Chronic Diarrhea for a Month: Possible Causes and Next Steps

Diarrhea for one month?

Hello doctor, I started experiencing diarrhea at the end of September.
After a week, I encountered my menstrual period, which usually causes me to have diarrhea.
However, in early October, my bowel movements returned to normal.
A week after my period ended, I continued to have diarrhea.
Initially, I thought it was due to taking collagen supplements, so I stopped taking them on October 17, but there was no improvement.
I still experience diarrhea intermittently (mostly watery, with occasional soft stools followed by watery stools).
Today, my menstrual period started, and similar to last month, my stools are more normal without any blood.
However, since a relative was recently diagnosed with colon cancer, my parents are very concerned about my condition and want to know if there could be something serious going on.
A couple of days ago, a clinic doctor suggested it might be due to stress, but I don't feel particularly stressed lately.
I would appreciate your clarification on this matter.
Thank you.
I plan to go to a major hospital for further examination after my period ends next week.

Shu Shu, 20~29 year old female. Ask Date: 2016/11/04

Dr. Ke Fangxu reply Surgery

At the age of 22, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is extremely low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to maintain a light diet and a good lifestyle routine.
If symptoms persist without improvement, you may ask your physician for medication.
If there is still no improvement or if you are very concerned, you can also arrange for a colonoscopy.

Reply Date: 2016/11/04

More Info

Chronic diarrhea lasting for a month can be concerning, especially given your family history of colon cancer. It's important to approach this situation with a thorough understanding of potential causes and the necessary next steps for evaluation and management.

Firstly, chronic diarrhea can stem from a variety of causes, including infections, inflammatory bowel diseases (IBD) like Crohn's disease or ulcerative colitis, irritable bowel syndrome (IBS), food intolerances, and even certain medications or supplements. In your case, you mentioned that the diarrhea began around the end of September and persisted despite stopping collagen supplements. This suggests that the collagen may not be the primary cause, especially since you noted a return to more normal bowel movements during your menstrual cycle.

The fact that your diarrhea is predominantly watery, with occasional softer stools, raises the possibility of a functional gastrointestinal disorder such as IBS. Stress is often cited as a trigger for IBS symptoms, but you mentioned not feeling particularly stressed recently. However, it's worth noting that stress can sometimes be subtle and may not always be consciously recognized.
Another consideration is the possibility of an infection, particularly if you have had any recent travel or exposure to contaminated food or water. Viral gastroenteritis, bacterial infections, or even parasitic infections can lead to prolonged diarrhea. If you have any accompanying symptoms such as fever, significant abdominal pain, or blood in your stool, these would warrant immediate medical attention.

Given your family history of colon cancer, it is prudent to take your symptoms seriously. While the likelihood of colon cancer in someone your age is relatively low, it is not impossible, especially if there are concerning symptoms such as a change in bowel habits, unexplained weight loss, or persistent abdominal discomfort.
Your plan to visit a larger hospital for further evaluation after your menstrual cycle is a good step. During this visit, it would be beneficial to discuss your symptoms in detail with your healthcare provider. They may recommend several diagnostic tests, including:
1. Stool Tests: To check for infections, parasites, or blood.

2. Blood Tests: To assess for signs of inflammation, infection, or anemia.

3. Colonoscopy: Depending on your age and risk factors, this may be recommended to visualize the colon and rule out any serious conditions.

In the meantime, it is essential to stay hydrated, especially since diarrhea can lead to dehydration. Consider drinking clear fluids, oral rehydration solutions, or electrolyte drinks to replenish lost fluids and electrolytes.
Additionally, keep a food diary to track what you eat and any correlation with your symptoms. This can help identify potential food intolerances or triggers.
In summary, while your symptoms may be related to a benign cause such as IBS or a temporary gastrointestinal upset, the combination of chronic diarrhea and family history of colon cancer necessitates a thorough evaluation. Make sure to communicate all your symptoms and concerns with your healthcare provider during your upcoming visit. Early intervention and appropriate testing can lead to better outcomes and peace of mind.

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