Gastrointestinal Issues: When to Seek Further Medical Attention - Surgery

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Gastrointestinal issues


Hello Doctor, I have been feeling the urge to have a bowel movement for the past few days, but when I sit on the toilet, I can't seem to go.
I also have a dull pain on both sides of my abdomen (around the lower back area) and I have been passing gas frequently.
So yesterday, I went to see a doctor and mentioned that I do not smoke, drink alcohol, or chew betel nut, and that there is no history of colorectal cancer in my family.
The doctor suggested that my constipation might be due to stress or an irregular diet, and that the abdominal pain is likely caused by difficulty in bowel movements.
The doctor prescribed medication to promote gastrointestinal motility and relieve bloating, and advised me to return if I have further issues.
Today, after taking the medication, I was able to have a bowel movement quickly, but the same area still hurts.
I have a daily bowel movement habit, and the stool is a normal yellow-brown color and shaped like a banana.
I would like to ask if stool that is slightly thicker than my thumb is considered thin.
Do I need to return for a follow-up visit or undergo further examinations? Thank you, Doctor.

Mr. Chen, 20~29 year old female. Ask Date: 2017/11/02

Dr. Ke Fangxu reply Surgery


At the age of 21, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is extremely low.
Based on your description, it seems more like simple constipation.
I recommend starting with a light diet and maintaining a good lifestyle.
You should avoid spicy, irritating, and greasy foods, and increasing your intake of dietary fiber may also be helpful.
If the symptoms persist without improvement, you can consult a physician for medication.
There should be no immediate need for a colonoscopy.

Reply Date: 2017/11/02

More Info


It sounds like you're experiencing a range of gastrointestinal symptoms that can be quite distressing. Based on your description, it seems you've been dealing with issues related to bowel movements, abdominal pain, and gas. While it's good to hear that you've been able to have bowel movements after taking the medication prescribed by your doctor, the persistence of pain in your abdomen is a concern that warrants further attention.

First, let's address your question about the thickness of your stool. Generally, stool that is slightly thicker than your thumb is still considered within the normal range, especially if it maintains a typical shape and color. However, changes in stool consistency, frequency, or accompanying symptoms can indicate underlying issues. In your case, the abdominal pain and the sensation of incomplete evacuation could suggest a few possibilities, including functional gastrointestinal disorders such as irritable bowel syndrome (IBS) or even mild constipation.

Given that your doctor has already prescribed medication to promote bowel motility and reduce gas, it's essential to monitor your symptoms closely. If the pain persists or worsens, or if you experience any new symptoms such as significant changes in your bowel habits, weight loss, or blood in your stool, you should definitely return to your healthcare provider for further evaluation.
In terms of when to seek further medical attention, consider the following guidelines:
1. Persistent Symptoms: If your abdominal pain continues despite treatment or if you notice it becoming more severe, it's important to follow up with your doctor. Persistent pain can sometimes indicate a more serious condition that may require additional diagnostic testing.

2. Changes in Bowel Habits: If you experience a significant change in your bowel habits, such as diarrhea, constipation, or the presence of blood in your stool, these are red flags that should prompt a visit to your healthcare provider.

3. Associated Symptoms: If you develop additional symptoms such as fever, vomiting, or unexplained weight loss, these could indicate a more serious underlying issue and warrant immediate medical attention.

4. Family History: While you mentioned that there is no family history of colorectal cancer, it's still important to be vigilant about any changes in your gastrointestinal health, especially if symptoms persist.

5. Response to Treatment: If you do not see improvement in your symptoms after a reasonable period of following your doctor's advice and taking prescribed medications, it may be time to revisit your healthcare provider for a reassessment.

In addition to seeking medical advice, consider making some lifestyle adjustments that can help alleviate your symptoms. These may include:
- Dietary Changes: Incorporate more fiber into your diet through fruits, vegetables, and whole grains, which can help promote regular bowel movements. Staying hydrated is also crucial.

- Stress Management: Since stress can significantly impact gastrointestinal health, consider techniques such as mindfulness, yoga, or other relaxation strategies to help manage stress levels.

- Regular Exercise: Engaging in regular physical activity can help stimulate bowel function and reduce symptoms of constipation.

In conclusion, while your initial treatment seems to have provided some relief, the ongoing abdominal pain is a signal that should not be ignored. It's essential to maintain open communication with your healthcare provider and advocate for your health. If symptoms persist or worsen, do not hesitate to seek further evaluation. Your health and well-being are paramount, and addressing these gastrointestinal issues promptly can lead to better outcomes.

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