There are still certain topics people have trouble discussing with their doctor. Take poop, for example.
From color and consistency to an inability to go — or the opposite — changes in your poop can signal bigger problems that may require a specialist, says Amanda Ayers, MD, colorectal surgeon with the Hartford HealthCare Digestive Health Institute in Waterford and Old Saybrook.
“Accidental bowel leakage, or fecal incontinence, for example, is an underrecognized problem,” says Dr. Ayers. “People talk about urinary incontinence but not this.”
Here are five digestion questions you may be afraid to ask your doctor, answered by an expert.
1. What causes diarrhea?
Diarrhea – loose, watery stools and increased frequency – can have many causes, including:
- What you eat. Artificial sweeteners or conditions like lactose intolerance, where you’re unable to digest lactose in dairy products, can trigger it.
- The pace your small intestine moves foods through.
- Infection.
- Medication. Antibiotics, for example, get rid of infection by killing bad bacteria but they can also kill good bacteria, disrupting the natural intestinal balance.
- Conditions like inflammatory bowel disease, inflammation of the lining of the small and large intestines that moves foods through faster than normal.
Adding fiber to your diet naturally with fresh produce or with supplements can bulk up your stool and prevent diarrhea and leakage, says Dr. Ayers.
2. What causes constipation?
Digestion starts with the release of acid to break down food in your stomach, before it moves to your small intestine where nutrients are absorbed and to your colon where water is added to help move the food out. But that process can be impacted by what you eat, says Ayers.
“If you don’t drink enough fluids, there’s not enough liquid to water down stool in the colon and move it out,” she explains. “That’s when you can get constipated.”
A colon that moves things through more slowly can also cause constipation. Addressing dehydration and fiber can help ease constipation. Other conditions require a specialist, she says.
> Related: 9 Common Causes of Constipation
3. Why is there undigested food in my stool?
Some foods, Dr. Ayers explains, cannot be digested completely because of their contents. Corn, for example, is only partially digested so you may see skin later.
“Or, maybe you eat quickly or have quick colon motility. That also pushes food along faster than your body can fully digest it,” she says.
To help prevent undigested food from sneaking through, she suggests chewing food well and eating slowly.
4. Why does my gas smell?
The smell of flatulence, again, reflects what you eat and what’s going on in your stomach, Dr. Ayers says.
“It’s natural for foods to generate gas for the body to absorb,” she says.
Nutrient deficiencies or conditions like lactose intolerance can worsen the smell because there’s more bacteria in the stomach.
“We all have bacteria in our guts, called the microbiome. The makeup of that determines the ways we respond to what we eat,” she explains.
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5. What can I do about bowel incontinence?
The important thing, Ayer stresses, is that there’s nothing to be ashamed of if your body can’t always control its bowels.
“This is much more common than people realize because no one wants to talk about it!” she says. “But, it’s not a normal part of aging.”
Treatments, she adds, include specialized physical therapy to strengthen the pelvic floor muscles and sacral nerve modulation, a minimally invasive outpatient procedure that stimulates nerves in the area to ease bowel dysfunction.