Persistent Lower Abdominal Discomfort After Bowel Movements: Causes and Solutions

After having a bowel movement, there is still a feeling of heaviness and bloating in the lower abdomen?

I have a regular bowel movement once in the morning and once after lunch.
My stools are often short or thin and float on the water.
Sometimes they are dark green, while other times they are brown or yellow.
However, for the past six months, I have experienced persistent bloating in my lower abdomen after each bowel movement, which worsens after dinner.
I feel a dull pain and have gas, but I am unable to pass stool.
My colon seems to be producing gas continuously, leading to frequent flatulence.
In April of this year, I underwent a fecal occult blood test, and the doctor only noted anemia.
Subsequently, I was prescribed a stool softener and fiber supplements, but this only increased the frequency and volume of my bowel movements without alleviating my symptoms.
I drink over 2000cc of water daily and consume plenty of vegetables, while eating very little meat and fatty foods.
Why is this happening?

Mi Mi, 30~39 year old female. Ask Date: 2015/12/20

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, it is recommended to consume more fruits and vegetables regularly.
Ensure adequate hydration, engage in moderate exercise, and reduce the intake of gas-producing foods.
If you still experience bloating, irregular bowel movements, or anemia, it is advisable to undergo stool tests or a colon examination.
Wishing you good health.
Dr.
Lin Ming-Hui, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/20

More Info

Persistent lower abdominal discomfort after bowel movements can be a frustrating and concerning issue. Based on the symptoms you've described, it seems that you are experiencing a combination of abdominal bloating, discomfort, and changes in stool consistency. Here are some potential causes and solutions to consider.

Possible Causes
1. Irritable Bowel Syndrome (IBS): One of the most common gastrointestinal disorders, IBS can cause symptoms such as abdominal pain, bloating, and changes in bowel habits. It often presents with alternating episodes of diarrhea and constipation. The discomfort you feel after bowel movements could be related to this condition, especially if you notice that stress or certain foods exacerbate your symptoms.

2. Dietary Factors: Even though you mentioned consuming a high-fiber diet and drinking plenty of water, certain foods can still contribute to bloating and gas. Foods that are high in fermentable carbohydrates (often referred to as FODMAPs) can lead to increased gas production and discomfort. Common culprits include beans, lentils, certain fruits (like apples and pears), and dairy products if you are lactose intolerant.

3. Gut Motility Issues: If your bowel movements are consistently short or thin, it may indicate an issue with gut motility. This could be due to a variety of factors, including dietary habits, stress, or even underlying gastrointestinal conditions that affect how your intestines function.

4. Pelvic Floor Dysfunction: Sometimes, the muscles responsible for bowel movements may not function properly, leading to a feeling of incomplete evacuation and discomfort after you go to the bathroom. This can be particularly relevant if you experience pain or discomfort during bowel movements.

5. Inflammatory Conditions: Although you mentioned a negative fecal occult blood test, conditions such as inflammatory bowel disease (IBD) can sometimes present with similar symptoms. It may be worth discussing further testing with your healthcare provider if symptoms persist.

Solutions and Recommendations
1. Dietary Adjustments: Consider keeping a food diary to identify any potential triggers that may be contributing to your symptoms. You might want to try a low-FODMAP diet under the guidance of a healthcare professional or dietitian to see if it alleviates your discomfort.

2. Hydration and Fiber: While you are already drinking a significant amount of water and consuming fiber, ensure that the fiber is coming from a variety of sources, including both soluble and insoluble fiber. Sometimes, increasing fiber too quickly can lead to bloating, so gradual adjustments may help.

3. Regular Exercise: Engaging in regular physical activity can help improve gut motility and reduce bloating. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Stress Management: Since stress can exacerbate gastrointestinal symptoms, incorporating stress-reduction techniques such as yoga, meditation, or deep-breathing exercises may be beneficial.

5. Consultation with a Specialist: If your symptoms persist despite making dietary and lifestyle changes, it may be helpful to consult with a gastroenterologist. They can perform further evaluations, such as imaging studies or endoscopy, to rule out any underlying conditions.

6. Medication Review: Since you mentioned being prescribed softeners and fiber supplements, it may be worth discussing with your doctor whether these medications are appropriate for your current symptoms or if adjustments are needed.

In conclusion, persistent lower abdominal discomfort can arise from various causes, and addressing it often requires a multifaceted approach. By carefully monitoring your diet, managing stress, and consulting with healthcare professionals, you can work towards finding relief from your symptoms.

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