Bowel Issues: When to Seek Further Medical Evaluation

Bowel issues

Hello, doctor.
Recently, my bowel habits have changed over the past three months, affecting my daily routine.
However, the doctors I have seen have not been able to identify any results, and I am considering whether or not to undergo further testing.
Back in February, I experienced diarrhea with blood, and the doctor diagnosed me with hemorrhoids.
After that, I used treatment for hemorrhoids, and I stopped bleeding, but during that time, I was almost constipated every day.
I would wake up in the morning feeling bloated, but I couldn't have a bowel movement.
Later, I consulted again and was treated with medication for gastroenteritis.
Although my symptoms have improved significantly since then, I still wake up in the morning feeling bloated, and I can't have a bowel movement.
My stool varies in consistency, sometimes being thick and sometimes thin, with episodes of constipation and diarrhea.
Occasionally, I have more normal stools, but due to my class schedule, I cannot have a bowel movement every morning.
However, if I don't, I feel bloated all day.
Should I consider undergoing further testing, given that I am only 18 years old?

Xiao Yu, 10~19 year old female. Ask Date: 2017/05/18

Dr. Lin Minghui reply Gastroenterology and Hepatology

Changes in bowel habits, morning bloating, and alterations in the nature and shape of stools can be common signs of conditions such as irritable bowel syndrome, especially considering your age.
If symptoms persist, such as blood in the stool, frequent urges to have a bowel movement without being able to, incomplete evacuation, abdominal pain, anemia, or weight loss, it is essential to seek medical attention.
Wishing you good health.

Reply Date: 2017/05/18

More Info

It sounds like you have been experiencing a range of gastrointestinal symptoms that have significantly impacted your daily life. Given your history of bloody diarrhea, constipation, and abdominal bloating, it is understandable that you are considering further medical evaluation.
Firstly, it is important to recognize that changes in bowel habits, especially when accompanied by symptoms like blood in the stool, should not be taken lightly. While your initial diagnosis of hemorrhoids may explain some of the bleeding, the presence of blood in the stool can also be indicative of other conditions, including inflammatory bowel disease (IBD), infections, or even polyps. The fact that you have experienced alternating constipation and diarrhea, along with abdominal bloating, raises the possibility of a functional gastrointestinal disorder, such as irritable bowel syndrome (IBS), but it is essential to rule out more serious underlying conditions first.

Your symptoms of abdominal bloating and irregular bowel movements could be related to dietary factors, stress, or a combination of both. Many individuals with IBS find that certain foods, particularly those high in fat or dairy, can exacerbate their symptoms. Keeping a food diary to track what you eat and how it affects your bowel habits may provide valuable insights. Additionally, stress and anxiety can significantly impact gastrointestinal function, leading to symptoms like bloating and changes in bowel habits.
Given your age and the persistence of your symptoms, it would be prudent to discuss the possibility of further diagnostic testing with your healthcare provider. Tests such as a colonoscopy or imaging studies may be recommended to evaluate the health of your colon and rule out any serious conditions. A colonoscopy is particularly useful for examining the lining of the colon and can help identify inflammation, polyps, or other abnormalities.
In the meantime, consider implementing some lifestyle changes that may help alleviate your symptoms. Regular physical activity can promote healthy bowel function and reduce bloating. Additionally, staying hydrated and increasing your fiber intake can help regulate bowel movements. If you find that certain foods trigger your symptoms, it may be beneficial to avoid them.
Lastly, if you are experiencing significant stress or anxiety related to your symptoms, seeking support from a mental health professional may also be beneficial. Stress management techniques, such as mindfulness, yoga, or cognitive-behavioral therapy, can help improve your overall well-being and may alleviate some gastrointestinal symptoms.

In summary, while your symptoms may suggest a functional gastrointestinal disorder, it is essential to rule out any serious underlying conditions. Discussing your concerns with your healthcare provider and considering further evaluation will help ensure that you receive appropriate care. Remember, you are not alone in this, and seeking help is a crucial step toward understanding and managing your bowel issues effectively.

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