# ibs or something else?



## trumpetguy (May 12, 2010)

Hi. I'm a 22 year old male. I struggled with constipation for years as a kid, through most of elementary school. When I finally started going regularly, the BM was always a huge quantity, and very large around (often a regular BM would clog a toilet). In college I gained weight, and now I'm overweight at around 251 pounds (5'10" ish). In March I exercised and dieted and lost 6 pounds and was feeling pretty good, but then near the end of march I had my first narrow stool. It looked normal colored, but it was much reduced in width and it looked rather flat. Ever since then, I've been having flat stools, though sometimes they aren't as flat as other times. Sometimes I feel like I have an almost normal bm--painless, soft, almost completely round. But then sometimes I have to strain just to squeeze out a little flat turd. Sometimes I have diarrhea, and when I do it floats and looks rather greasy. Sometimes I see little white blobs of something in my stool. Sometimes my stools are orange colored, other times they're dark brown, and sometimes they're a normal light brown color. Sometimes they're soft, sometimes they're hard. But they're never quite round, and sometimes they're downright ribbon-flat. I have intermittent abdominal pain that never seems to stay in one spot, though the most regular spots in appears is in the lower left portion. The pain is never severe, but more just like a muscle cramp or a dull ache like someone playfully hit me in the stomach. I believe I suffer from hemorrhoids, because for many years my BMs have been somewhat painful, and sometimes I find little streaks of bright red blood on the toilet paper, but never in the bowl or on the stool. Sometimes the blood is also a little yellow, like pus or mucus is mixed in with it. I've also had a clear liquidy discharge from the anus for a long time which at first I thought was sweat but it was too much and in the wrong place for that. This discharge happens mostly within the hour or two after a BM, and usually after a BM my bottom hurts for a while. Also, a lot of the time, I couldn't just evacuate all my BM simply by pushing, but I had to squeeze the muscles down there to squeeze the rest of it out, like the muscles/nerves don't work correctly. When I sit I have a strange sensation in my tailbone that's not painful, but more of a tickly sensation. My urine stream also isn't as strong as it probably ought to be, and I think it might be because all the vicious straining for years with constipation might have damaged some muscles down there.After my flat stools started, I stopped exercising until I got to see the doctor, because I didn't want to keep exercising if that's what caused/exacerbated my problem. After meeting with my GP (who knows me quite well), and telling her my problems and digestive history, she palpated my abdomen and put her stethoscope on various places, then told me I have an acquired megacolon from all the constipation, and she prescribed me Lactulose, 1 dose every day for a year to make the megacolon/megarectum shrink. All she did about the narrow stools (which were what prompted me to go to her in the first place) was give me an x-ray and a CT scan (for which I had to drink a huge bottle of watery liquid beforehand, and during which I was given a blood injection to further enhance the image). After seeing the CT scan, she told me I was not obstructed and to just take the Lactulose.I've been on the Lactulose for over a month now. I have extremely foul smelling gas, but other than that I feel like my abdomen isn't as distended as it used to be, and my general level of bloating has decreased dramatically. I still have the narrow stools, but it doesn't hurt as often due to the stools being softer, but I still have to push frequently to empty my bowel. Besides the intermittent abdominal discomfort, I don't have any other symptoms...no anemia or fatique. In fact, I've been needing less sleep lately than I used to. However, I tend to not have as big an appetite as I used to, and it doesn't take as much food to satisfy me. I'm not sure if this is just because I've been dieting and eating smaller portions on purpose to help control my weight or not. Oh, and I still find blood on the toilet paper and I still have the discharge, although that has decreased in frequency as well. There is no history of colon cancer in my family. My mom has IBS, and I don't believe anyone in my family has developed polyps at an early age. My Dad has type 2 diabetes, and a couple other, more distant, family members have it, too. I haven't been tested for any of that yet. So what do you all think? I still have narrow stools, and sometimes I still have to strain to have one little BM, but that's not how it always is. Could I have big internal hemorrhoids that squeeze the BMs, or is it IBS, or could it be something worse?I also suffer from asthma and environmental allergies.


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## Kathleen M. (Nov 16, 1999)

flat or thin stools are softer than full width stools. They are not dangerous.Floating stools have to do with how much GAS is trapped inside the stool.Every stool looking different is common in IBS and is not a sign of anything else.Abdominal pain including what you describe is found in IBS. Some pain or discomfort is techinically required for an IBS diagnosis.Megacolon is not required for IBS but that seems to be something your doctor has a handle on.Did the soft stools start during this "constipation so bad it altered your colon anatomy" thing or only after the lactulose which is supposed to soften the stool.Lactulose can cause gas, you might try miralax. It doesn't ferment but does the same osmotic laxative thing.If you strain a lot even with soft or loose stools you might need to have your pelvic floor evaluated.If you have been eating less it is normal for smaller meals to make you feel full.


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## Bonzi (Mar 18, 2010)

Your recent symptoms are spot on with mine. Its just an issue of IBS. Alternating normal stools to flat, travelling abdominal pains, mainly in the left though,etc. I couldve written your paragraph thats how similar are issues are!Your BMs change shape due to how hard or soft they are.


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## hasenfuss (Dec 28, 2006)

The left sided pain seems very typical of IBS. I would say mine is 90% of the time in the left and it's also intermittened pain.


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## trumpetguy (May 12, 2010)

Kathleen, the soft stool started happening after taking the lactulose. Before that they were big and hard and lumpy. I've also thought about the pelvic floor thing and think I'll bring it up next time I go to the dr. considering I also have the urine problem (not realy a "problem" but more of an abnormality). Seems like it makes sense that the pelvic floor muscle is loose or damaged or something.


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## Kathleen M. (Nov 16, 1999)

the lactulose should soften up and loosen the stool, so that is normal for people taking it.The dose to get "perfect" stool may be hard to determine and may change from day to day. Overshooting to "soft" is usually better than not getting enough.


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