Question:

I have issues with too many stools each day. They are soft, not diarrhea. But normal days I always have at least three. I take a fiber supplement, have had stool studies done and had a colonoscopy last fall. I also take a probiotic daily. I'm not sure where to go from here. Any ideas? 

Answer by pelvic health rehabilitation therapist Sam Weber, DPT, PT:

You’ve done a lot so far to try to manage your bowel habits. Many factors can affect how often and what type of stool you have. It’s normal to have bowel movements anywhere from three times per day to three times per week. How much this frequency impacts your day-to-day life is unique to each person. 

Factors that may influence your stool include:

• Fiber intake.
• Water intake.
• Diet.
• How often and how much you eat.
• Caffeine and alcohol use.
• Stress levels.
• Mental health.
• Exercise and daily physical activity level.
• Sleep.
• Medications. 

Increasing your fiber intake can help add shape to your stools. How much fiber do you consume each day, including the fiber supplement? Generally, 25 to 30 grams of fiber per day is the recommended amount. 

Probiotics can cause diarrhea and constipation. We generally have a balance between good and bad bacteria in our gut. Probiotics, which contain live bacteria or yeast, aim to increase good bacteria in your gut. However, during the process of rebalancing your gut, you may experience diarrhea. 

High levels of stress and/or poor mental health can negatively impact your bowel movements and gut health. Finding time to relax and practice small acts of self-care can help manage your stress and mental health. Exercise, movement and good sleep hygiene are also very beneficial for stress management and mental health ─ both of which impact the gut. 

The best way to treat digestive issues is by first determining the cause. I’d encourage you to see a gastrointestinal specialist who can consider your lifestyle, diet and unique medical history and how these factors are impacting your bowel movements. 

They can also screen you for IBS and IBD, two distinct gastrointestinal disorders.