Changes in Bowel Habits: From Diarrhea to Constipation

Q: Changes in Bowel Habits: From Diarrhea to Constipation

Hello： A change in bowel habits should be compared to one's own usual habits; if it has been consistent over many years, it cannot be considered a change. <br>However, if there is accompanying weight loss or blood in the stool, a follow-up visit is necessary. <br>After all, the s

Changes in bowel habits

Hello Doctor: I have a rather impatient personality and tend to get nervous easily.
I exercise regularly, but I have had gastrointestinal issues since my school days, with my stools generally being soft or loose.
Whenever I have exams and feel anxious, I experience diarrhea.
After meals, I often pass gas and frequently hear bowel sounds.
My usual bowel habit is once a day, either in the morning after waking up or after breakfast.
However, I've noticed that if I have a bowel movement right after waking up, the stool is soft and formed, but if I wait about 30 minutes after breakfast, it becomes loose.
I have consulted at a medical center (my family has no history of colorectal cancer) and underwent a fecal occult blood test, which was normal.
The doctor believes I have irritable bowel syndrome and does not recommend a colonoscopy.
I would like to ask if a change in bowel habits refers to my tendency to have frequent bowel movements potentially turning into constipation?

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

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: A change in bowel habits should be compared to one's own usual habits; if it has been consistent over many years, it cannot be considered a change.
However, if there is accompanying weight loss or blood in the stool, a follow-up visit is necessary.
After all, the sensitivity and specificity of fecal occult blood tests for colorectal diseases are not very high, and changes in clinical symptoms are the primary basis for deciding whether to perform a colonoscopy.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2015/12/30

More Info

Changes in bowel habits can be a significant indicator of gastrointestinal health, and understanding these changes is crucial for maintaining overall well-being. In your case, it seems that you have a history of gastrointestinal sensitivity, particularly during stressful periods, which is quite common among individuals with anxiety or a nervous disposition.
From your description, it appears that your bowel habits have been relatively consistent, with daily bowel movements that are typically soft but can vary in consistency depending on factors such as diet and stress levels. The fact that you experience looser stools after breakfast suggests a possible connection between your eating habits and your bowel function, which is not uncommon. The gastrointestinal tract is highly responsive to food intake, and meals can stimulate bowel movements due to the gastrocolic reflex, which is a physiological response that triggers bowel activity after eating.

When discussing changes in bowel habits, it is essential to consider what constitutes a "change." In your case, if you have noticed a shift from your usual pattern of daily bowel movements to experiencing constipation or infrequent stools, this could be classified as a change. However, if your bowel movements remain daily but vary in consistency, this may not necessarily indicate a pathological change but rather a response to dietary or lifestyle factors.

Given your history of soft stools and occasional diarrhea, it is possible that your bowel habits are influenced by your diet, particularly your intake of fiber and hydration. A diet low in fiber can lead to softer stools, while increased fiber intake can help regulate bowel movements and improve stool consistency. Additionally, stress and anxiety can exacerbate gastrointestinal symptoms, leading to changes in bowel habits, including diarrhea or constipation.

You mentioned that you have undergone a fecal occult blood test, which returned normal results, and that your physician has diagnosed you with irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, including diarrhea and constipation. It is essential to manage IBS through dietary modifications, stress management, and possibly medication if necessary.

To address your concerns about whether your current bowel habits indicate a shift towards constipation, it is crucial to monitor your symptoms closely. If you find that you are experiencing fewer bowel movements, harder stools, or discomfort during bowel movements, these could be signs of constipation. On the other hand, if your bowel movements remain regular but vary in consistency, this may simply reflect the ongoing influence of diet and stress.

In summary, changes in bowel habits can be multifactorial, influenced by diet, stress, and underlying gastrointestinal conditions. Given your history and current symptoms, it would be beneficial to focus on maintaining a balanced diet rich in fiber, staying well-hydrated, and managing stress through relaxation techniques or counseling. If you continue to experience significant changes in your bowel habits or if new symptoms arise, it would be advisable to follow up with your healthcare provider for further evaluation and management.

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