Can stress have an impact on bowel movements?

Question

Hello doctor,

My stomach starts hurting with sharp cramps right before a bowel movement, and then it typically feels better. I have been experiencing this for four to six weeks now. There has been a change in bowel habits and stool size over the last month. Stools are flatter than they used to be and somewhat loose. I have been under a lot of stress and started taking Sertraline three weeks ago, which is making my stomach even more unsettled. I have had a tiny bit of blood in my stool, but only twice, and it was very little. There is more tissue or mucus, not bright red. I have had blood work and a CT (computed tomography) scan on my pelvis, and everything came back normal. Is this probably IBS (irritable bowel syndrome) related?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am reviewing your case history and the attached files (attachments removed to protect the patient's identity), including the medical history, blood report, and CT (computed tomography) scan report. Your hemoglobin levels are well preserved, and the CT scan of your abdomen and pelvis is normal. Your clinical presentation and symptoms strongly suggest irritable bowel syndrome (IBS) rather than inflammatory bowel disease (IBD). Supporting points for IBS include:

Recent onset of significant stress, with symptoms associated with stress.
Recent changes in the frequency and consistency of stools, alternating between constipation and loose stools.
Abdominal cramps are relieved by passing stools.
Increased stress leads to more symptoms.

Regarding the small amount of rectal bleeding, this can be explained by hard stools at times. Suggestions include:

Relaxation is key. Overthinking can exacerbate symptoms, as this is typical behavior for IBS.
Your CT scan and blood report are normal, and the scheduled colonoscopy is expected to be normal as well, which will help confirm the diagnosis of IBS.
You are taking Sertraline; these medications take time to be effective but should work for you. Additionally, try to avoid stressors as much as possible.
Pay attention to your diet. If you start avoiding certain foods based on your symptoms, you may inadvertently limit your options, which is not recommended. When you are relaxed, your symptoms are likely to diminish on their own.

I hope there has been no weight loss and no significant family history of gut-related diseases like cancer.

Wishing you good health.

I hope this helps you.

Thank you.