Should You See a Doctor for Changes in Bowel Habits?

Is it necessary to see a doctor if there are changes in bowel habits?

Hello Doctor, I have recently changed my lifestyle, which has also affected my bowel habits.
I am unsure whether I should visit a large hospital to see a doctor (to avoid wasting health insurance).
Recently, I have reduced my late-night activities and carbohydrate intake (2 bowls per day) and limited sugar consumption (no more than 3 times a week).
I have increased my water intake (2 to 4 liters) and exercise (running 1600 meters plus 40 push-ups and 40 sit-ups every 2 to 3 days).

My original bowel habits included: color being yellow-brown or dark brown, frequency of 1 to 3 times every 3 days, and the shape resembling a banana, occasionally with cracks and a beaded appearance due to dehydration, with a diameter similar to a 10 NT dollar coin to a 50 NT dollar coin.
I experienced some difficulty during bowel movements before changing my routine.

In the past 10 days: the color has changed to bright yellow, frequency is 1 to 2 times a day, the shape is loose stools or watery stools, and the amount, considering moisture and frequency, is still about half of what it was originally.
Bowel movements are not difficult but I feel a sense of diarrhea.

After 10 days of changing my routine: the color remains bright yellow, frequency is 1 to 3 times a day, the shape is loose stools or thin strips not exceeding 10 cm, or although they exceed 10 cm, they cannot maintain a banana shape (they curl up on the water surface).
The amount, considering the current food intake, still feels somewhat reduced compared to the original amount, with a diameter larger than a 5 NT dollar coin.
There is no sensation of diarrhea or difficulty.
Regarding colorectal cancer symptoms: there is no blood in the stool, minimal lower abdominal pain, no symptoms of anemia, good appetite, and I have lost 2 to 3 kg over the past 3 weeks, but it is difficult to assess due to reasonable exercise.

Personal medical history and family history: I have a long history of constipation (X-ray images could not determine if there is a tumor due to constipation), long-term halitosis, but three occult blood tests over six years have shown no abnormalities, the most recent being in March of this year.
Among my close relatives, four have had gastrointestinal cancer, and one among my third-degree relatives has been informed that colorectal cancer is not easily detected.
Therefore, I would like to ask the doctor if I belong to a moderate or higher risk group and whether I should seek medical examination.

Mark, 20~29 year old female. Ask Date: 2017/11/09

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Please consult a gastroenterologist to evaluate whether further examinations are necessary.

Reply Date: 2017/11/09

More Info

Changes in bowel habits can be concerning, especially when they deviate from your normal patterns. Given your recent lifestyle changes, including dietary adjustments and increased physical activity, it's understandable that you may be experiencing alterations in your bowel movements. However, the nature of these changes—such as the frequency, consistency, and color of your stools—can provide important clues about your gastrointestinal health.

From your description, it appears that you have shifted from having bowel movements every 1 to 3 days to a more frequent pattern of 1 to 3 times a day. The change in stool color from brown to bright yellow and the transition from well-formed stools to looser, more watery stools could indicate several things. Bright yellow stools can sometimes be a sign of rapid transit through the intestines, which might occur due to dietary changes or increased physical activity. However, it can also suggest malabsorption or other gastrointestinal issues that warrant further investigation.

Your history of long-term constipation and the fact that you have family members with a history of gastrointestinal cancers are significant factors to consider. While the absence of blood in your stool, abdominal pain, and anemia are reassuring signs, the family history of colorectal cancer does place you at a higher risk. The fact that you have had negative occult blood tests in the past is also encouraging, but it does not completely rule out the possibility of underlying issues, especially given your symptoms.

In general, it is advisable to consult a healthcare professional when you notice significant changes in your bowel habits, particularly if these changes persist for more than a few weeks or are accompanied by other concerning symptoms. In your case, the combination of a family history of gastrointestinal cancer, your previous history of constipation, and the recent changes in your bowel habits suggests that it would be prudent to seek medical advice. A healthcare provider can perform a thorough evaluation, which may include a physical examination, laboratory tests, and possibly imaging studies or a colonoscopy, depending on their assessment.

It's important to remember that while lifestyle changes can significantly impact bowel habits, they can also unmask underlying conditions. A healthcare professional can help you determine whether your symptoms are a benign response to dietary changes or if they require further investigation. Early detection and intervention are key in managing any potential gastrointestinal issues, especially in individuals with a family history of colorectal cancer.

In conclusion, while it may feel like a burden to seek medical attention, especially with concerns about healthcare costs, your health and peace of mind are paramount. It is better to err on the side of caution and consult a doctor who can provide personalized advice based on your specific situation. They can help you navigate your symptoms and determine the best course of action for your health moving forward.

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