What are Regular Bowel Movements?
Having three bowel movements per week to three movements per day is considered as normal in general population.
Irregular Bowel Movements
An individual has irregular bowel movements, if he/she has:
- Over three loose stools per day (diarrhea – loose bowel movements)
- Less than three stools per week (constipation)
- Change in usual stool frequency
- Change in stool consistency
1. Causes of Diarrhea
Small Children (Under 5 Years of Age)
Rotavirus is leading cause of diarrhea in small children worldwide. In Africa, South Asia, South and Middle America it is still a common cause of death. Treatment is relatively easy with replacement of lost fluid. Pre-prepared re-hydration solutions (Pedyalite, Rehydralite, etc) are available in markets, and oral rehydration solution (ORS) is delivered by World Health Organization (WHO) where necessary. Effective vaccinations are available.
Bacterial and parasitic infections, mainly from food or water poisoning, are also common.
Fruit juices. Fructose from fruit juices, if ingested in excess, cannot be properly absorbed by child’s small intestine – this is a common cause of chronic diarrhea (toddler’s diarrhea), mainly in western world. Solution: a child with unexplained chronic diarrhea should not drink a lot of fruit juices.
Food allergies, mainly to cow’s milk, eggs, soy, wheat, tree-nuts, and peanuts can’t be treated, but symptoms (hot flushes, itch, diarrhea, difficult breathing) may be relieved by anti-allergic medications (histamines or corticosteroids) by mouth. Many food allergies go away until adolescence though.
Older Children and Adults
Food poisoning with bacterial, or rarely parasitic infection of the bowel, is often accompanied by bloating and gas. Treatment (only if diarrhea lasts over 5 days, or a lot of fluid is lost – like in cholera) is by antibiotics, prescribed by a doctor. In massive diarrhea, a doctor has to be visited immediately, and intravenous fluid replacement started. In meantime, oral rehydration solution should be given.
Antibiotics can cause diarrhea from five days to several weeks after start of taking them. Therapy is in changing or dropping of an antibiotic, and use of probiotics containing Lactobacillus acidofilus or Saccharomyces boullardi.
Alcohol in excess, severe or constant stress, and panic attack are another common causes of acute (short lasting) diarrhea .
Inflammation of the bowel (Crohn’s disease or ulcerative colitis), lactose intolerance, fructose malabsorption, and celiac disease are main causes of chronic diarrhea. Treatment is with lactose-free, fructose-free, or gluten-free diet, or anti-inflammatory drugs.
2. Causes of Constipation
General causes of constipation are:
- not enough drinking
- lack of exercise
- lack of fibers in the diet
- stress (anxiety or depression)
Congenital diseases as cystic fibrosis or Hirschsprung disease are main cause of constipation in newborns.
Psychological causes are common in school-aged children.
Any heavy disease (pneumonia, neurological diseases), or pain, or being bedridden for a long periods (or even staying in a hospital for few days) may be a reason for constipation.
Peptic ulcer, intestinal inflammation, polyps, and hemorrhoids may need gastroscopy or colonoscopy to be identified.
Hypothyroidism, diabetes, pregnancy, and adrenal gland insufficiency are main hormonal causes.
Medications like sedatives, opiates, diuretics, anti-acids, iron supplements, to name a few, are common cause of constipation, as they are surgery, or investigations like colonoscopy.
Irritable bowel syndrome (IBS), a diagnosis often given, when no causes of constipation or diarrhea can’t be found, is actually often caused by stress or reaction to food (especially to foods containing lactose (in dairy), fructose, sorbitol, xylitol, or HFCS).
3. Change in Stool Frequency
Menopause, menstrual period, anxiety, change in diet, changing a job, moving a house, or other major event may all cause change in stool frequency.
4. Change is Stool Consistency
Change in diet, or amount of fluid taken, gallbladder or pancreatic disease are often causes of change in the softness of the stool.