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What Causes Pebble Like Stool?

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Posted on Thu, 3 Jul 2014
Question: i have stool problem, when i poo it looks goat poo sometimes. what is wrong with me? Also i have hemoroid too sometimes it bleeds sometimes it doesnt.
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
COnstipation and haemorrhoids need management

Detailed Answer:
Thank you for asking!
I can understand the concern but explaining the stools with mere correlation to goats stools is not helpful. Do you mean you dont get full emptying of bowel, or the constipation, i believe you mean you have difficulty passing stools and constipation needs to be a likely cause for it as concomitant hemorrhoid make it more likely.
The bowel needs a little work up to sort out the cause for constipation.till then diet and lifestyle modifications and laxatives would help.
I want you to know that Constipation is quite a common issue these days and quite underrated. It needs a lot of diet and lifestyle modifications and work up to sort out the cause. Lets discuss what can be done to constipation. Remember constipation remains there unless the underlying cause is addressed and taken care of
Lower gastrointestinal (GI) endoscopy, colonic transit study, defecography, anorectal manometry, surface anal electromyography (EMG), and balloon expulsion ,complete blood count (CBC),Thyroid function tests, Serum electrolytes for metabolic cause of constipation, such as hypokalemia and hypercalcemia and also potassium, calcium, glucose, and creatinine, for electrolytes imbalance and last but not the least histopathological examinations are some of the baseline workup necessary to sort out the constipation cause.
Increase fiber intake and take plenty of fluids. manual disimpaction and transrectal enemas would work for a while now. Then a complete management would be needed and should focus on dietary change and exercise rather than laxatives, enemas, and suppositories, none of which really address the underlying problem.

The key to treating most patients with constipation is correction of dietary deficiencies, which generally involves increasing intake of fiber and fluid and decreasing the use of constipating agents (eg, milk products, coffee, tea, alcohol).

Medications to treat constipation include the following:

Bulk-forming agents (fibers; eg, psyllium): arguably the best and least expensive medication for long-term treatment
Emollient stool softeners (eg, docusate): Best used for short-term prophylaxis (eg, postoperative)
Rapidly acting lubricants (eg, mineral oil): Used for acute or subacute management of constipation
Prokinetics (eg, tegaserod): Proposed for use with severe constipation-predominant symptoms
Stimulant laxatives (eg, senna): Over-the-counter agents commonly but inappropriately used for long-term treatment of constipation
Newer therapies for constipation include the following:

Prucalopride, a prokinetic selective 5-hydroxytryptamine-4 (5-HT4) receptor antagonist that stimulates colonic motility and decreases transit time
The osmotic agents lubiprostone and linaclotide,which are FDA approved for chronic idiopathic constipation, constipation caused by irritable bowel syndrome, and (in the case of lubiprostone) opioid-induced constipation in adults with chronic, noncancer pain
Get to your gastroenterologist and discuss some newer advancements like sacral nerve stimulation and some surgical interventions if need be with them and let them decide what is best for you.

Now the haemorrhoids , let me give a brief explainationand provide you all the options so that you can select from it with your doctor's opinion what is best for you.
Haemorrhoids management depends on their grading. low grades one and two manage conservatively with diet and lifestyle modification and topical care. Grade 3 or 4 where haemorrhoid come out of anus and need manual retraction need surgical correction. In past dietary modifications, incantations, voodoo, quackery and hot pokers applications were used to treat haemorrhoids. Molten lead was also used.
Haemorrhoids can self resolve with diet and conservative medical therapy if low grade, and complications can arise once high grades and prop lapses are there along with increase recurrences. thrombosis, infection, abscess, ulceration, fissures, tags and incontinences and recurrences are some of them.
All you need is diet and lifestyle modification. Warm sitz baths and high fibrous diet like psyllium seeds(metamucil) and methylcellulose (citrucel) A diet of at least 25g fiber is recommended.
and trained toilet habits and stool softeners and topical agents like hydrocortisones, anaesthetic gels, suppositories, enema, foam etc.
Long term monitoring with weight loss preferences, avoiding sitting on toilet for long time, changing sedentary lifestyle to active and healthy one and hygiene of anorectal area will be the goals to reduce the trouble of constipation.
Some non surgical options which can be considered for hemorrhoids are following once ruled out the contraindications for them.they are as follow
Rubber band ligation
Coagulation, electrocautery, and electrotherapy
Sclerotherapy and cryotherapy
Laser therapy and radiowave ablation

following are the contraindications for such procedure and if you have any of them you wont be able to have these
Acquired immunodeficiency syndrome (AIDS): Human immunodeficiency virus (HIV) infection and anal disease often occur together—conservative therapy is suggested, especially if immunosuppression is evident; poor healing occurs with low CD4 counts, especially when less than 200 cells/mm3
Immunodeficiency disorders
Coagulopathy
Irritable bowel disease
Pregnancy: This condition is associated with many anorectal complaints; nonoperative treatment or office thrombectomy usually relieves complaints, although operative hemorrhoidectomy is safe in pregnant women
Immediate postpartum period
Rectal wall prolapse
Large anorectal fissure or infection
Tumor
SOme surgical options for haemorrhoids are as follows
Surgical hemorrhoidectomy both Nonlaser versus laser hemorrhoidectomy
Stapled hemorrhoid surgery/ procedure for prolapsing hemorrhoids (PPH)
Remember these 5 goals to prevent future troubles
Avoid constipation
Weight loss
Avoid prolonged sitting on the toilet
Avoid prolonged sitting at work
Improved anorectal hygiene
following group of medicines are usually prescribed , some are available over the counter.
Stool softeners like Docusate sodium (Colace, Correctol, Dok, Dulcolax) etc
Topical anesthetics like Lidocaine ointment 5% (Lidoderm, Regenecare, LidaMantle)
Mild astringents like Hamamelis water (Witch Hazel)
Analgesics like Acetaminophen (Tylenol, Aspirin Free Anacin, Feverall, Mapap)

I hope it helps. Get to a general surgeon and let him take care of you.discuss these all options with them and see what comes up best for you.
I hope it helps.Dont forget to close the discussion please.
Take care
Regards
S Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shafi Ullah Khan (5 hours later)
Doctor what i meant by goat stool is that my stool comes out little by little separately like a pebles, when i eat plenty of fruit it doesnt come out like that. that is why i am worried.
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Needs management

Detailed Answer:
Thank you for asking!
I understand your concern and i took up the correlation exactly you meant it.. That is a constipated bowel and it needs management which i explained in the previous answer. consult a gastroenterologist and let them take care of you. Drink plenty of water and use soft diet till then. needs work up and a complete clinical correlation for that.
Take care
Khan
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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What Causes Pebble Like Stool?

Brief Answer: COnstipation and haemorrhoids need management Detailed Answer: Thank you for asking! I can understand the concern but explaining the stools with mere correlation to goats stools is not helpful. Do you mean you dont get full emptying of bowel, or the constipation, i believe you mean you have difficulty passing stools and constipation needs to be a likely cause for it as concomitant hemorrhoid make it more likely. The bowel needs a little work up to sort out the cause for constipation.till then diet and lifestyle modifications and laxatives would help. I want you to know that Constipation is quite a common issue these days and quite underrated. It needs a lot of diet and lifestyle modifications and work up to sort out the cause. Lets discuss what can be done to constipation. Remember constipation remains there unless the underlying cause is addressed and taken care of Lower gastrointestinal (GI) endoscopy, colonic transit study, defecography, anorectal manometry, surface anal electromyography (EMG), and balloon expulsion ,complete blood count (CBC),Thyroid function tests, Serum electrolytes for metabolic cause of constipation, such as hypokalemia and hypercalcemia and also potassium, calcium, glucose, and creatinine, for electrolytes imbalance and last but not the least histopathological examinations are some of the baseline workup necessary to sort out the constipation cause. Increase fiber intake and take plenty of fluids. manual disimpaction and transrectal enemas would work for a while now. Then a complete management would be needed and should focus on dietary change and exercise rather than laxatives, enemas, and suppositories, none of which really address the underlying problem. The key to treating most patients with constipation is correction of dietary deficiencies, which generally involves increasing intake of fiber and fluid and decreasing the use of constipating agents (eg, milk products, coffee, tea, alcohol). Medications to treat constipation include the following: Bulk-forming agents (fibers; eg, psyllium): arguably the best and least expensive medication for long-term treatment Emollient stool softeners (eg, docusate): Best used for short-term prophylaxis (eg, postoperative) Rapidly acting lubricants (eg, mineral oil): Used for acute or subacute management of constipation Prokinetics (eg, tegaserod): Proposed for use with severe constipation-predominant symptoms Stimulant laxatives (eg, senna): Over-the-counter agents commonly but inappropriately used for long-term treatment of constipation Newer therapies for constipation include the following: Prucalopride, a prokinetic selective 5-hydroxytryptamine-4 (5-HT4) receptor antagonist that stimulates colonic motility and decreases transit time The osmotic agents lubiprostone and linaclotide,which are FDA approved for chronic idiopathic constipation, constipation caused by irritable bowel syndrome, and (in the case of lubiprostone) opioid-induced constipation in adults with chronic, noncancer pain Get to your gastroenterologist and discuss some newer advancements like sacral nerve stimulation and some surgical interventions if need be with them and let them decide what is best for you. Now the haemorrhoids , let me give a brief explainationand provide you all the options so that you can select from it with your doctor's opinion what is best for you. Haemorrhoids management depends on their grading. low grades one and two manage conservatively with diet and lifestyle modification and topical care. Grade 3 or 4 where haemorrhoid come out of anus and need manual retraction need surgical correction. In past dietary modifications, incantations, voodoo, quackery and hot pokers applications were used to treat haemorrhoids. Molten lead was also used. Haemorrhoids can self resolve with diet and conservative medical therapy if low grade, and complications can arise once high grades and prop lapses are there along with increase recurrences. thrombosis, infection, abscess, ulceration, fissures, tags and incontinences and recurrences are some of them. All you need is diet and lifestyle modification. Warm sitz baths and high fibrous diet like psyllium seeds(metamucil) and methylcellulose (citrucel) A diet of at least 25g fiber is recommended. and trained toilet habits and stool softeners and topical agents like hydrocortisones, anaesthetic gels, suppositories, enema, foam etc. Long term monitoring with weight loss preferences, avoiding sitting on toilet for long time, changing sedentary lifestyle to active and healthy one and hygiene of anorectal area will be the goals to reduce the trouble of constipation. Some non surgical options which can be considered for hemorrhoids are following once ruled out the contraindications for them.they are as follow Rubber band ligation Coagulation, electrocautery, and electrotherapy Sclerotherapy and cryotherapy Laser therapy and radiowave ablation following are the contraindications for such procedure and if you have any of them you wont be able to have these Acquired immunodeficiency syndrome (AIDS): Human immunodeficiency virus (HIV) infection and anal disease often occur together—conservative therapy is suggested, especially if immunosuppression is evident; poor healing occurs with low CD4 counts, especially when less than 200 cells/mm3 Immunodeficiency disorders Coagulopathy Irritable bowel disease Pregnancy: This condition is associated with many anorectal complaints; nonoperative treatment or office thrombectomy usually relieves complaints, although operative hemorrhoidectomy is safe in pregnant women Immediate postpartum period Rectal wall prolapse Large anorectal fissure or infection Tumor SOme surgical options for haemorrhoids are as follows Surgical hemorrhoidectomy both Nonlaser versus laser hemorrhoidectomy Stapled hemorrhoid surgery/ procedure for prolapsing hemorrhoids (PPH) Remember these 5 goals to prevent future troubles Avoid constipation Weight loss Avoid prolonged sitting on the toilet Avoid prolonged sitting at work Improved anorectal hygiene following group of medicines are usually prescribed , some are available over the counter. Stool softeners like Docusate sodium (Colace, Correctol, Dok, Dulcolax) etc Topical anesthetics like Lidocaine ointment 5% (Lidoderm, Regenecare, LidaMantle) Mild astringents like Hamamelis water (Witch Hazel) Analgesics like Acetaminophen (Tylenol, Aspirin Free Anacin, Feverall, Mapap) I hope it helps. Get to a general surgeon and let him take care of you.discuss these all options with them and see what comes up best for you. I hope it helps.Dont forget to close the discussion please. Take care Regards S Khan