Bowel Issues: When to Seek Help for Digestive Health

Bowel issues

Hello, Dr.
Chen.
I am a 23-year-old female studying abroad and I don't often return to Taiwan, so it's difficult for me to seek medical attention immediately.
A few months ago, I experienced rectal bleeding after every bowel movement and had constipation.
I consulted a traditional Chinese medicine practitioner and was diagnosed with external hemorrhoids.
Following the doctor's advice, I used a topical treatment and took herbal medicine, which reduced the swelling of my hemorrhoids, and I no longer experienced rectal bleeding after bowel movements.

However, I suddenly started having daily bowel movements, and sometimes I feel the urge to go again even after finishing.
My stools vary in size, with some being thick and others thin like a pencil, and at times they are unformed (loose or fragmented).
The color is darker than usual, and they typically sink to the bottom of the toilet.
It has been a month since I stopped taking the herbal medicine and the topical treatment, and I am a bit worried.
I have read about the symptoms of colorectal cancer online and have frightened myself.
I hope Dr.
Chen can help me.
Thank you!

N, 20~29 year old female. Ask Date: 2016/04/30

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Based on the symptoms, it appears to be a hemorrhoid issue.
It is recommended to refrain from using traditional Chinese medicine and hemorrhoidal ointments, and it is necessary to seek treatment from a colorectal surgeon.

Reply Date: 2016/04/30

More Info

Hello! It sounds like you're experiencing a range of bowel issues that can be quite concerning, especially given your family history and previous health challenges. Let's break down your symptoms and discuss when it might be necessary to seek medical attention.

From what you've described, you have experienced rectal bleeding, constipation, and changes in your bowel habits, including the consistency and shape of your stools. While it's good to hear that your hemorrhoids have improved and the bleeding has stopped, the new symptoms you're experiencing warrant attention.

1. Bowel Movement Changes: The fact that your stools vary in shape and consistency—from thick to thin, and sometimes loose—can indicate several things. Changes in bowel habits can be due to dietary factors, stress, or even underlying gastrointestinal conditions. The presence of both hard and loose stools may suggest a condition known as Irritable Bowel Syndrome (IBS), which is characterized by abdominal pain and altered bowel habits without any identifiable organic cause.

2. Color and Consistency: You mentioned that your stools are darker and sometimes sink in the water. Dark stools can be caused by various factors, including dietary choices (like consuming iron-rich foods or supplements) or bleeding from the upper gastrointestinal tract. However, if the stools are consistently dark and you notice any other symptoms, such as abdominal pain or weight loss, it is crucial to consult a healthcare professional.

3. When to Seek Help: Given your family history of colorectal issues, including your brother's recent diagnosis of colon cancer and your father's history of polyps, it's essential to be vigilant about your gastrointestinal health. Here are some red flags that indicate you should seek medical attention:
- Persistent changes in bowel habits lasting more than a few weeks.

- Blood in your stool, whether bright red or dark.

- Unexplained weight loss.

- Severe abdominal pain or discomfort.

- A feeling of incomplete evacuation after a bowel movement.

4. Screening Recommendations: Given your family history and age, it may be advisable to undergo a screening colonoscopy sooner rather than later. The general recommendation is to start screening at age 45, but with a family history of colorectal cancer, your doctor may suggest starting earlier. This procedure can help identify any polyps or abnormalities in your colon before they become serious.

5. Lifestyle Considerations: While waiting for a medical appointment, consider keeping a food diary to track what you eat and how it affects your bowel movements. Increasing your fiber intake, staying hydrated, and managing stress through relaxation techniques can also help improve your digestive health.

In conclusion, while some of your symptoms may be benign, given your family history and the nature of your symptoms, it is advisable to consult with a healthcare professional as soon as possible. They can provide a thorough evaluation and determine if any further testing is necessary. Remember, it's always better to err on the side of caution when it comes to your health. Take care!

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