Bowel Issues: Causes and Solutions for Constipation

Bowel issues

Seventeen years ago, I underwent abdominal surgery.
Five years ago, during a laparoscopic procedure, my gynecologist mentioned that I had intestinal adhesions and took the opportunity to address some of the adhesions.
I have a bowel movement at least once every one to two days, but each time, the stool is small and pellet-like, resembling rabbit droppings.
Occasionally, after consuming black coffee or soy milk, I manage to pass a longer, softer stool.
I generally enjoy a diet rich in fiber, including high-fiber vegetables and whole grain rice, and I take probiotics daily.
I also try to drink plenty of water, but I find myself frequently urinating, with little improvement in my bowel movements.
Earlier this year, I had a colonoscopy, which revealed only superficial polyps and internal hemorrhoids, which the doctor deemed normal.
After each bowel movement, while I don’t always experience bleeding, I do notice some orange-yellow mucus when wiping.
Is this normal? Why is my stool consistently small and difficult to pass? What other methods can I try to improve this situation?

Niming, 40~49 year old female. Ask Date: 2015/07/28

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, intestinal adhesions can affect gastrointestinal motility, making constipation more likely.
If you have already consumed sufficient fluids and fiber but still cannot improve bowel movements, you may need to increase your intake moderately.
Of course, it is also necessary to avoid fried and irritating foods.
Some individuals with more severe adhesions may require medications to promote motility and stool softeners.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/07/28

More Info

Understanding bowel issues, particularly constipation, can be complex, especially when there are underlying factors such as previous surgeries or conditions like adhesions. Based on your description, it seems you are experiencing a form of constipation characterized by hard, pellet-like stools, which can be quite uncomfortable and frustrating.

Causes of Constipation
1. Dietary Factors: While you mentioned consuming high-fiber foods, it’s important to ensure that your fiber intake is balanced with adequate hydration. Fiber absorbs water, and without sufficient fluid intake, it can lead to harder stools. Additionally, certain foods can contribute to constipation, such as dairy products, processed foods, and excessive caffeine.

2. Physical Activity: Regular physical activity is crucial for maintaining healthy bowel function. Sedentary lifestyles can slow down digestion and lead to constipation.

3. Previous Surgeries: You noted having undergone abdominal surgery and laparoscopic procedures for adhesions. Surgical interventions can sometimes lead to changes in bowel motility or function, contributing to constipation.

4. Medications: Some medications, including certain pain relievers, antidepressants, and iron supplements, can cause constipation as a side effect.

5. Irritable Bowel Syndrome (IBS): Given your symptoms, it’s possible that you may have IBS, which can manifest as alternating patterns of constipation and diarrhea, along with abdominal discomfort.

6. Hydration: Although you mentioned drinking plenty of water, it’s essential to ensure that you are consuming enough fluids relative to your fiber intake. Sometimes, people may not drink enough water to complement their fiber-rich diet.

Solutions for Constipation
1. Increase Fluid Intake: Aim to drink at least 8-10 glasses of water daily. Herbal teas and clear broths can also contribute to your fluid intake.

2. Adjust Fiber Intake: While you are already consuming high-fiber foods, consider the types of fiber. Soluble fiber (found in oats, beans, and fruits) can help soften stools, while insoluble fiber (found in whole grains and vegetables) adds bulk. A balance of both types is ideal.

3. Regular Exercise: Incorporate regular physical activity into your routine. Even simple activities like walking can stimulate bowel movements.

4. Probiotics: You mentioned taking probiotics, which can be beneficial for gut health. Ensure you are using a high-quality probiotic that contains strains known to support bowel regularity.

5. Establish a Routine: Try to set a regular time each day for bowel movements, ideally after meals when the gastrocolic reflex is strongest. This can help train your body to have more regular bowel habits.

6. Consider a Stool Softener or Laxative: If dietary changes do not yield results, over-the-counter stool softeners or mild laxatives may be helpful. However, these should be used sparingly and not as a long-term solution without consulting a healthcare provider.

7. Consult a Specialist: Since you have a history of bowel issues and previous surgeries, it may be beneficial to consult a gastroenterologist. They can provide a thorough evaluation and may recommend additional tests or treatments tailored to your specific situation.

Regarding Mucus in Stool
The presence of orange-yellow mucus in your stool can be concerning. While some mucus is normal, especially if you have a history of hemorrhoids or anal irritation, excessive mucus can indicate underlying issues, such as inflammation or infection. It’s advisable to discuss this symptom with your healthcare provider, especially since it occurs consistently.

Conclusion
Constipation can be a multifaceted issue, particularly with your medical history. By making dietary adjustments, increasing physical activity, and possibly seeking medical advice, you can work towards improving your bowel health. If symptoms persist or worsen, further evaluation by a healthcare professional is essential to rule out any serious conditions and to receive appropriate treatment.

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