Abdominal Pain and Changes in Bowel Habits: IBS or Colon Cancer?

Abdominal pain and changes in bowel habits?

Hello Doctor: I used to have a bowel movement every 2-3 days, but over the past year, it has changed to once or twice a day.
The stool varies in thickness and consistency, sometimes soft and sometimes hard.
After eating, I experience abdominal pain within thirty minutes and feel the urge to use the restroom, usually resulting in soft, mucous-like stools.
After I have a bowel movement, the pain subsides.
When I do not have abdominal pain, my bowel movements are generally normal.
I had a fecal occult blood test and CEA level check in January of last year, both of which were normal.
In July, I experienced diarrhea with blood streaks, and I subsequently had another fecal occult blood test, which was also normal.
Could these symptoms indicate irritable bowel syndrome or colon cancer?

y, 20~29 year old female. Ask Date: 2018/06/16

Dr. Ke Fangxu reply Surgery

At the age of 25, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to maintain a light diet and a good lifestyle routine.
Spicy, irritating, and greasy foods should be avoided.
Increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2018/06/16

More Info

When it comes to understanding abdominal pain and changes in bowel habits, distinguishing between conditions like Irritable Bowel Syndrome (IBS) and more serious issues such as colon cancer is crucial. Based on the symptoms you've described, it seems that you are experiencing a combination of abdominal pain, changes in bowel frequency, and variations in stool consistency.
Firstly, IBS is a common gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, which can include diarrhea, constipation, or alternating between the two. The fact that your abdominal pain occurs shortly after eating and resolves after a bowel movement is consistent with IBS. Additionally, the variability in stool consistency—ranging from soft to hard—further supports this diagnosis. IBS is often triggered by dietary factors, stress, or hormonal changes, and it does not typically lead to serious complications.

On the other hand, colon cancer can present with symptoms that overlap with those of IBS, such as abdominal pain and changes in bowel habits. However, there are certain red flags that may indicate a more serious condition. These include persistent abdominal pain, significant changes in bowel habits, blood in the stool, unexplained weight loss, and a family history of colorectal cancer. In your case, while you have experienced episodes of blood in your stool, your previous fecal occult blood tests and CEA levels were normal, which is reassuring. However, the presence of blood, even if it is just streaks, should not be ignored, especially given your family history of colon cancer.

Given your symptoms and the fact that you have had a family history of colon cancer, it is advisable to pursue further evaluation. While your symptoms may suggest IBS, the presence of blood in your stool warrants a thorough investigation to rule out any serious conditions, including colon cancer. A colonoscopy is often recommended in such cases, especially if you have a family history of colorectal cancer or if your symptoms persist or worsen. This procedure allows for direct visualization of the colon and the opportunity to biopsy any suspicious lesions.

In summary, while your symptoms may align more closely with IBS, the presence of blood in your stool and your family history of colon cancer necessitate further investigation. It is essential to consult with a healthcare professional who can perform the necessary diagnostic tests and provide a comprehensive evaluation of your gastrointestinal health. Regular screenings, especially for individuals with a family history of colorectal cancer, are crucial for early detection and prevention.

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