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For the past couple of years, I have had inconsistent bowel movements. At first I thought it might be something more serious like rectal prolapse or some other similar condition, but since I am only in my 20s, and upon examination from doctors, it has been determined that all my bowel muscles are healthy.

As usual, whenever I see a doctor about my condition, I am told it is due to a lack of fiber in my diet and that it is just a simple case of constipation, but my stool is rarely difficult to pass because it is hard. It usually seems to have more to do with my bowel muscles. In fact, when the stool is hard, I seem to have better bowel movements since then it comes out in one piece and I feel relieved afterward. Often, though, it comes out normal and soft but my muscles contract and only a part of it will be able to come out. Sometimes the rest can come out, other times I have difficulty getting the muscles to relax. Sometimes, the stool is somewhat hard and comes out in little pebble like pieces, or clumps of pebble like pieces. Often with these pebble like pieces, I see mucus. Because the intestine walls are not smooth but have lines, the clumps and the pebbles look like they were wedged into crevices in the intestine or something.

Every once in a while, I have diarrhea. Sometimes it is all liquid diarrhea, other times it is watery with some some clumps mixed in. But this is not that common. Maybe once or twice a month at most, and usually when I don't get enough sleep or I'm stressed or eat something weird the day before.

A lot of my symptoms are not that uncommon as even healthy people without IBS often have inconsistent bowel movements depending on their emotional and mental state, diet, physical condition, etc. And I think part of my problem may be that I have to retrain my mind and my body to have regular bowel movements since for a time I did strain and sit on the toilet for a long time when I did not know what my condition was and thought I had to push to get the stool out, especially when part of the stool came out and then the muscle contracts and I had the feeling of incomplete evacuation.

But I do think that my situation is not just a simple case of eating something my stomach can't handle or lack of sleep since even when everything is fine, I sometimes have inconsistent bowel movements.

My question: since there is no real treatment as of yet for IBS, should I still go to a hospital and get myself checked out? I've visited many doctors, including a colon specialist. The colon specialist treated me for hemorrhoids (I got three small ones removed with band ligation) and told me to eat a high fiber diet. I know a lot of clinics run tests on volunteers with IBS symptoms to help determine possible treatment options, but I'm hesitant to submit myself to medical testing for IBS when, first, I'm not even sure I have IBS, and secondly, it's all experimental and there are risks associated with medical testing. Also, although it is not a serious concern, I have been thinking about what if my symptoms were actually a sign of something more serious? Every once in a while, difficult bowel movements have had some blood, but not necessarily blood in the stool but more like blood from the tissue, like an anal fissure or hemorrhoids. It is usually just streaks of blood, like as if you picked at a scab and then wiped away the blood. Very rarely, it was red blood on the tissue, but my thought is that was probably due to the small fissure accumulating blood.

At any rate, if anyone knows more about possible explanations for my symptoms, any help would be much appreciated. And if further information is needed, please let me know. Thank you.

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if it is IBS then you need to ensure you dont eat the trigger foods that can aggravate it and also consider seeing a hypnotherapist. hypnosis is one of the only reliable ways to manage IBS although most doctors would not probably consider this a treatment option so it would have to be paid for out of your own pocket. normally there are 3- 4 sessions involved and a personalised recording to listen to inbetween sessions. 

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Hard, pebble-like stool is caused by inadequate water intake and/or an EXCESS of fiber. Taking fiber supplements will only perpetuate the issue, and may cause a bowel obstruction. A hard or compacted bowel movement may also cause tearing of the colon or anus. My suggestion (as a fellow sufferer) is to eat only vegetables, fruit, and Greek yogurt or kefir for a few days. Drink between 1-2 ltrs of water each day. It'll help. If things still don't come out okay (pardon the jest :-D), try colace. It takes two days to work, but is a Godsend.
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