Gastrointestinal Discomfort: When to Seek Further Medical Advice

Gastrointestinal discomfort?

Hello Dr.
Lin: In early April, I visited a colorectal surgeon due to rectal bleeding that lasted nearly a week.
By the time of my appointment, there was no bleeding, and the doctor performed a rectoscopy, which revealed only mild hemorrhoids.
I was prescribed medication and suppositories.
Three days after the consultation, I started experiencing rectal bleeding again (only a small amount when wiping), but the bleeding stopped after a few days.
However, I have been feeling a persistent urge to have a bowel movement, yet I find it difficult to pass stool.
Recently, I have started to experience mild abdominal discomfort, with a sensation of my intestines moving, but my bowel movements are normal and not diarrhea.
After I do have a bowel movement, the discomfort eases a bit, but it returns shortly after.
Should I consider scheduling another appointment or further examinations?

Sihui, 20~29 year old female. Ask Date: 2016/04/19

Dr. Lin Minghui reply Gastroenterology and Hepatology

Abdominal pain and difficulty with bowel movements that improve after defecation are common symptoms of irritable bowel syndrome (IBS).
If symptoms persist or recur, further evaluation may be necessary.
Wishing you good health, thank you.

Reply Date: 2016/04/19

More Info

When experiencing gastrointestinal discomfort, especially symptoms like rectal bleeding, persistent abdominal pain, and changes in bowel habits, it is crucial to seek further medical advice. Your situation, as described, raises several important considerations that warrant a thorough evaluation.

Firstly, the presence of rectal bleeding, even if it is minimal and associated with mild hemorrhoids, should not be overlooked. While hemorrhoids can cause bleeding, other potential causes must be ruled out, especially if the bleeding recurs. Conditions such as anal fissures, diverticular disease, or even more serious issues like colorectal polyps or cancer can present with similar symptoms. Given that you experienced bleeding shortly after your initial examination, it would be prudent to follow up with your healthcare provider.

The sensation of incomplete evacuation, or the feeling of having to go but being unable to, can be indicative of several gastrointestinal issues. This could be related to functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), or it could suggest a more obstructive process. The fact that you are experiencing mild abdominal discomfort alongside these symptoms further emphasizes the need for a comprehensive evaluation.
In terms of next steps, I recommend scheduling an appointment with a gastroenterologist. They may suggest additional diagnostic tests, such as a colonoscopy, to visualize the colon and rectum more thoroughly. This procedure is essential for identifying any abnormalities that may not have been apparent during the initial examination. Although you may have concerns about the discomfort associated with such procedures, they are often necessary for accurate diagnosis and can be performed with sedation to minimize discomfort.

Moreover, it is important to discuss your symptoms in detail with your doctor, including the frequency and characteristics of your bowel movements, any dietary changes, and any other symptoms you may be experiencing, such as weight loss, changes in appetite, or fatigue. These details can help your physician determine the most appropriate course of action.

In the meantime, consider keeping a symptom diary to track your bowel habits, dietary intake, and any other relevant factors. This information can be invaluable during your consultation and may help identify potential triggers or patterns related to your symptoms.

In summary, given your ongoing symptoms of rectal bleeding, abdominal discomfort, and altered bowel habits, it is advisable to seek further medical evaluation. A gastroenterologist can provide a more comprehensive assessment and determine if additional diagnostic testing is necessary. Early intervention is key in managing gastrointestinal issues effectively and ensuring that any serious conditions are addressed promptly.

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