What is the cause of abnormal feces (stool)?

From the Guidelines

Abnormal feces, or stool, can be caused by a variety of factors, including infections, inflammatory bowel disease, dietary issues, and other health conditions, as supported by the most recent and highest quality study 1.

Causes of Abnormal Feces

The causes of abnormal feces can be broadly categorized into several groups, including:

• Infections, such as Clostridium difficile infection, which can cause chronic diarrhea and other symptoms 1
• Inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, which can cause changes in stool color, consistency, and frequency 1
• Dietary issues, such as lactose intolerance and disaccharidase deficiency, which can cause bloating, gas, and changes in stool consistency 1
• Other health conditions, such as thyroid disease, diabetes, and pancreatic disease, which can cause changes in stool consistency and frequency 1

Evaluation and Diagnosis

Evaluation and diagnosis of abnormal feces typically involve a combination of medical history, physical examination, and diagnostic tests, such as:

• Stool tests, such as stool culture and stool PCR, to detect infections and other abnormalities 1
• Endoscopy and colonoscopy to visualize the colon and detect inflammation and other abnormalities 1
• Blood tests, such as complete blood count and serum chemistries, to detect inflammation and other abnormalities 1

Treatment and Management

Treatment and management of abnormal feces depend on the underlying cause and may involve:

• Antibiotics and other medications to treat infections and inflammation 1
• Dietary changes, such as increasing fiber intake and avoiding lactose, to manage dietary issues 1
• Other treatments, such as surgery and immunosuppressive therapy, to manage underlying health conditions 1 It is essential to consult with a healthcare provider for proper evaluation and treatment of abnormal feces, as persistent changes in bowel habits and other symptoms can indicate underlying health conditions that require medical attention.

From the FDA Drug Label

The adverse effects reported during clinical investigations of loperamide hydrochloride are difficult to distinguish from symptoms associated with the diarrheal syndrome. A number of the adverse events reported during the clinical investigations and post-marketing experience with loperamide are frequent symptoms of the underlying diarrheal syndrome (abdominal pain/discomfort, nausea, vomiting, dry mouth, tiredness, drowsiness, dizziness, constipation, and flatulence).

The cause of abnormal feces (stool) is not directly stated in the drug label. However, it can be inferred that diarrheal syndrome may be a cause of abnormal feces.

• The drug label mentions that the adverse effects of loperamide are difficult to distinguish from symptoms associated with the diarrheal syndrome.
• The label also lists symptoms of the underlying diarrheal syndrome, which may be related to abnormal feces, such as constipation and abdominal pain/discomfort 2.

From the Research

Causes of Abnormal Feces (Stool)

The causes of abnormal feces (stool) can be attributed to various factors, including:

• Dietary factors, such as a deficient intake of dietary fiber 3
• Gastrointestinal sensorimotor dysfunctions resulting from peripheral and/or central mechanisms 4
• Gut microbiota imbalance 5, 6, 7
• Inflammatory responses 7
• Neurotransmitter imbalance 7

Role of Dietary Fiber

Dietary fiber plays a crucial role in maintaining normal bowel function, and its deficiency can lead to abnormal feces (stool) 3. Different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. For example:

• Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides, can cause abdominal pain/discomfort, abdominal bloating/distension, and flatulence in patients with irritable bowel syndrome (IBS) 3
• Long-chain, intermediate viscous, soluble, and moderately fermentable dietary fiber, such as psyllium, can improve the overall symptoms in patients with IBS 3

Role of Probiotics

Probiotics can also play a role in maintaining normal bowel function and relieving constipation 5, 6, 7. Different strains of probiotics, such as Bifidobacterium and Lactobacillus, can have different effects on the gut microbiota and bowel function. For example:

• Bifidobacterium lactis can improve whole gut transit time, stool frequency, and stool consistency 6
• Multi-strain probiotics with different ratios of Bifidobacterium and Lactobacillus can relieve constipation by regulating intestinal flora, restoring motilin and vasoactive intestinal peptide levels, and downregulating inflammatory factors 7