Hello,
Since you have been experiencing loose stools for almost one year, I would recommend a proper evaluation to identify the underlying cause.
Passing stools once or twice daily is within the normal frequency range. However, persistently loose or watery stools are not necessarily normal, even when the frequency is low.
Possible causes include:
1. Functional diarrhoea: A condition characterized by recurrent loose or watery stools without significant abdominal pain.
2. Food intolerance: Certain fruits and vegetables contain fermentable carbohydrates, such as fructose and sorbitol, which can cause loose stools in susceptible individuals.
3. Malabsorption disorders: Conditions such as celiac disease may occasionally present with chronic loose stools.
4. Chronic intestinal infections: Certain parasitic infections, including giardiasis, can produce persistent loose stools.
5. Inflammatory intestinal conditions: These are less likely without bleeding or other symptoms, but may need consideration depending on the clinical findings.
Recommended investigations:
Since your symptoms have persisted for one year, I suggest consulting a gastroenterologist. Depending on your clinical examination, investigations may include:
-
Complete blood count (CBC).
- Celiac screening (tTG-IgA with total IgA).
- Stool examination, including Giardia testing when indicated.
- Fecal calprotectin to assess for intestinal inflammation.
-
Thyroid function tests if clinically indicated.
Colonoscopy is not routinely necessary at your age in the absence of warning signs, but may be recommended if the initial evaluation suggests an underlying intestinal disorder.
Dietary advice:
For the time being, identify and limit the particular fruits or vegetables that aggravate your symptoms rather than avoiding all fruits and vegetables. Maintain adequate hydration and consider a food diary to identify triggers.
Please clarify a few things:
1. Are your stools completely watery or simply soft and unformed?
2. Do you experience abdominal pain or urgency before passing stools?
3. Have you experienced any weight loss during the past year?
4. Do you ever wake up at night to pass stools?
These details will help distinguish functional diarrhoea from other causes.
My recommendation: Since this has persisted for one year, a gastroenterology consultation and a few targeted investigations would be appropriate. Most causes can be managed effectively once identified.