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Dr. Andrew Rynne

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What do flatulence and multiple bowel movements indicate?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2853 Questions

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Posted on Mon, 27 Mar 2017 in Digestion and Bowels
Question: Hi Doctor,

Not sure how long this has been going on because I really never paid much attention to it until now. But, I have noticed that I have 2 bowel movements in the morning usually each day. I wake up and go, and then I have to again in an hour or so. I also notice that I have been having allot of gas recently, especially at night.

I have also noticed that my stool is sometimes loose and dark. Not sure if it’s black or not, but definitely dark. Now, I do take multivitamins and eat allot of fruits and vegetables. My diet also contains iron and fiber so that could be the reason. I also take Paxil.

I do also have a history of hemorrhoids and possibly anal fissure as I do sit allot; especially on the toilet for longer than I should. I say this because currently when I wipe I notice blood streaks on the toilet paper and it hurts sometimes when I wipe and because it feels like I’m wiping a cut/sore. Occasionally at night I will also experience itching in the anal area as well.

Not sure if this is any alarm for concern or not. I am 30 years old and have recently had a physical about 7 months ago.
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Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
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Detailed Answer:
Hello,

None of this sounds as though it is cause for alarm. But let's look at it in detail.

If your bowel movements have been more frequent than usual, and more gas, did this start after any of the things you listed, such as increase fruits and vegetables, or the Paxil? All of these can cause more frequent movements. In addition, if you were recently on an antibiotic, that can cause changes as well. If you were recently on an antibiotic, then I recommend taking a probiotic with lactobacillus acidophilus and bifidus.

Now about stools looking dark, iron can certainly do that. Black, tarry stools usually indicates bleeding in the stomach or higher up. The acid in the stomach acts on the blood to give it that appearance. Consider going off of the iron for a few days and see if that doesn't resolve the blackish color.

The bleeding on the toilet paper, associated with tenderness, is most likely due to an anal fissure or hemorrhoid. Itching goes more with a hemorrhoid flare up. Just to be sure, you can go to the doctor and have her/him have a look. You can also try Preparation H and see if that helps the situation.

Please let me know if I can provide further information.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 48 minutes later
Thank you for your reply. I am hoping that the underlying issue is my diet and vitamins and not something more serious like cancer as allot of these symptoms are associated with that. I haven't been on a antibiotic but Can Paxil cause these symptoms as well?
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Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
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Detailed Answer:
For some people, Paxil can cause diarrhea. It would not cause the black stools. It would not cause the bleeding, but may indirectly be associated: if you are going to the bathroom more, and wiping more, there would be more rectal/anal irritation.

My sister had colon cancer at a young age (43). But most of your symptoms seem explainable by other causes. For example, with bleeding from colon cancer, I would not expect there to be anal itching.

However, if making modifications does not resolve your symptoms, then do get checked out. A colonoscopy is easy enough and provides a lot of information about the lower gastrointestinal tract (although the prep is quite unpleasant). It wouldn't provide information on the black stools, however, if that is from your gastrointestinal tract (rather than iron) because bleeding in that case would be from the stomach or higher, and a colonoscopy only looks at the colon, not the stomach.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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