Changes in Stool Shape and Frequent Diarrhea: Causes and Solutions

Frequent diarrhea with thin, unformed stools?

Hello Dr.
Chen, I have noticed a significant change in the shape of my stool over the past month; it has become noticeably thinner, and I often experience diarrhea with unformed stools.
Initially, I had no urge to defecate, and when I did, the amount was small.
I also find myself passing gas frequently.
After a few days, I started experiencing stomach pain and diarrhea.
Eating a lighter diet has improved the diarrhea somewhat.
In the past two weeks, I have had some urge to defecate, but sometimes I still have diarrhea, and at other times, my stools are soft and scattered.
Occasionally, I experience stomach pain, and about three to four times a week, I suddenly pass gas.
I have been eating fruits and vegetables regularly, drinking water, and exercising, but after observing my bowel habits for a month, they still haven't returned to normal.
I had a colonoscopy three months ago, and the doctor said everything was fine.
Six months ago, I had an upper endoscopy, and it was noted that I have a relaxed lower esophageal sphincter.
Should I consider having another colonoscopy or upper endoscopy? Could this be a case of irritable bowel syndrome? I also have hemorrhoids (both internal and external, but not severe).
Could this affect the thickness of my stool? Would taking a stool softener help in my situation, or would dietary adjustments suffice?

14, 20~29 year old female. Ask Date: 2015/11/03

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, generally speaking, hemorrhoids do not affect the caliber of stool.
Your symptoms may indicate gastrointestinal dysfunction, which can also be referred to as irritable bowel syndrome (IBS).
The main dietary adjustments are as follows: reduce oil, dairy, and irritating foods, and maintain a gentle and balanced diet.
You may consider using digestive enzymes.
- Dr.
Chi-Feng Chen, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/11/03

More Info

Understanding changes in stool shape and frequent diarrhea can be quite concerning, and it’s important to approach this issue with a comprehensive understanding of potential causes and solutions. Based on your description, it seems you are experiencing a combination of symptoms including changes in stool consistency, abdominal discomfort, and increased flatulence.
Firstly, the changes in stool shape and consistency can be attributed to several factors. One common condition that may be relevant in your case is Irritable Bowel Syndrome (IBS), which is characterized by a combination of abdominal pain and altered bowel habits, including diarrhea and constipation. IBS can be triggered by dietary changes, stress, or alterations in gut microbiota. Given that you have been experiencing these symptoms for about a month, it is plausible that your digestive system is reacting to changes in your diet or lifestyle.

Your history of having undergone a colonoscopy three months ago, which showed no abnormalities, is reassuring. However, if your symptoms persist or worsen, it may be worth discussing with your healthcare provider whether a follow-up colonoscopy is necessary, especially considering your previous history of polyps. It’s also important to note that while IBS is a functional disorder and does not show structural abnormalities, it can still cause significant discomfort and distress.

Regarding your dietary habits, you mentioned consuming a diet rich in fruits and vegetables, which is generally beneficial for digestive health. However, if you are consuming excessive amounts of fiber suddenly, it can lead to gas and bloating, which may explain your increased flatulence. It’s crucial to balance fiber intake and ensure it is gradually increased to allow your digestive system to adjust. Additionally, certain high-fiber foods can be more fermentable, leading to gas production.
You also mentioned experiencing abdominal pain and diarrhea, which improved with a lighter diet. This suggests that your digestive system may be sensitive to certain foods or food groups. Keeping a food diary can help identify any specific triggers that may be exacerbating your symptoms.
As for your question about the impact of hemorrhoids on stool shape, while hemorrhoids themselves typically do not change stool consistency, they can cause discomfort during bowel movements, which might lead to changes in your bowel habits. If you are experiencing pain or discomfort, it may lead to a tendency to avoid straining, which can affect stool formation.

In terms of treatment, dietary adjustments are often the first line of management for IBS and other functional gastrointestinal disorders. You might consider reducing high-fat foods, dairy products, and caffeine, as these can sometimes exacerbate symptoms. Additionally, staying well-hydrated and incorporating regular physical activity can support digestive health.

Regarding the use of stool softeners, they can be helpful if you are experiencing hard stools or straining during bowel movements. However, if your stools are already soft or loose, stool softeners may not be necessary and could potentially worsen diarrhea.
In conclusion, while your symptoms may suggest a functional gastrointestinal disorder such as IBS, it is essential to work closely with your healthcare provider to monitor your condition. If symptoms persist or worsen, further evaluation may be warranted. Regular follow-ups and open communication with your doctor will help ensure that any underlying issues are addressed and that you receive appropriate management for your symptoms.

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