Abnormal Intestinal Motility: When to Consider a Colonoscopy

Abnormal intestinal motility

Hello Doctor: I have a history of gastroesophageal reflux disease, and I've been feeling much better after taking medication for the past six months.
However, I've recently noticed some unusual changes in my bowel movements.
Previously, my bowel motility was very slow, and I would only have a bowel movement every 3 to 5 days.
Recently, though, I've been having a bowel movement once a day, often accompanied by gas.
My stools appear somewhat mucous and are quite bulky.
Additionally, I sometimes experience a cramp-like pain in my lower left abdomen, but it's still tolerable and doesn't affect my daily activities.
I would like to know if I need to undergo a colonoscopy.
I had one two years ago, which showed no issues, and I had similar symptoms at that time, including increased flatulence (I have never been a person who passes gas frequently, but I was doing so several times a day back then).
Should I consider getting another examination this time?

Rica, 20~29 year old female. Ask Date: 2016/03/24

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Based on the symptoms, aside from gastroesophageal reflux disease (GERD), the other issues are related to gastrointestinal dysfunction.
Treatment with probiotics can be initiated, and if there is no improvement, further examination should be conducted.

Reply Date: 2016/03/24

More Info

When it comes to understanding abnormal intestinal motility and determining whether a colonoscopy is necessary, it's essential to consider several factors related to your symptoms, medical history, and the potential underlying causes of your gastrointestinal issues.

Based on your description, you have a history of gastroesophageal reflux disease (GERD) and have been managing it with medication. Recently, you have noticed a significant change in your bowel habits, with increased frequency of bowel movements (once a day), the presence of mucus in your stool, and occasional left lower abdominal pain that feels like cramping. These symptoms, particularly the change in bowel habits and the presence of mucus, warrant careful consideration.

When to Consider a Colonoscopy
1. Change in Bowel Habits: A sudden change in bowel habits, especially if it is accompanied by other symptoms such as abdominal pain, can be a sign of underlying gastrointestinal issues. In your case, the transition from infrequent bowel movements to daily occurrences, along with the presence of mucus, is noteworthy.

2. Presence of Mucus: The appearance of mucus in your stool can indicate several conditions, ranging from benign issues like irritable bowel syndrome (IBS) to more serious conditions such as inflammatory bowel disease (IBD) or infections. While mucus alone is not necessarily alarming, it should be evaluated in the context of other symptoms.

3. Abdominal Pain: Although you describe the pain as tolerable and not affecting your daily life, any persistent abdominal discomfort should be assessed. Cramping pain can be associated with various gastrointestinal conditions, including infections, inflammatory processes, or functional disorders.

4. Previous Colonoscopy: Since you had a colonoscopy two years ago that did not reveal any issues, it is essential to consider whether your current symptoms are significantly different from what you experienced previously. If your symptoms have changed or worsened, it may be prudent to undergo another evaluation.

5. Family History and Risk Factors: If you have a family history of colorectal cancer or other gastrointestinal diseases, this may increase your risk and necessitate more frequent screenings.

Recommendations
Given your symptoms and medical history, it would be advisable to consult with your healthcare provider about the possibility of undergoing a colonoscopy. They may recommend this procedure to rule out any serious conditions, especially if your symptoms persist or worsen. A colonoscopy can provide valuable insights into the health of your colon and help identify any abnormalities that may require treatment.

In addition to a colonoscopy, your doctor may suggest other diagnostic tests, such as stool tests to check for infections or inflammatory markers, imaging studies, or even dietary modifications to assess the impact of your diet on your symptoms.

Conclusion
In summary, while your symptoms may not seem severe at the moment, the changes in your bowel habits, the presence of mucus, and abdominal discomfort are all factors that should be taken seriously. A colonoscopy could be a valuable tool in diagnosing any underlying issues and ensuring your gastrointestinal health. It is always best to discuss your concerns with your healthcare provider, who can guide you on the most appropriate next steps based on your individual situation.

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