Loose Stools After Internal Hemorrhoids: Causes and Solutions - Gastroenterology and Hepatology

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Internal hemorrhoids with loose stools?


Hello Doctor: About two weeks ago, I started experiencing diarrhea, possibly due to gastroenteritis (there was no blood in the stool).
I also felt weak all over.
After a day or two, I felt slightly better, and my strength gradually improved, but then I began to notice blood in my stool, filling the toilet bowl.
I subsequently visited Mackay Memorial Hospital, where the doctor performed a digital rectal examination and indicated that the bleeding was due to a ruptured internal hemorrhoid caused by the diarrhea.
The doctor prescribed suppositories for two weeks.
During these two weeks, I did not experience any diarrhea or bleeding, but my stools have remained unformed and loose.
I also noticed that the stool on the toilet paper was particularly sticky.
Additionally, I have been experiencing increased abdominal rumbling and gas, with bowel movements occurring about 1 to 2 times a day, at most 3 times, which I consider normal.
My weight has not decreased, and my appetite is fairly good, although I have become hesitant to eat.
(Prior to the gastroenteritis, my bowel movements were normal, and everything happened suddenly.) I would like to ask the doctor what this situation might be.
(I believe my dietary habits are not particularly poor, I exercise regularly, and there is no family history of colorectal cancer.) Thank you, Doctor, for your patient response.

Chang, 20~29 year old female. Ask Date: 2015/02/04

Dr. Cai Anshun reply Gastroenterology and Hepatology


Hello: After gastroenteritis, the intestinal function and mucosa need some time to recover, so there may be temporary changes in bowel habits.
It is important to pay attention to the types of food consumed, avoiding high-fat, high-protein, and low-fiber foods.
If the issue is purely caused by acute gastroenteritis, it will gradually improve.
However, if symptoms persist without improvement, it is recommended to seek medical attention again to determine if further examination is necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2015/02/04

More Info


It sounds like you have been through quite a challenging experience with your gastrointestinal health, particularly following your bout with gastroenteritis and the subsequent issues with your internal hemorrhoids. Let's break down your situation and explore the potential causes of your loose stools, as well as possible solutions.

Firstly, it's important to understand that gastroenteritis, which is an inflammation of the stomach and intestines, can lead to a variety of symptoms, including diarrhea, abdominal pain, and nausea. In your case, it seems that the diarrhea was severe enough to cause trauma to your internal hemorrhoids, resulting in significant bleeding. This is a common complication, as the straining associated with diarrhea can exacerbate existing hemorrhoids or lead to new ones.

Now, regarding your current symptoms of loose stools and the changes in your bowel movements, there are several factors to consider:
1. Post-Gastroenteritis Effects: After an episode of gastroenteritis, it is not uncommon for the bowel to take some time to return to its normal function. This can result in loose stools or changes in stool consistency. The intestines may still be sensitive and reactive, leading to what is often referred to as "post-infectious irritable bowel syndrome" (IBS). This condition can manifest as ongoing diarrhea, abdominal discomfort, and changes in bowel habits.

2. Dietary Factors: While you mentioned that your diet is generally good, it’s essential to consider any recent changes in your eating habits. After a gastrointestinal illness, some people may develop temporary food intolerances or sensitivities, particularly to dairy or high-fiber foods. Keeping a food diary can help identify any specific triggers that may be contributing to your loose stools.

3. Hydration and Electrolyte Balance: Diarrhea can lead to dehydration and an imbalance of electrolytes, which can further affect bowel function. Ensure you are drinking plenty of fluids, and consider electrolyte solutions if you feel dehydrated.

4. Medication Effects: The suppositories prescribed by your doctor may also have an impact on your bowel movements. Some medications can cause changes in stool consistency or frequency. If you have concerns about the side effects of any medications, it’s best to discuss them with your healthcare provider.

5. Anxiety and Stress: It’s also worth noting that stress and anxiety can significantly impact gastrointestinal health. If you are feeling anxious about your symptoms, this could contribute to changes in your bowel habits. Practicing stress-reduction techniques such as mindfulness, yoga, or deep-breathing exercises may be beneficial.


Solutions and Recommendations:
- Follow-Up with Your Doctor: Since you have experienced significant changes in your bowel habits, it’s crucial to keep your healthcare provider informed. They may recommend further evaluation, such as stool tests or imaging studies, to rule out any underlying conditions.

- Dietary Adjustments: Consider a bland diet initially, gradually reintroducing foods to see how your body reacts. Foods that are easy on the stomach, such as bananas, rice, applesauce, and toast (the BRAT diet), may help stabilize your stools.

- Fiber Intake: Once your symptoms improve, gradually increase your fiber intake to help normalize your bowel movements. Soluble fiber, found in foods like oats, beans, and fruits, can help absorb excess water and form more solid stools.

- Hydration: Continue to stay well-hydrated, especially if you have had episodes of diarrhea. Drinking clear fluids and electrolyte solutions can help maintain hydration and electrolyte balance.

- Monitor Symptoms: Keep track of your bowel movements, any associated symptoms, and dietary changes. This information can be invaluable for your healthcare provider in determining the best course of action.

In summary, while your current symptoms may be concerning, they are not uncommon following a gastrointestinal infection and subsequent complications. With proper monitoring, dietary adjustments, and communication with your healthcare provider, you can work towards restoring your gastrointestinal health. If symptoms persist or worsen, do not hesitate to seek further medical advice.

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