Regularity... or not.

I was loosely diagnosed (no testing done) with IBS in the past.  Anxiety runs in my family and I have a feeling that it wreaks havoc on our bowels also due to the strong connection between the brain and the gut.

My situation has been going on for quite some time but curiosity has finally gotten the best of me and caused me to post this question.  

I am VERY regular... I go to the restroom every morning typically right around 9:00am.  My first visit to the bathroom is pretty average; stools are of normal size and consistency (or maybe slightly soft).  However, nearly every morning after completing my first bathroom visit, I have to go again about 30 minutes later.  My second bathroom visit typically results in stools that are thin (2-3 times pencil width) and smaller in size (4-5 inches long max).  The amount of stool in significantly less during the second trip but the change in consistency from visit to visit is what prompts my question.

What could cause this?  Obviously there is no bowel obstruction since the first visit is almost always normal - and this has been going on for quite some time.  Could this be a side effect of the IBS, anxiety, or possible something else all together?

Thanks!

[Kevin Pho, MD]

The symptoms can certainly be caused by IBS.  I agree with the tests you had thus far, including the imaging studies and stool tests.

I would consider a colonoscopy at this time, to evaluate for inflammatory bowel disease or anatomical abnormalities.  

A blood test can also be done for celiac disease.  

If negative, IBS can be treated for.  Options can include increasing the amount of fiber in the diet, antispasmodic agents, tricyclic medications or antibiotics like Rifaximin.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[TiredOfThis]

I forgot to add:
• 31 year old Male
• 6 feet - 140 pounds (tall and slender runs in my family too)
• No previous major medical issues

[TiredOfThis]

One more update... I just made my third trip to the restroom this morning (this is not the norm) and this trip was practically diarrhea.  How is it possible to go from nearly constipated to nearly diarrhea in the course of 3 hours?

[TiredOfThis]

I sincerely apologize for adding so many comments - but I was composing that post at the office and was trying to be quick.

I actually did have the following tests done for right side abdominal pain in the past:
- Abdominal CT Scan w/Barium Swallow
- Abdominal Ultrasound
- Stool Samples/Testing
- Abdominal X-Ray

All were negative.

Thank you again reading and assessing my post.