Bowel irritation is one of those common terms used by patients that does not identify a specific symptom or condition. It can describe any number of symptoms including diarrhea, loose or frequent stool that do not fit the specific definition of diarrhea, urgency to defecate, feeling of incomplete evacuation, excessive flatulence and abdominal pain or cramping. Normal bowel movements vary from 3 times a day to 3 times a week. The stool is typically soft but firm, tan to brown in color and is passed out without pain or much strain. Mild abdominal discomfort is not uncommon after eating a very large meal and the passing of flatus (gas) is a normal phenomenon. It is when there is a deviation from the norm and the presence of other bowel-related symptoms that a person may report a bowel irritation without understanding the exact nature of the condition.
Symptoms of Bowel Irritation
The term bowel irritation will refer to one or more of the following symptoms :
- Diarrhea – passing of more than 200ml to 200g per day in more than 3 bowel movements and the stool is often loose and watery
- Frequent bowel movements – defecating more often than normal but not large volume nor loose and watery stools.
- Loose to watery stool – passing stool that is not as firm as usual or liquid stools but the number of bowel movements is unchanged.
- Bloating – a sensation of fullness in the abdomen
- Abdominal distension – enlargement of the abdominal girth with or without the sensation of fullness
- Excessive flatulence – passing of gas through the anus.
- Abdominal pains – which can vary from mild discomfort, to cramps, mild to intense abdominal pains.
- Urgency to defecate – sudden and intense need to pass out stool that is almost unbearable.
- Feeling of incomplete evacuation – sensation that the bowels are not empty even after passing stool.
Other features such as loud bowel sounds, abnormally colored stool, blood in the stool and mucus in the stool may also be included under the term bowel irritation but usually accompanies one or more of the symptoms above.
Causes of Bowel Irritation
A number of factors can cause bowel irritation which in turn leads to various gastrointestinal symptoms. It should not be confused with irritable bowel syndrome – this is a functional bowel disorder characterized by abdominal cramps and pain as well as change in bowel habit.
The more common causes of bowel irritation is :
Gastroenteritis is the acute inflammation of mainly the stomach and small intestine most commonly caused by viruses and bacteria that enter the gut through contaminated food or water. It is also known as the stomach flu or gastric flu. When it arises due to the action of bacterial toxins without an infection and other noxious chemicals in food then it is known as food poisoning. Intense nausea with or without vomiting usually precedes the onset of explosive watery diarrhea.
Food intolerance is a condition where the ability to digest certain foods is impaired as a result of deficient or defective digestive enzymes. Sometimes this is due to inherited tendencies while at other times it develops during life due to some underlying bowel disease. One of the more common forms is lactose intolerance where the symptoms are triggered or exacerbated by foods containing lactose like dairy. Another type of related bowel condition is malabsorption syndromes where the gut’s ability to absorb certain nutrients is affected. This is seen in conditions such as celiac disease and fructose malabsorption. The typical symptoms are abdominal cramps and pain a short while after eating the trigger food and is often followed by loose or watery stool or diarrhea.
Inflammatory bowel disease (IBD) is a chronic condition mainly affecting the colon and rectum where there are episodes of severe inflammation for unknown causes. It is believed to be associated with autoimmune factors. There are two main types – ulcerative colitis and Crohn’s disease. While ulcerative coliis is isolated to the colon and rectum, Crohn’s disease can affect any part of the alimentary tract. Recurrent episodes of diarrhea is the main feature of inflammatory bowel disease and there may also be blood and mucus in the stools.
Gallstones and bile duct stones are the presence of stones in the gallbladder and bile duct respectively. These stones can disrupt bile secretion and even affect the digestive action of the pancreas thereby affecting digestion. It is marked by intense pain particularly after eating. Jaundice which is a yellow discoloration of the skin and “whites” of the eye (sclera) may also be present.
Pancreatitis is inflammation of the pancreas that may be acute or chronic. Acute episodes is often related to gallstones, bouts of excessive alcohol consumption and abdominal injury although there are a host of other causes. Excruciating abdominal pain, nausea, vomiting and frequent bowel movements with oily stools are some of the symptoms that may be present. Chronic pancreatitis can be silent for long periods interspersed with acute episodes.
Bowel obstruction is a partial or complete blockage of the small or large intestine. It can arise for any number of reasons as is discussed under blocked bowel (small intestine) and blocked colon (large intestine). Abdominal pain, cramping, diarrhea initially and then constipation later are some of the signs and symptoms seen with bowel obstruction. There may be loud bowel sounds (borborygmi), nausea and vomiting.
Diverticulitis is the inflammation of pouches that form in the wall of the bowels, particularly in the large intestine. It is more common in people over the age of 40 years. Although the exact cause for the formation of diverticula is not fully known, it is believed that it is associated with constant straining and pressure within the bowels associated with chronic constipation. Symptoms include abdominal pain, tenderness, nausea, vomiting, bloating, constipation, diarrhea and fever.
Irritable bowel syndrome is a functional disorder of the bowel. This means that there is no disease process causing the bowel symptoms but the cause is unknown. It is thought to be associated in changes with normal bowel motility, normal intestinal flora (bowel bacteria) and possibly psychosomatic factors. It may be of two types – diarrhea predominant or constipation predominant. Abdominal pain and cramping accompanies the change in bowel habit. If there is a change in the bowel habit without pain and cramping then it is known as functional constipation or functional diarrhea.
There are a host of other causes of bowel irritation which may require further medical investigation in order to be diagnosed. It is important to note that at times bowel symptoms may be secondary to some other disorder outside of the gastrointestinal tract.