Bowel Habits: Is Your Digestive Health Normal? - Gastroenterology and Hepatology

Bowel-related issues

Hello, Doctor.
I generally have bowel movements at least three times a day: after waking up, after lunch, and after dinner.
I rarely experience constipation, and my stools are usually well-formed and tubular.
Occasionally, I have diarrhea.
After waking up at 7:40 AM and having a bowel movement, I feel the urge to go again after breakfast between 9:30 and 10:30 AM (this happens more than five days a week).
When I go, I often pass a significant amount, and sometimes I may have another bowel movement in the afternoon (though this is less common).
Therefore, I can have up to five bowel movements in a day.
I often feel the urge to go right after meals, and sometimes I even have to excuse myself to use the restroom while eating.
After a bowel movement, I always feel a sense of emptiness and slight bloating in my abdomen.

1.
Is this bowel movement pattern normal? Could it be irritable bowel syndrome (IBS)?
2.
I would like to change my bowel habits to eliminate the morning and afternoon bowel movements.
Is it possible to hold off when I feel the urge and wait until after work in the evening to have a bowel movement? Would this be effective?
3.
Sometimes when I am out, I cannot have a bowel movement in a timely manner.
If I hold it in during the afternoon and wait until the evening, could this lead to difficulty or even constipation? How long does it take for stool to lose moisture in the colon and potentially cause constipation?
4.
Occasionally, I pass smooth, tubular stools, but after sitting in water for a few minutes, they become slightly disintegrated (still tubular but with a somewhat loose surface).
Is this type of stool normal?
Thank you, Doctor, for taking the time to answer my questions.

Zheyang paibian zhengchang ma?, 30~39 year old female. Ask Date: 2015/08/05

Dr. Yang Zhichao reply Gastroenterology and Hepatology

1.
Irritable bowel syndrome (IBS) requires the exclusion of other possible diseases for diagnosis, so please consult with a physician for an evaluation to confirm whether it is IBS.

2.
If increased bowel movements are not due to a disease and you feel the urge to defecate, you should go to the restroom.
If the environment does not permit it, holding it in will not cause issues, but this behavior is not recommended on a regular basis.

3.
The absorption of water from stool varies from person to person, so we cannot provide a definitive answer.

4.
Loose stool structure is not necessarily indicative of a disease or abnormality.
If you are concerned, please visit a hospital to arrange for a stool examination; if there are no abnormalities, there is no need for worry.
Thank you for your inquiry.
Changhua Hospital cares about your health.

Reply Date: 2015/08/05

More Info

Understanding bowel habits is crucial for assessing digestive health, and your inquiry raises several important points regarding normal bowel function, potential gastrointestinal disorders, and the impact of lifestyle choices on bowel habits.

1. Normal Bowel Habits: The frequency of bowel movements can vary significantly among individuals. While the typical range is anywhere from three times a week to three times a day, your pattern of having at least three bowel movements daily, particularly after meals, can be considered within the realm of normal for some individuals. However, the fact that you experience this frequently, especially after meals, could suggest a condition known as "postprandial defecation," which is common in individuals with irritable bowel syndrome (IBS). IBS can manifest as a combination of symptoms, including abdominal pain, bloating, and altered bowel habits, which may include diarrhea or constipation.

2. Adjusting Bowel Habits: Attempting to alter your bowel habits by holding off on bowel movements until a more convenient time can be challenging and may not be advisable. The urge to defecate is a natural reflex, and ignoring it can lead to complications such as constipation or fecal impaction over time. If you consistently suppress the urge to defecate, the stool may become harder and more difficult to pass, leading to discomfort and potential bowel issues. It is generally recommended to respond to your body’s signals and maintain a regular schedule that aligns with your natural urges.

3. Impact of Delaying Bowel Movements: If you find yourself needing to delay bowel movements due to being out and about, it is possible that this could lead to constipation, especially if it becomes a habitual practice. The colon absorbs water from the stool as it remains in the intestines, and if stool is retained for too long, it can become dry and hard, making it difficult to pass. The time it takes for stool to move through the colon can vary, but typically, if stool remains in the colon for more than 24 hours, it can start to lose moisture, leading to constipation.

4. Characteristics of Stool: The description of your stool being formed but occasionally having a smooth surface that breaks apart in water suggests that it may be well-formed but possibly lacking in fiber. A stool that is too soft or breaks apart easily can indicate a lack of dietary fiber or hydration. Ideally, stools should be well-formed, easy to pass, and not overly hard or soft. If you notice a consistent change in your stool's consistency, it may be beneficial to evaluate your diet and ensure you are consuming adequate fiber and fluids.

In conclusion, while your bowel habits may not be alarming, they warrant attention, especially if they are accompanied by discomfort or significant changes. It may be beneficial to consult with a healthcare professional, particularly a gastroenterologist, to discuss your symptoms in detail. They can provide a thorough evaluation, including dietary recommendations and possibly tests to rule out conditions like IBS or other gastrointestinal disorders. Maintaining a balanced diet rich in fiber, staying hydrated, and responding to your body’s natural urges to defecate are essential steps in promoting healthy bowel function.

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