Health Conditions / Digestive Health / Constipation

PERT is the main treatment for EPI, but some people may also benefit from adjusting their diet or taking specific supplements to fill nutrient gaps. EPI treatment may also need to be tailored if your doctor believes another health issue triggered it in the first place, Dr. Othman says. 3. Should I eat a special diet to feel better? Not necessarily, but Dr. Ahmad says “some patients may need a high-fat, high-protein diet if they are nutritionally depleted.” This is not recommended for everyone, but if your doctor determines you’re malnourished (which often presents as rapid weight loss), you may need to try this route.That said, it’s important to be aware of consuming too much fat if you’re feeling crummy already, Dr. Hart says. “Fat is really the weakest link in the chain,” he explains. “If a patient’s intake of fat exceeds the ability of their pancreas to digest and absorb that fat, they will develop symptoms.” In general, Dr. Ahmad says she recommends that her patients follow a “moderate diet that includes all food groups.” It’s important to remember that a daily diet is highly individualized. Depending on your symptoms, you may benefit from eating smaller, frequent meals, adjusting your fiber intake, or generally avoiding foods that trigger your digestive distress.1 If you’re already speaking with your doctor about your next steps, this is a great time to ask them about how you can get nutritional support, and whether they can help connect you to a clinical dietitian who can give you specialized advice.4. Do I need to take supplements to stay healthy?This depends on your personal situation, but your doctor may recommend that you take certain supplements to help you meet your nutritional needs. Because EPI can lead to malabsorption of many nutrients, your doctor should perform a blood test to see if you’re lacking appropriate levels of essential vitamins and minerals, Dr. Hart says. If they determine you have any insufficient levels of anything, you’ll likely need a supplement.People with EPI tend to have a harder time absorbing fat-soluble nutrients like vitamins A, D, E, and K, per the Cleveland Clinic. “Patients may also develop deficiencies of calcium, folic acid, thiamine, magnesium, and zinc and may require supplementations for these,” Dr. Ahmad notes. You should work closely with your doctor or a dietitian to determine what supplements you may need and at what dosage. They can also recommend a reputable brand for you to consider.Taking your enzymes with every meal should also help your body properly absorb nutrients, Dr. Othman adds. 5. Are there potential EPI complications I should be aware of? EPI can set the stage for complications, especially if the condition goes untreated.3 Complications are often linked to malnutrition, which can up your risk for hair loss, persistent fatigue, memory and concentration issues, muscle loss, osteoporosis, and mental health conditions like depression, among other side effects, per the Cleveland Clinic.

Certain aspects of having a period are talked about more frequently than others, like dealing with menstural cramps, sore boobs, and bloating. But there’s one common symptom that, for whatever reason, gets less buzz: period poop.Yup, it’s not just you—pooping habits can get weird during your period. “Many people do get bowel changes just before or during their period,” Kyle Staller, MD, a gastroenterologist at Massachusetts General Hospital, tells SELF. That includes a whole potential host of things, from period constipation to period diarrhea, with some people just pooping more than usual during that time of the month.Maybe you just happened to notice that period poop is a thing for you and are simply curious about what, exactly, is going on down there. Or maybe period poop is a problem for you and you need a solution ASAP. Either way, getting to the bottom of this (no pun intended) can go a long way toward helping you understand your body and figuring out a solution if your period poops start to interfere with your life. Here’s what you need to know about this totally normal phenomenon.What are period poops?Some people refer to changes in bowel movement that happen around their menstrual cycle as period poops. As with most other period wonkiness, you can thank hormonal fluctuations for this phenomenon. “The reason that this happens is largely due to hormones,” Dr. Staller says. That includes constipation that starts before your period and subsequent diarrhea or excessive pooping that happens once aunt Flo has actually come to town.Preperiod constipation could be a result of an increase in the hormone progesterone, which starts to increase in the time between ovulation and when you get your period.1 Progesterone can cause food to move more slowly through your intestines, backing you up in the process.But levels of progesterone plummet around the same time that your period starts.1 Simultaneously, there’s an increase in hormone-like compounds in your body called prostaglandins. The cells that make up the lining of your uterus (known as endometrial cells), produce these prostaglandins, which get released as the lining of your uterus breaks down right before and during menstruation. These chemicals cause the blood vessels and muscles in the uterus to contract. If your body has high levels of prostaglandins, they can make their way into the muscle that lines your bowels.There, they can cause your intestines to contract just like your uterus and push out fecal matter quickly, Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center, tells SELF. (Fun fact: These prostaglandins are also responsible for those painful menstrual cramps you might get every month.) This explains why you might have diarrhea or poop so much more often during your period.Of course this can all vary for different people. But if you notice you experience constipation or diarrhea right around your period like clockwork, this may be why.Back to topCan health conditions cause period poop changes?Certain health conditions like endometriosis, Crohn’s disease, irritable bowel syndrome, or ulcerative colitis, can flare up during menstruation, leading to bowel changes. For example, if you struggle with Crohn’s disease, which can often cause diarrhea, or IBS-D (a form of IBS that causes people to have diarrhea), your body’s release of prostaglandins during your period may exacerbate your condition, worsening your diarrhea. But if you suffer from IBS-C (IBS that causes people to have constipation), you may find yourself struggling even more to have a bowel movement on your period as progesterone further slows your bowels’ activity. Since ulcerative colitis can lead to both diarrhea and constipation, you might experience an uptick in either during your period.Back to topWhat does it mean if it hurts to poop during my period?There are a few potential reasons why it might hurt to poop on your period. If it’s something you notice here and there—especially if you’re dealing with a lot of diarrhea—it could be a side effect of diarrhea itself, like cramping in your stomach or even irritation around your anus from going so often, Dr. Farhadi says.

When you’re trying to conceive, it’s understandable to hope that sudden bodily changes indicate that it’s finally happened. You may wonder, “Is diarrhea a symptom of pregnancy?” if you’re now hitting up the bathroom all the time. The answer isn’t so straightforward.“Pregnancy can affect your bowel movements, but it’s also common to just get diarrhea for other reasons,” Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women & Babies, tells SELF.But your bathroom habits may clue you into the state of your G.I. tract and uterus. Let’s dive in.What is diarrhea, exactly?Diarrhea is basically poop hell. But more technically speaking, it’s defined as loose, watery bowel movements that occur three or more times in a day, according to the U.S. National Library of Medicine (NLM). It usually lasts just a day or two which is called acute diarrhea. (Diarrhea that lasts longer than a few days may signal a more serious problem, as can diarrhea lasting a few weeks, called chronic diarrhea1.)Ever wonder what’s actually going on in your body to make your butt expel its contents so violently? There are a few different potential mechanisms, depending on the underlying cause (of which there are many, which we’ll get to). But generally speaking, diarrhea occurs when your digestive system fails to remove enough water from your stool, Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. That commonly happens when stool moves too quickly through the digestive tract, as Merck Manuals explains, or when your stool is diluted by excess water secreted by the intestines.Back to topIs diarrhea a symptom of early pregnancy?The answer is going to take a sec, so pull up a seat.Your hormones fluctuate throughout your menstrual cycle, and you might know that these hormonal changes can make your poop real weird around the time of your period2. That’s largely thanks to a hormone that helps prep your body for pregnancy called progesterone.Progesterone levels increase after ovulation, anticipating that the egg your ovaries just released will be fertilized, the NLM explains. If you don’t become pregnant, progesterone levels fall back down, and you get your period. If the egg is fertilized and you do become pregnant, your levels of progesterone will continue to rise, Mary Rosser, MD, PhD, an ob-gyn at New York-Presbyterian/Columbia University Irving Medical Center, tells SELF.How does this early pregnancy progesterone surge affect poop? Progesterone helps relax the smooth muscles, like your uterus and intestines. While relaxed intestines might sound like a recipe for the loose, speedy bowel movements that characterize diarrhea, that isn’t what actually happens. In fact, without your G.I. muscles contracting as hard to move things along, food passage starts to slow down and bowel movements become sluggish, G. Thomas Ruiz, MD, an ob-gyn at Memorial Care Orange Coast Medical Center in Fountain Valley, California, tells SELF.In other words, high levels of progesterone result in constipation, i.e. the exact opposite of diarrhea. Many people experience constipation in early pregnancy3, so diarrhea really isn’t an accurate sign of early pregnancy, Dr. Rosser says.Total caveat alert: some people have the opposite reaction.“While constipation is more common in early pregnancy, sometimes the hormonal changes in pregnancy impact people differently and result in diarrhea,” Dr. Greves says. What’s more, some people may be pregnant and crave foods that don’t agree with them, which can lead to diarrhea, Dr. Greves says. For instance, maybe you are lactose intolerant but can’t get enough cheese.Of course, diarrhea can happen for other reasons completely unrelated to growing a baby. One super common cause is a stomach bug, which is caused by consuming food contaminated with parasites, bacteria, or viruses4, Dr. Rosser says. But numerous other things can lead to loose stool, including bacteria-contaminated food or water, viruses (like the flu or norovirus), parasites, certain medications (like antibiotics), and food intolerances, according to the NLM. (And sometimes, the cause is a mystery, but that’s typically NBD if it goes away after a couple days.)

As for what causes IBD, both ulcerative colitis and Crohn’s disease happen when a person’s immune system accidentally attacks their G.I. tract, according to the NIDDK. Ulcerative colitis and Crohn’s disease are separate conditions, but they do share a few risk factors. Both diseases tend to run in families, so researchers are working to understand the connection, according to the Mayo Clinic. Both also usually start causing symptoms before a person turns 30 and are more likely to affect those of Eastern European Jewish descent.There’s also a question of how a person’s environment or lifestyle factors, like medications and diet, may cause or exacerbate both IBD and IBS.Back to topHow do you get an IBS diagnosis or an IBD diagnosis?There’s no definitive test for IBS, so doctors typically diagnose it after excluding most other potential causes. In addition to evaluating your symptoms, they may perform a host of exams to identify the problem.For example, they may order a colonoscopy or a flexible sigmoidoscopy (using a thin tube to examine your rectum and only part of your colon) to see if your gut shows signs of inflammation. IBS symptoms can also mimic an overgrowth of bacteria in your gut or parasites, so your provider might want to conduct a stool sample to check your poop for germs, according to the Mayo Clinic.Because celiac disease, an immune response to eating gluten, can cause similar symptoms, doctors may want to take a blood test to rule it out before diagnosing you with IBS, says Jill Deutsch, MD, a gastroenterologist at Yale Medicine and an assistant professor at Yale School of Medicine. Once celiac and any other conditions your doctor wants to explore are ruled out, IBS can usually be diagnosed based on your symptoms.Diagnosing IBD can be similarly time-consuming. Your doctor will likely order a range of tests to pick up on any abnormalities that could signal these conditions, including blood tests, a colonoscopy, a flexible sigmoidoscopy, or an x-ray or CT scan. They may also test your poop to see if any blood is present. According to Dr. Hanauer, doctors often look for white blood cells—which may signal inflammation in the gut—in your stool if they’re testing for inflammatory bowel disease.If your doctor suspects Crohn’s disease has affected your small intestine, they may also have you do exams like a capsule endoscopy, which involves swallowing a capsule that has a camera in it to view your intestines. An external recorder captures the images, and you’ll later poop the capsule out.Back to topWhat does IBS treatment look like vs. IBD treatment?Although IBS and IBD share commonalities, they aren’t managed in the same way. “The treatment of IBD is focused on controlling inflammation. IBS treatment is about controlling the heightened sensitivity to what’s going on in the gut,” Dr. Hanauer says.If you’re diagnosed with IBS, your doctor may recommend a range of treatment options depending on your exact symptoms, and it can take some trial and error to get it right. According to the Mayo Clinic, if you have IBS-C (which causes constipation), your doctor might suggest adding more fiber to your diet since it soaks up water as it moves through your digestive system, making your poop softer and easier to expel. They may also recommend laxatives or prescription medications that boost the amount of fluid that gets into your poop.

Digestive troubles, for many people, top the list of symptoms that are straight-up miserable to live with. After all, who wants to feel constantly gassy or bloated while running to the bathroom left and right? Not only can these symptoms feel uncomfortable (or even downright painful), they can seriously impact how you feel about yourself and the way you live your daily life. If you’re not sure what’s going on, don’t fret. Oftentimes, there is a simple explanation for gastrointestinal (GI) issues. But if they’re starting to feel constant, it’s worth exploring whether something more complicated could be lingering under the surface. Take this quiz to find out what might be causing your stomach problems, and when you should consider seeing a doctor about them—because you deserve to feel good in your body.

Pooping is a natural and essential bodily function. Everybody poops—no matter your location, socioeconomic status, or delicate sensibilities. Unfortunately, something that is supposed to be second nature can also sometimes be super difficult. So if you’ve ever found yourself straining to poop, you are definitely not alone.“Almost everyone experiences the feeling of having a hard time having a bowel movement,” Alex Sherman, MD, board-certified gastroenterologist at Vanguard Gastroenterology and a clinical professor at NYU Grossman School of Medicine, tells SELF.While that piece of information won’t exactly make you feel better when you’re stuck on the toilet, it should reassure you that straining to poop isn’t necessarily concerning. In fact, if it happens every once in a while, you’re likely okay and things can often be resolved with something as simple as increasing the fiber intake in your diet.But if you find yourself straining to poop frequently, that could potentially signal an underlying issue that needs your attention, Dr. Sherman says. Want to find out why it hurts to poop—and what to do about it? We turned to top docs for the answers to all your poop questions.First, let’s talk about why you’re straining to poop.“Someone sits down and they are trying to push, push, push—that’s really what straining is,” Felice Schnoll-Sussman, MD, professor of clinical medicine and director of the Jay Monahan Center for Gastrointestinal Health at Weill Cornell Medicine, tells SELF. People can strain to poop for all sorts of reasons, but constipation is really the main cause of this. By definition, constipation symptoms include passing hard, dry stools, having fewer than three bowel movements a week, or feeling like you haven’t really gotten everything out (if you know what we mean), according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).It’s important to understand that people poop at different frequencies, so pooping less than three times a week doesn’t always mean you’re constipated. For example, one person may poop twice a week for as long as they can remember and feel completely fine. “There is no rulebook for how often someone should go to the bathroom,” Dr. Schnoll-Sussman says. “The only time we are concerned is when there is a significant change for you.” If you’re frustrated because it feels impossible to poop and nothing comes out, then that’s also a problem. So, then, what causes constipation? A number of things, but dietary habits are a big contributor to this particular problem, Shilpa Ravella, MD, assistant professor of medicine at Columbia University Medical Center, tells SELF. “I see a lot of patients coming in who have way too little fiber in their diets. That can lead to hard stools and constipation that can cause people to strain a lot when they go to the bathroom,” Dr. Ravella says.That’s why constipation treatment typically includes eating more fiber-rich food, which adds weight to your stool and helps it stay soft, making it easier to pass. Drinking more fluids than you’re currently getting and increasing your physical activity can also help move stool through your digestive tract, according to Johns Hopkins Medicine.Some medications, including things like blood pressure drugs, opioids, antacids, and antidepressants, can also cause constipation, according to Dr. Ravella. And finally, constipation can be a symptom of certain medical conditions like irritable bowel syndrome (IBS) and celiac disease.Your body mechanics might also explain why you’re straining to poop. There are two sphincter muscles in the rectum (the inner and the outer sphincter) that assist with bowel movements.1 The inner sphincter is controlled involuntarily, meaning your brain tells that muscle it’s time to relax (so you can poop) when your rectum is full. Your outer sphincter is a muscle that you knowingly control. And some people may not have good control over the outer sphincter, so they tense their muscles, holding poop in when they should really be relaxing that muscle to let poop out.2 This can make you feel like you’ve never really emptied everything in your bowels.

Real talk: Everybody farts, including supermodels, politicians, actors—everybody. While it can be embarrassing and awkward to let one rip in front of a crowd, that doesn’t mean it’s not perfectly normal (same goes for burping).Still, if you’re suddenly letting flatulence fly like it’s your job, you might take a beat to wonder, “Why do I have so much gas?” Also, if you’re farting that much, you might be a little uncomfortable, too, whether you’re also dealing with bloating or just feeling anxious about the idea of accidentally clearing a room in public.Again, farting is a fact of life, but it’s not typical to desperately hold back your gas to the point of constant discomfort. Not sure if you should be concerned? Here are the most common excessive gas causes, and how to get some relief already.What causes gas in the first place?Gas forms in your digestive tract for two reasons: from the air that you swallow and from the breakdown of undigested food by the trillions of bacteria that live in your large intestine, according to the U.S. National Library of Medicine. “We all have bacteria in our gut, which produces gas—and it has to go somewhere,” Sophie Balzora, MD, gastroenterologist and assistant professor of medicine at NYU Langone Medical Center, tells SELF.Whether you fart or burp, gas comes out of your body in one form or another. In fact, we all pass gas an average of up to 20 times each day, according to the Mayo Clinic. In most cases, the gas you expel from your body is odorless, a mix of carbon dioxide, nitrogen, hydrogen, and sometimes methane. Sometimes, however, the bacteria we mentioned release gases that include sulfur, which is the culprit behind the unpleasant odor associated with passing gas, according to Johns Hopkins Medicine.Occasional gas is perfectly healthy. Excessive gas, however, can cause discomfort to the point of bloating and abdominal pain, and it can actually be a symptom of a more serious condition.Back to topWhy do I have so much gas?There’s a pretty wide range of excessive gas causes, and some are more easily remedied than others. Here are the most common ones to be aware of:1. You’re eating a lot of fiber-rich food.Usually, the food you’re eating can be to blame for any excessive gas you’re dealing with. A food that causes gas in one person may not in another, but there are some common culprits. “The classic food groups are high-fiber foods such as whole wheat and grains, fresh fruits and cruciferous vegetables (such as broccoli, cabbage, Brussels sprouts, kale, etc.),” Felice Schnoll-Sussman MD, gastroenterologist and director of the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF.Fiber is usually recommended to combat constipation, but it can lead to excessive gas if it’s eaten in excess. This is because fiber isn’t fully digested by the small intestine, and the bacteria required to ferment or break down fiber-rich foods in the large intestine produce gas as a by-product, per Johns Hopkins Medicine.So, as with all good things, moderation is key. “Fiber must be slowly incorporated into the diet,” Dr. Schnoll-Sussman explains. “If you binge on kale for its obvious nutritional value, you will most likely feel it with gas and bloating.”Another tip? Make sure you’re drinking enough water, as fiber promotes healthy bowel movements best when there’s an adequate amount of water in your body.2. You have a sneaky food sensitivity.“Many people as they get older have difficulty digesting milk products,” Dr. Schnoll-Sussman says. So even if you’re not full-on intolerant, your body’s level of lactase (the enzyme that breaks down lactose) may be lower than it used to be, making dairy a problem food. “Someone who is very lactose intolerant may experience bloating, cramps, and flatulence as soon as they ingest milk or other dairy products.” But your level of gassiness will vary depending on how sensitive you are.

If you have heartburn here and there, you probably don’t have a huge issue on your hands. Most people can manage the discomfort with over-the-counter antacids, which help neutralize stomach acid, after a particularly triggering meal (thanks, greasy pizza!). But “heartburn that is so severe it keeps you up at night for more than one to two weeks warrants investigation with a gastroenterologist, Dr. Shukla says.Constant heartburn is a sign of uncontrolled acid reflux, or gastroesophageal reflux disease (GERD)—a condition that impacts roughly 20% of people in the U.S., per the NIDDK. Getting a proper diagnosis is crucial if you deal with heartburn or other symptoms—like difficulty swallowing, regurgitation, or unexplained coughing—more than twice a week, as untreated reflux can lead to complications over time, like inflammation or narrowing of the esophagus, which can possibly cause ulcers or problems with swallowing, respectively.To complicate things further, heartburn can feel similar to cardiac chest pain, which can signal a heart attack, Dr. Chen points out. “If you are unsure, please call your doctor for advice on next steps,” she says. If you feel other possible signs of a heart attack—like unexplained shortness of breath, pain in your back, neck, jaw, or either arm, or sudden sweating—it’s best to seek immediate medical attention.Back to top4. You’re having an oddly difficult time swallowing.You may not think of issues with your throat as a “digestive” symptom, but think about it: Your entire digestion process starts in your mouth!Having a sore throat that makes it uncomfortable to swallow is very different from actually feeling like you can’t swallow well. Dysphagia is the medical name for this phenomenon, and it goes beyond not feeling like you can get food down easily. You may cough a lot after eating, hear gurgling sounds from your throat while eating, clear your throat a lot, chew very slowly, or feel chest discomfort after swallowing, per the U.S. National Library of Medicine.“Any type of swallowing difficulty should prompt a visit to the doctor,” Dr. Chen says. (If you know the issue is caused by an object stuck in your esophagus or you’re having trouble swallowing even saliva, she recommends heading to the emergency room.)With that said, if you’re having a difficult time swallowing, there could be an underlying issue to address. As we mentioned, it could be caused by uncontrolled acid reflux, but dysphagia can also be rooted in stress or anxiety, a brain or nerve condition, or direct issues with your tongue, throat, or esophagus, so it’s not something to ignore if it’s interfering with your day-to-day life. In some cases, trouble swallowing can point to esophageal cancer, but Dr. Shukla says this is a less likely explanation.Back to top5. Your stomach pain is borderline agonizing.Severe abdominal pain is different from the stomach ache you experience after eating too much. Instead, you may be experiencing intense cramping that won’t let up or sharp, stabbing pain that forces you to lay down. “If the abdominal pain is severe and persists, it needs to be evaluated,” Dr. Chen says.If you’re really uncomfortable but it’s not so bad that it’s disrupting your daily life, make an appointment with your primary care doctor if you have one, Dr. Chen says. But if you’re doubled over in pain and can’t imagine going on with your day in that state, it’s best to head to the emergency room.