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What Could Cause Chronic Loose Bowel Movement Despite Trying Different Kinds Of Diet?
Question: Hi,
I have had loose bowel movements for over 8 years (I'm in early 20s). By that I mean the chances of my BMs to be solid like sausage are about 1/100 if not worse. The BMs do vary but in order of frequency: Sometimes mushy but even individual bits not entirely solid, sometimes small pebbles and at times mixtures of shapes and sizes. Ocassionally it is diarhhea full on liquid but usually that is due to stressful or exciting situations.
I'm trying to figure out what is causing this. My main reason for the concern (given that I've had it for so long without other complications as far as I know) is because very often I can't completely empty my BMs. This means that it's very difficult to clean the area with just toilet paper...
I know that this is the case because, 1) If I stay in the toilet long enough, I can always get a little bit more out with extreme pushing and 2) I've waxed the area before and it didn't make a difference. 3) In the unlikely event that my BMs are solid sausages, there is usually very little to nothing on tissues.
Been to GP many times and they couldn't really find anything wrong. Put me on some tests for a serious condition years ago (can't remember what it was) but that was all negative.
I only drink water, juices and ocassionally alcohol but have gone for months without alcohol without seeing any difference.
I feel I eat plenty of veg and fruit and nuts so unless I have coeliac or some other food allergy, I don't think it's a diet/fibre problem. In regards to allergies, I don't get any other syptoms that these allergies usually give so not really sure if they are the cause.
I do probably have a mild form of IBS but again I'm not sure the symptoms completely match my situation. Most of the time, even if the BMs are not solid, I can still hold them in without a problem if I don't have immediate access to a toilet etc.
Overall I want to see if there is anything I can do to solve this. I'm even considering going on a gluten,soy, dairy free diet but have read that it could take months to see any effects, so hoping I can maybe rule out quicker causes first.
Many thanks
I have had loose bowel movements for over 8 years (I'm in early 20s). By that I mean the chances of my BMs to be solid like sausage are about 1/100 if not worse. The BMs do vary but in order of frequency: Sometimes mushy but even individual bits not entirely solid, sometimes small pebbles and at times mixtures of shapes and sizes. Ocassionally it is diarhhea full on liquid but usually that is due to stressful or exciting situations.
I'm trying to figure out what is causing this. My main reason for the concern (given that I've had it for so long without other complications as far as I know) is because very often I can't completely empty my BMs. This means that it's very difficult to clean the area with just toilet paper...
I know that this is the case because, 1) If I stay in the toilet long enough, I can always get a little bit more out with extreme pushing and 2) I've waxed the area before and it didn't make a difference. 3) In the unlikely event that my BMs are solid sausages, there is usually very little to nothing on tissues.
Been to GP many times and they couldn't really find anything wrong. Put me on some tests for a serious condition years ago (can't remember what it was) but that was all negative.
I only drink water, juices and ocassionally alcohol but have gone for months without alcohol without seeing any difference.
I feel I eat plenty of veg and fruit and nuts so unless I have coeliac or some other food allergy, I don't think it's a diet/fibre problem. In regards to allergies, I don't get any other syptoms that these allergies usually give so not really sure if they are the cause.
I do probably have a mild form of IBS but again I'm not sure the symptoms completely match my situation. Most of the time, even if the BMs are not solid, I can still hold them in without a problem if I don't have immediate access to a toilet etc.
Overall I want to see if there is anything I can do to solve this. I'm even considering going on a gluten,soy, dairy free diet but have read that it could take months to see any effects, so hoping I can maybe rule out quicker causes first.
Many thanks
Brief Answer:
A clear cut case of irritable bowel syndrome if all investigations are normal
Detailed Answer:
Hello,
As per your queries and details given by you all your symptoms as well as duration of illness is suggestive of Irritable bowel syndrome.However IBS is a diagnosis of exclusion as there is no test to confirm you have IBS, it means that when you have nothing or all your investigations are normal you are labelled as having IBS.
Only thing required in your case are three tests-
* CT abdomen
* Colonoscopy of large intestine
* Stool routine and microscopy with serum calprotectin (indicator of inflammation in gut)
IBS as you already are aware of is a common disorder affecting the large intestine. Abdominal pain, bloating, gas constipation and diarrhea are some of the signs and symptoms of IBS. Foods, stress and other diseases can trigger the problem.No one till date is however confirm that what causes it. It is very common in young age and is fully controllable though not curable.
studies over years suggest that a lot of factors play a major role. The intestinal walls are lined with a layer of muscle which contracts and relaxes in a rhythm when they move to your rectum through your intestinal tract. If you acquire irritable bowel syndrome, the contractions can get stronger and last much longer than usual. This causes diarrhea, bloating and gas. In some cases, the opposite can also occur, this can be characterized by weak intestinal contractions, which slows food passage resulting to dry and hard stools.Some patients presents with constipation while other have loose stools. Every patient with IBS is different with varying symptoms.
In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect SO in lay mans language till date we are not sure whats the exact cause of this problem. The million dollar question is how to repair a system when you don't know which part of it is faulty(Some says it can be brain other says it can be hormone anxiety age etc).
If three tests sugested above are normal i would like to start you on-
Tab cibis 8mg thrice daily(contains Chlordiazepoxide, Clidinium Bromide, and Dicyclomine) consult your local pharmacy for this salt combination.
Why cibis?
Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.
Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of frequent stools.
Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.
Take a probiotic daily with food as proper digestion of food.
Food pattern recommended is-
* Eat simple and natural home cooked food.
* If possible try detox diet (Raw vegans) for at least 3 month. * * Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders.
* Avoid taking excessive fiber. A total fiber intake of about 20-25 gram per day would be good for you.
* No pizza, Burger, Red meat, and dairies for few weeks.
* No alcohol or smoking.
As to take natural food rich in probiotics like Yoghurt, Kimchi etc. This doesn't mean that you have to take them as much as you can. Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily. Drink cleaner water, it will help a lot.
Avoid over spicy and heavy food.
If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.
Hope I have answered your query. In case you need any other help feel free to ask. I would be happy to help you.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
A clear cut case of irritable bowel syndrome if all investigations are normal
Detailed Answer:
Hello,
As per your queries and details given by you all your symptoms as well as duration of illness is suggestive of Irritable bowel syndrome.However IBS is a diagnosis of exclusion as there is no test to confirm you have IBS, it means that when you have nothing or all your investigations are normal you are labelled as having IBS.
Only thing required in your case are three tests-
* CT abdomen
* Colonoscopy of large intestine
* Stool routine and microscopy with serum calprotectin (indicator of inflammation in gut)
IBS as you already are aware of is a common disorder affecting the large intestine. Abdominal pain, bloating, gas constipation and diarrhea are some of the signs and symptoms of IBS. Foods, stress and other diseases can trigger the problem.No one till date is however confirm that what causes it. It is very common in young age and is fully controllable though not curable.
studies over years suggest that a lot of factors play a major role. The intestinal walls are lined with a layer of muscle which contracts and relaxes in a rhythm when they move to your rectum through your intestinal tract. If you acquire irritable bowel syndrome, the contractions can get stronger and last much longer than usual. This causes diarrhea, bloating and gas. In some cases, the opposite can also occur, this can be characterized by weak intestinal contractions, which slows food passage resulting to dry and hard stools.Some patients presents with constipation while other have loose stools. Every patient with IBS is different with varying symptoms.
In IBS there is some problem in the functional ability of the gut that leads to the symptoms of irritable bowel syndrome. The structure of the intestines is normal, only functional abnormality occurs in this condition.So frankly speaking (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect SO in lay mans language till date we are not sure whats the exact cause of this problem. The million dollar question is how to repair a system when you don't know which part of it is faulty(Some says it can be brain other says it can be hormone anxiety age etc).
If three tests sugested above are normal i would like to start you on-
Tab cibis 8mg thrice daily(contains Chlordiazepoxide, Clidinium Bromide, and Dicyclomine) consult your local pharmacy for this salt combination.
Why cibis?
Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.
Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of frequent stools.
Chlordiazepoxide works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain.
Take a probiotic daily with food as proper digestion of food.
Food pattern recommended is-
* Eat simple and natural home cooked food.
* If possible try detox diet (Raw vegans) for at least 3 month. * * Take normal food in lunch while in supper take uncooked raw (low fiber) natural form of food. This can play wonders.
* Avoid taking excessive fiber. A total fiber intake of about 20-25 gram per day would be good for you.
* No pizza, Burger, Red meat, and dairies for few weeks.
* No alcohol or smoking.
As to take natural food rich in probiotics like Yoghurt, Kimchi etc. This doesn't mean that you have to take them as much as you can. Follow your body increase their uptake gradually.
Drink lots of juices and fresh water daily. Drink cleaner water, it will help a lot.
Avoid over spicy and heavy food.
If possible go for a detox diet but again don't force your body rather let your body adopt gradually to things.
Hope I have answered your query. In case you need any other help feel free to ask. I would be happy to help you.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for the detailed answer Dr. XXXXXXX XXXXXXX
One further question:
Is the occasional inability to completely empty my bowels also part of IBS or is there something else I may need to do for that, different to the suggestions already made?
Thank you!
One further question:
Is the occasional inability to completely empty my bowels also part of IBS or is there something else I may need to do for that, different to the suggestions already made?
Thank you!
Brief Answer:
Follow up answer.
Detailed Answer:
Hello,
As explained earlier every patient is unique and symptoms are different.
Inability to evacuate completely or not feeling fully fresh can be due to it so go for colonoscopy(if there is any other problem it would be reflected in colonoscopy).
* Get three tests done.
* Get a diagnosis and go for treatment. The earlier the better.
Hope I was helpful.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Follow up answer.
Detailed Answer:
Hello,
As explained earlier every patient is unique and symptoms are different.
Inability to evacuate completely or not feeling fully fresh can be due to it so go for colonoscopy(if there is any other problem it would be reflected in colonoscopy).
* Get three tests done.
* Get a diagnosis and go for treatment. The earlier the better.
Hope I was helpful.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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