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Ask the Doc Q&A
For the past few months, I’ve had bloating and bowel movement changes such as constipation, diarrhea, slim stools, mucus-type stools, and bowel movements that I’d consider violent and explosive. I went to an urgent care center, where I was told I was impacted — with advice to buy stool softeners. The pain lasted 3-5 more days. I have had no weight loss, but I am tired a lot. Any suggestions?
For the past few months, I’ve had bloating and bowel movement changes such as constipation, diarrhea, slim stools, mucus-type stools, and bowel movements that I’d consider violent and explosive. I went to an urgent care center, where I was told I was impacted — with advice to buy stool softeners. The pain lasted 3-5 more days. I have had no weight loss, but I am tired a lot. Any suggestions?
htmASKTHEDOCdigestivedisordersimpacted
If you are in your teens or twenties — and the symptoms have been present for more than 6 months — the most likely diagnosis is irritable bowel syndrome (IBS). But there are multiple other possibilities.
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2012-11-16
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Howard LeWine, M.D.
2015-11-16
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Ask The Expert
Harvard Medical School
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General Medical Questions
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Q: For the past few months, I’ve had bloating and bowel movement changes such as constipation, diarrhea, slim stools, mucus-type stools, and bowel movements that I’d consider violent and explosive. I went to an urgent care center, where I was told I was impacted — with advice to buy stool softeners. The pain lasted 3-5 more days. I have had no weight loss, but I am tired a lot. Any suggestions?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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November 16, 2012
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A:

You need to make an appointment with your primary care doctor. Your doctor will need more details about your symptoms.

How old are you? And when did you first begin having any abdominal discomfort or bowel movement changes? If you are in your teens or twenties — and the symptoms have been present for more than 6 months — the most likely diagnosis is irritable bowel syndrome (IBS). But there are multiple other possibilities.

To rule out those possibilities, your doctor will ask additional questions.

You mentioned that you had no weight loss. That is reassuring. Your doctor will also want to know if you have had any fever, traveled outside the United States, and/or had specific areas of pain in your abdomen or elsewhere. If you answer “yes” to any of these questions, your doctor will consider the possibility of an infection. This is especially true if the symptoms began just recently.

Do the symptoms wake you up at night? In general, people with IBS don’t wake up during sleep because of symptoms. Other conditions, such as ulcerative colitis and Crohn’s disease, can cause symptoms at night as well as daytime.

Have you noticed any blood in your stool? If yes, then you likely need further testing before calling the problem IBS.

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