Changes in Stool Patterns and Occasional Blood: A Gastrointestinal Concern

The stool consistency has been changing, and sometimes there is a little blood when wiping?

Hello, doctor.
I have had gastrointestinal issues since I was young, with poor absorption.
I tend to stay up late.
I am a male, 170 cm tall and weigh 48 kg.
Over the past six months, I have noticed that the shape of my stool frequently changes; sometimes it is thin, sometimes normal.
I also experience abdominal pain about once every 1-2 weeks, accompanied by diarrhea.
My energy levels and weight have not changed, and my appetite remains good.

I have noticed that since starting college, I have developed a strong liking for spicy food, and I used to eat it frequently, which led to more frequent diarrhea.
Recently, I have been trying to cut back on spicy foods, and there has been some improvement.
However, my stool shape continues to vary frequently over the past six months.
Sometimes I experience constipation, with hard stools, but I usually have a bowel movement almost every day.
During constipation, it may be every two days, but when I do go, the stool is generally small, hard, and minimal.

When I am not constipated, my stool is often hard at the beginning and softens towards the end.
Sometimes it breaks apart when flushed, and occasionally I have a long, normal, somewhat soft stool followed by a bit of thin, small stool.
I have also noticed a little bit of red blood on the toilet paper after wiping, and I am unsure if this is due to hard stools causing anal fissures, as I feel some pain when passing the initial part of the stool, while the latter part is smoother.
However, I still have a slight feeling of incomplete evacuation.
My father also has symptoms of irritable bowel syndrome.
I hope the doctor can clarify my concerns.
Thank you.
I also tend to eat a fair amount of vegetables.

Guo Xiansheng, 20~29 year old female. Ask Date: 2017/08/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
You may have irritable bowel syndrome.
It is important to adjust your lifestyle and dietary habits.
If you continue to experience bleeding, please visit a gastroenterology clinic for an examination.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2017/08/26

More Info

When it comes to gastrointestinal health, changes in stool patterns and the presence of blood can be concerning symptoms that warrant careful consideration. Based on the symptoms you've described, it appears that you may be experiencing a combination of factors that could be contributing to your gastrointestinal discomfort and changes in bowel habits.

Firstly, the variability in your stool consistency—from hard and small pellets to softer, more normal stools—suggests that you may be dealing with a form of irritable bowel syndrome (IBS), particularly given your family history of similar symptoms. IBS is a functional gastrointestinal disorder characterized by a range of symptoms, including abdominal pain, bloating, and changes in bowel habits, which can include diarrhea, constipation, or alternating between the two.

The presence of blood on the toilet paper after wiping could indicate a few potential issues. One common cause is anal fissures, which can occur when hard stools pass through the anal canal, causing small tears in the skin. This can lead to pain during bowel movements and blood on the toilet paper. Given that you mentioned experiencing some pain during bowel movements, this could be a plausible explanation for the blood you observed.

Moreover, your recent dietary habits, particularly your increased consumption of spicy foods, may also be contributing to your gastrointestinal symptoms. Spicy foods can irritate the gastrointestinal tract and may exacerbate symptoms of IBS or lead to episodes of diarrhea. It’s good to hear that you have started to moderate your intake of spicy foods, as this might help alleviate some of your symptoms.

In addition to dietary factors, it’s essential to consider hydration and fiber intake. While you mentioned eating vegetables, ensuring that you have adequate fiber in your diet is crucial for maintaining regular bowel movements and preventing constipation. Drinking enough water is equally important, as it helps to soften stools and promote regularity.

Given your symptoms and the potential for underlying issues, it is advisable to seek a thorough evaluation from a healthcare professional, particularly a gastroenterologist. They may recommend tests such as a stool analysis to check for blood or infections, and possibly a colonoscopy if deemed necessary, especially considering your family history of gastrointestinal issues.

In the meantime, here are some general recommendations that might help manage your symptoms:
1. Dietary Adjustments: Continue to monitor your diet, focusing on a balanced intake of fiber-rich foods (fruits, vegetables, whole grains) while limiting spicy and processed foods that may irritate your gut.

2. Hydration: Ensure you are drinking plenty of fluids throughout the day to help keep your stools soft and promote regular bowel movements.

3. Regular Exercise: Physical activity can help stimulate bowel function and reduce stress, which may also alleviate some gastrointestinal symptoms.

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

5. Monitor Symptoms: Keep a diary of your symptoms, dietary habits, and bowel movements to help identify any patterns or triggers that may be contributing to your discomfort.

In conclusion, while changes in stool patterns and the occasional presence of blood can be alarming, they are often manageable with appropriate lifestyle modifications and medical guidance. It is essential to consult with a healthcare provider to rule out any serious conditions and to develop a tailored plan that addresses your specific symptoms and concerns.

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