Symptoms: Weakness, Bloating, and Irregular Bowel Movements

Weakness in the limbs, abdominal distension, and thin or unformed stools?

Hello doctor, I had issues with intestinal colic when I was a child, and for the past five years, I have been experiencing irritable bowel syndrome (IBS).
Recently, I have had a sudden increase in constipation, alternating with diarrhea.
I also feel chest tightness and difficulty breathing, and I experience bloating whenever I eat.
My bowel movements have changed; the stool is either thin or loose and unformed, but the color has not changed significantly (it hasn't turned black).
I notice mucus when wiping.
I have seen three clinics (one gastroenterology, one internal medicine, and one family medicine), and they all diagnosed me with IBS along with bloating causing breathing difficulties.
I have been taking medication, but I still feel easily fatigued and have weakness in my limbs.
After resting, I haven't been able to recover much.
After a few days, my energy has improved somewhat, but I still feel like there is something stuck in my abdomen.
My bowel movements are minimal, and the shape is either loose and unformed or thin like a finger width.
There is no black stool.
Could this possibly indicate that I have colon cancer?

Li Tongxue, 20~29 year old female. Ask Date: 2016/05/08

Dr. Ke Fangxu reply Surgery

The likelihood of developing colorectal cancer at the age of 22 is not zero, but generally, it is very, very low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to start with a light diet and maintain a good lifestyle.
If symptoms persist without improvement, you can consult a physician for medication.
If there is still no improvement or if you are very concerned, a colonoscopy can be arranged.

Reply Date: 2016/05/08

More Info

Based on your symptoms and medical history, it appears that you are experiencing a combination of irritable bowel syndrome (IBS) and possibly some functional gastrointestinal issues. Your history of intestinal colic as a child and the recent exacerbation of symptoms, including alternating constipation and diarrhea, bloating, and changes in stool consistency, align with the characteristics of IBS.
IBS is a common functional gastrointestinal disorder characterized by abdominal pain or discomfort associated with changes in bowel habits. The symptoms can vary widely among individuals and may include bloating, gas, diarrhea, constipation, or a combination of these. The fact that you have been experiencing these symptoms for an extended period, along with the recent increase in severity, suggests that your IBS may be flaring up due to various factors, including dietary changes, stress, or other lifestyle factors.

The presence of mucus in your stool is not uncommon in IBS and can occur due to increased intestinal motility or irritation of the intestinal lining. The changes in stool shape—becoming thinner or more fragmented—can also be indicative of IBS, particularly if there is associated abdominal discomfort. However, it is essential to differentiate between IBS and other potential gastrointestinal issues, including more serious conditions like colorectal cancer.

Your concern about colorectal cancer is understandable, especially given the changes in your bowel habits and the presence of mucus. However, the absence of alarming symptoms such as significant weight loss, blood in the stool, or severe abdominal pain is reassuring. Colorectal cancer typically presents with more pronounced symptoms, and your current symptoms are more consistent with IBS. Nevertheless, it is crucial to remain vigilant and consult with a gastroenterologist for further evaluation, especially if your symptoms persist or worsen.

In terms of management, it is essential to focus on lifestyle modifications that can help alleviate your symptoms. Here are some recommendations:
1. Dietary Changes: Consider keeping a food diary to identify any potential triggers for your symptoms. Common triggers for IBS include high-fat foods, dairy products, caffeine, and certain types of carbohydrates (FODMAPs). A low-FODMAP diet may be beneficial for some individuals with IBS.

2. Hydration: Ensure you are drinking enough fluids, as dehydration can exacerbate constipation. Aim for at least 8-10 glasses of water per day.

3. Regular Exercise: Physical activity can help improve bowel function and reduce stress, which may alleviate some of your symptoms.

4. Stress Management: Since stress can significantly impact IBS symptoms, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

5. Medications: If you have not already done so, discuss with your healthcare provider the possibility of medications that can help manage IBS symptoms, such as antispasmodics for abdominal pain or laxatives for constipation.

6. Follow-Up: Given your symptoms and history, it may be prudent to have regular follow-ups with your healthcare provider to monitor your condition and make any necessary adjustments to your treatment plan.

In conclusion, while your symptoms are concerning, they are more indicative of IBS rather than colorectal cancer, especially in the absence of alarming signs. However, ongoing monitoring and communication with your healthcare providers are essential to ensure your symptoms are managed effectively and to rule out any serious conditions. If you experience any new or worsening symptoms, do not hesitate to seek medical attention promptly.

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