases (such as colitis or tumors) and is not helpful for functional disorders.
If you have any questions, please consult a physician for treatment and appropriate testing.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2013/08/22

More Info


Understanding high water content in stool can be quite complex, especially when considering conditions like Irritable Bowel Syndrome (IBS). Based on your description, it seems that you have been experiencing significant changes in your bowel habits, including high water content in your stool, increased frequency of bowel movements, and episodes of diarrhea. These symptoms can indeed be indicative of IBS, but they can also arise from other gastrointestinal issues.

IBS is a functional gastrointestinal disorder characterized by a group of symptoms that typically include abdominal pain, bloating, and changes in bowel habits, which can manifest as diarrhea, constipation, or alternating between both. The criteria for diagnosing IBS often include the presence of abdominal discomfort or pain that is related to bowel movements and changes in stool frequency or form. Given that you have experienced a shift from constipation to more frequent, watery stools, it is reasonable to consider IBS as a potential diagnosis.

However, it is essential to rule out other possible causes of your symptoms. For instance, your history of gastrointestinal issues, including previous ulcers and the recent changes in your bowel habits, could suggest an underlying condition that may require further investigation. The presence of "yellow foam" in your stool and the feeling of passing gas could indicate malabsorption or an imbalance in your gut microbiota, which can also be associated with IBS.

To assess your condition further, several diagnostic tests may be recommended. A stool analysis could be beneficial to check for infections, parasites, or signs of malabsorption. Blood tests may also be useful to rule out inflammatory conditions or other systemic issues. While an abdominal ultrasound can provide some insights into the structure of your gastrointestinal tract, it may not be as definitive for functional disorders like IBS. A colonoscopy or flexible sigmoidoscopy could be considered if there are concerns about structural abnormalities or if your symptoms do not improve with initial management.

In terms of management, lifestyle modifications can play a significant role in alleviating symptoms associated with IBS. Increasing your fiber intake through fruits, vegetables, and whole grains can help regulate bowel movements. Staying well-hydrated is crucial, but it is also essential to monitor the types of fluids consumed, as certain beverages may exacerbate symptoms. Regular physical activity can also help improve gut motility and reduce stress, which is often a contributing factor in IBS.

Additionally, since you mentioned that magnesium and probiotics helped normalize your stool consistency temporarily, it may be worth discussing with your healthcare provider the possibility of reintroducing these treatments or exploring other options, such as dietary adjustments or medications specifically targeting IBS symptoms.

In conclusion, while your symptoms may align with IBS, it is vital to conduct a thorough evaluation to rule out other potential causes. Working closely with a healthcare provider, possibly a gastroenterologist, will help you navigate the appropriate tests and management strategies tailored to your specific situation. Remember, maintaining a healthy diet, staying active, and managing stress are key components in managing gastrointestinal health.

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