Abnormal Bowel Movements: When to Seek Help

Abnormal bowel movements?

Hello Dr.
Ke, I am 27 years old.
I discovered blood in my stool at the beginning of April this year and promptly underwent a colonoscopy in mid-April.
The results indicated mild internal hemorrhoids, and the doctor said there was no major concern, only prescribing a suppository.
However, for the past seven months, my bowel movements have either been thin and slightly bloody or alternating with diarrhea, and my stools are not normal.
I have heard that blood in the stool accompanied by constipation and alternating diarrhea could potentially develop into colorectal cancer.
I would like to ask the doctor: since I had a colonoscopy only in April, and my bowel habits have not improved since then, how should I proceed? Thank you! Concerned, Xiao Xiang.

Xiao Xiang, 20~29 year old female. Ask Date: 2016/11/16

Dr. Ke Fangxu reply Surgery

At the age of 27, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is relatively 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, avoiding spicy, irritating, and greasy foods.
If symptoms persist without improvement, you may consult a physician for medication.
Since you have already undergone a colonoscopy this year, theoretically, you do not need to repeat the examination within 3 to 5 years unless other different symptoms arise.

Reply Date: 2016/11/16

More Info

Hello, 小祥. Thank you for reaching out with your concerns regarding your bowel movements and the presence of blood in your stool. It's understandable to feel anxious about these symptoms, especially given the potential implications. Let's break down your situation and discuss the appropriate steps you can take.

Firstly, it's important to recognize that blood in the stool can arise from various causes, and while you have been diagnosed with mild internal hemorrhoids, the ongoing symptoms you describe warrant further evaluation. The fact that you have experienced alternating episodes of diarrhea and constipation, along with the presence of blood, suggests that there may be an underlying issue that needs to be addressed.

When to Seek Help
1. Persistent Symptoms: Since your bowel habits have not improved over the past seven months, it is crucial to consult with a healthcare professional. If you notice any changes in the frequency, consistency, or color of your stool, or if the blood becomes more pronounced, these are red flags that should prompt immediate medical attention.

2. Change in Bowel Habits: The alternating pattern of diarrhea and constipation can indicate several gastrointestinal conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even infections. A thorough evaluation by a gastroenterologist can help determine the cause.

3. Associated Symptoms: Pay attention to any additional symptoms you may experience, such as weight loss, abdominal pain, fatigue, or changes in appetite. These can provide important clues to your healthcare provider about the underlying issue.

Recommended Actions
1. Follow-Up Colonoscopy: Given your history of blood in the stool and the persistence of your symptoms, it may be advisable to undergo another colonoscopy. This can help rule out any serious conditions, including colorectal cancer, especially since you are concerned about the potential for cancer given your symptoms.

2. Dietary Adjustments: Consider making dietary changes to improve your bowel health. Increasing your fiber intake through fruits, vegetables, and whole grains can help regulate your bowel movements. Staying well-hydrated is also essential. If you are experiencing diarrhea, it may be beneficial to avoid high-fat, spicy, or overly processed foods that can exacerbate symptoms.

3. Medication Review: If you are currently taking any medications, including over-the-counter remedies, discuss these with your doctor. Some medications can contribute to gastrointestinal symptoms.

4. Stress Management: Stress can significantly impact bowel habits. Techniques such as mindfulness, yoga, or regular exercise can help manage stress levels and improve gut health.

5. Regular Monitoring: Keep a diary of your bowel movements, noting any changes in consistency, frequency, and the presence of blood. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

Conclusion
While your initial diagnosis of mild internal hemorrhoids may not seem alarming, the ongoing changes in your bowel habits and the presence of blood necessitate further investigation. It is essential to communicate openly with your healthcare provider about your symptoms and concerns. Early intervention can lead to better outcomes, so do not hesitate to seek help. Remember, your health is paramount, and addressing these issues proactively is the best approach.
Take care, and I hope you find relief and answers soon.

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