Constipation: Symptoms, Causes, and When to Seek Help

Constipation issues?

Hello Doctor: I have had poor bowel habits for a long time without paying much attention.
Sometimes I experience constipation, and other times I start with constipation but then end up with diarrhea.
Typically, I have bowel movements every two days.
I have used enemas, but I make sure not to use too much at once; usually, after using an enema once, I won’t use it again that week.
I don’t need to rely on enemas for every bowel movement.
A month and a half ago, I noticed some blood in my stool (it was bright red, not dark red) during a bowel movement.
Since it was the first time this happened, I was quite alarmed, and I started paying more attention to my stool.
However, I haven’t had any bleeding issues since then.
About a month later, I noticed a small amount of light red streaks in my stool, but it was very minimal, and I felt a dull ache in my lower left abdomen.
I was concerned that I might have polyps in my colon, and I initially planned to see a doctor for an examination.
However, after taking some gastrointestinal medications, the symptoms subsided.
I’m not sure if this situation indicates inflammation in my intestines, but since then, I have not seen any blood in my stool.
I have started to pay more attention to my diet and lifestyle; I try not to stay up late, jog three times a week, drink plenty of water, and eat at least 100g of vegetables at each meal.
I also make sure to include corn and steamed root vegetables (potatoes, carrots, sweet potatoes) with some meat in one meal each day.
My bowel movements have improved to once a day, but I still feel like I can’t empty my bowels completely.
The stool varies in size and sometimes appears thin and elongated.
Occasionally, I feel a dull ache and bloating in my lower left abdomen, but it’s not severe.
I am unsure how to improve this situation.
I am also wondering if I might have polyps in my colon or something else.
I would like to hear your opinion, and I would also like to know which department I should visit for these symptoms.
Thank you for your response.

Riko, 20~29 year old female. Ask Date: 2018/07/26

Dr. Ke Fangxu reply Surgery

Constipation in young women is not uncommon.
If you can have a bowel movement once a day, that's considered good, and I don't think there's a need for further improvement.
To determine if there are any colorectal polyps, a colonoscopy is necessary; however, polyps typically do not cause this issue.
Based on your situation, I would recommend increasing your intake of dietary fiber and reducing the time spent on the toilet, which should help alleviate your discomfort.
You may also consider consulting a gastroenterologist or a colorectal surgeon for further evaluation.

Reply Date: 2018/07/26

More Info

Constipation is a common gastrointestinal issue that can manifest in various ways, including infrequent bowel movements, difficulty passing stool, or a sensation of incomplete evacuation. Your description indicates that you have experienced a mix of symptoms, including occasional constipation, diarrhea, and the presence of blood in your stool, which understandably raises concerns about your gastrointestinal health.

Symptoms of Constipation
Common symptoms of constipation include:
- Infrequent bowel movements (fewer than three times a week)
- Difficulty passing stool
- Hard or lumpy stools
- A feeling of blockage in the rectum
- A sensation of incomplete evacuation after a bowel movement
- Abdominal discomfort or bloating

Causes of Constipation
Several factors can contribute to constipation, including:
- Dietary Factors: Low fiber intake, inadequate hydration, and excessive consumption of processed foods can lead to constipation.

- Lifestyle Factors: Sedentary behavior, lack of physical activity, and irregular bathroom habits can exacerbate the condition.

- Medications: Certain medications, such as opioids, antacids containing aluminum, and some antidepressants, can cause constipation as a side effect.

- Medical Conditions: Conditions such as irritable bowel syndrome (IBS), hypothyroidism, diabetes, and neurological disorders can affect bowel function.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Persistent constipation lasting more than three weeks
- Severe abdominal pain or cramping
- Blood in your stool (even if it appears to be a small amount)
- Unexplained weight loss
- Changes in bowel habits that last for more than a few weeks
- Symptoms of dehydration, such as dizziness or decreased urine output

Your Situation
Given your history of occasional blood in your stool, it is essential to approach this symptom with caution. While you mentioned that the bleeding has stopped and you have made positive lifestyle changes, the presence of blood, even if it is minimal, warrants further investigation. Blood in the stool can be caused by various factors, including hemorrhoids, anal fissures, diverticular disease, or more serious conditions like polyps or colorectal cancer.

Recommendations
1. Consult a Healthcare Provider: Given your symptoms and concerns, it is advisable to consult a gastroenterologist. They specialize in digestive system disorders and can perform necessary evaluations, such as a colonoscopy, to rule out any serious conditions like polyps or inflammation.

2. Dietary Adjustments: Continue to focus on a high-fiber diet, including fruits, vegetables, whole grains, and legumes. Ensure you are drinking plenty of water, as hydration is crucial for softening stool.

3. Regular Exercise: Maintaining a regular exercise routine can help stimulate bowel movements and improve overall digestive health.

4. Monitor Symptoms: Keep a record of your bowel habits, dietary intake, and any symptoms you experience. This information can be valuable for your healthcare provider.

5. Avoid Overuse of Laxatives: While occasional use of laxatives or enemas can be helpful, relying on them frequently can lead to dependency and worsen constipation in the long run.

Conclusion
Your proactive approach to improving your diet and lifestyle is commendable, and it may help alleviate some of your symptoms. However, given your previous experiences with blood in your stool and ongoing discomfort, it is crucial to seek professional medical advice. A gastroenterologist can provide a thorough assessment and guide you toward appropriate treatment options tailored to your specific needs. Remember, early intervention is key to managing gastrointestinal health effectively.

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