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 Shannon Roth, PT, DPT:

It sounds like you've tried a lot of things. Digestion is incredibly complex and affected by what you eat, how much you move and even your mental health.

Stool frequency depends on:

• Fiber intake
• Water intake
• Caffeine and alcohol use
• Stress levels
• Exercise
• Medications

Anywhere from three times a week to three times a day can be normal for bowel movement frequency. Increasing your fiber intake can help add shape to your stools. How much fiber do you consume each day (including the fiber supplement)? As a rule, 25 to 30 grams of fiber daily is the recommended amount.

Probiotics can cause diarrhea (and constipation, too). We generally have a balance between good and bad bacteria in our body. Containing live bacteria or yeast, probiotics aim to increase good bacteria in your body. During that process of rebalancing your gut, you might experience diarrhea.

Stress can also affect your bowel movements. Minimizing stress at home or work as well as getting plenty of sleep can help your gut health.

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. They'll ask you questions like:

• What times of day do you normally poop?
• Do you strain? Do you ever see bleeding?
• What's your typical diet? 
• How much coffee or alcohol do you drink?
• Do you have a family history of colon cancer or gastrointestinal conditions?
• How's your mental health? Are you frequently stressed?

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