Bowel Issues: IBS or Colorectal Cancer Concerns? - Gastroenterology and Hepatology

Bowel issues: Irritable Bowel Syndrome (IBS)? Colorectal cancer?

Hello Doctor: Since I was young, I haven't had daily bowel movements (about every three to four days).
However, whenever I feel anxious, I often have the urge to go to the bathroom and I tend to experience bloating.
I'm not sure if it's related to my job change (sitting for long hours, over ten hours a day, and sometimes I hold it in because I'm the only one managing the store).
In the past six months, I've started to have difficulty going for three to four days at a time (though this doesn't happen every time, the frequency has increased compared to before).
Occasionally, I still feel the urge to go when I'm anxious! I'm worried that not having bowel movements for a long time could lead to a buildup of toxins, so for the past month, I've been trying to establish a routine of going to the bathroom daily.
Since I don't feel the urge, I often feel like I'm straining more, and I have a sensation of being blocked! I'm not sure if changes in my diet have also affected this (currently, for breakfast, I only eat an egg pancake, for lunch, I have a large plate of raw vegetables with boiled chicken breast, and for dinner, I eat a bowl of rice with some steamed vegetables, which means I'm consuming fewer carbohydrates and fats).
I drink about 1500cc of water a day, and my stool is yellowish-brown, without blood, and it's not pencil-thin.
My weight is about the same as before, but there are days when I feel no urge to go, which makes me anxious.
Doctor, is there a problem with this? Is it due to poor motility, or could there be other issues? I'm really worried about cancer.
What can I do to improve this? Or what tests should I undergo? (Recently, I had blood tests, and my AFP level was 1.66 ng/ml and LDH level was 125 U/L).
Thank you for your help, Doctor.

Ting, 30~39 year old female. Ask Date: 2018/05/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, it seems that the slow peristalsis is the cause.
It is still recommended to consume more fiber-rich fruits and vegetables, increase physical activity, and ensure adequate hydration.
If necessary, consider using laxatives to assist with bowel movements.
We hope you can achieve normal bowel function.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/05/27

More Info

When it comes to bowel issues, particularly the concerns surrounding irritable bowel syndrome (IBS) and colorectal cancer, it is essential to understand the symptoms, potential causes, and necessary evaluations to differentiate between these conditions.

Based on your description, it seems you have been experiencing irregular bowel habits, including infrequent bowel movements (every three to four days), a feeling of incomplete evacuation, and occasional abdominal discomfort. You also mentioned that stress tends to exacerbate your urge to use the restroom, which is a common symptom associated with IBS. IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and changes in bowel habits, which can include diarrhea, constipation, or alternating between the two.

Your dietary changes, such as reducing carbohydrates and fats while increasing your intake of vegetables and lean proteins, can significantly impact your bowel habits. While a high-fiber diet is generally recommended for promoting regular bowel movements, it is crucial to ensure that you are consuming enough fiber and fluids to facilitate digestion. Insufficient fiber intake can lead to constipation, especially if your body is not used to a sudden dietary shift. The fact that you are drinking around 1500cc of water daily is good, but you may want to assess whether you are getting enough dietary fiber from fruits, vegetables, and whole grains.

Regarding your concerns about colorectal cancer, it is understandable to feel anxious, especially when experiencing changes in bowel habits. However, the absence of alarming symptoms such as blood in your stool, significant weight loss, or severe abdominal pain is reassuring. The stool color you described as "土黃色" (earthy yellow) and the fact that it is not pencil-thin also suggest that there may not be an immediate cause for concern regarding cancer. Your recent blood tests, including the AFP (Alpha-fetoprotein) and LDH (Lactate Dehydrogenase) levels, appear to be within normal ranges, which further reduces the likelihood of malignancy.

To address your concerns and improve your bowel health, consider the following recommendations:
1. Dietary Adjustments: Gradually increase your fiber intake by incorporating whole grains, fruits, and vegetables. This can help promote regular bowel movements and alleviate constipation. Aim for a balanced diet that includes a variety of food groups.

2. Regular Physical Activity: Engaging in regular exercise can help stimulate bowel function and reduce stress, which may contribute to your symptoms. Even simple activities like walking can be beneficial.

3. Stress Management: Since stress seems to trigger your bowel issues, consider incorporating relaxation techniques such as deep breathing, meditation, or yoga into your routine.

4. Routine Check-ups: If your symptoms persist or worsen, it may be prudent to consult a healthcare professional for further evaluation. This could include a colonoscopy, especially if there are any changes in your symptoms or if you have a family history of colorectal cancer.

5. Monitor Symptoms: Keep a diary of your bowel habits, dietary intake, and any associated symptoms. This information can be valuable for your healthcare provider in assessing your condition.

In conclusion, while your symptoms may be indicative of IBS, it is essential to remain vigilant and consult with a healthcare professional if you have ongoing concerns. Regular monitoring and lifestyle adjustments can significantly improve your bowel health and overall well-being. Remember, early intervention is key, and addressing your concerns with a qualified healthcare provider can provide peace of mind and appropriate care.

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