Bowel Issues: Blood, Pain, and Changes in Stool Shape

Bowel movement issues?

Hello Doctor, I have been experiencing rectal bleeding when I go to the bathroom recently.
On the morning of July 26, my stool was flat and I noticed blood, along with pain in my rectum.
Out of fear, I went to a clinic where the doctor diagnosed me with an anal fissure and prescribed medication and ointment.
After that, I did not experience any more bleeding.
In the following days, my bowel movements were normal at the front but had a mud-like consistency at the back.
Because I was still concerned, I visited the hospital on August 3.
The doctor performed a rectal examination and confirmed that I had a mild anal fissure, prescribing me an ointment.
I have scheduled a colonoscopy, but today my stool has become very thin, resembling the size of a finger.
Is this normal? I read some alarming information online, so I would like to ask the doctor: 1.
I have been under stress and not sleeping well lately; could this affect the shape and consistency of my stool? 2.
How thin does stool need to be to be considered abnormal? I know many people are waiting for their colonoscopy appointments until the end of the month, so I wanted to consult with you first.
Thank you, Doctor.

Xiao An, 20~29 year old female. Ask Date: 2018/08/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
You can follow the doctor's instructions for treatment and examinations to alleviate any concerns, so please do not worry.
Intestinal tumors causing obstruction can lead to symptoms such as thinner stools, severe abdominal bloating, and pain, which, based on your description, does not seem to be the case.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/08/09

More Info

It's understandable to be concerned about changes in bowel habits, especially when accompanied by symptoms like blood in the stool and pain. Based on your description, it seems you have been experiencing a range of gastrointestinal issues, including constipation, the presence of blood and mucus in your stool, and changes in stool shape. Let's break down your concerns and provide some insights.

1. Understanding Your Symptoms
Blood and Pain: The presence of blood during bowel movements, especially if accompanied by pain, can often indicate conditions such as hemorrhoids or anal fissures. An anal fissure is a small tear in the lining of the anus, which can occur due to passing hard stools. This aligns with your experience of having flat stools and pain during bowel movements. The fact that your doctor diagnosed you with a mild anal fissure and prescribed topical treatments is a positive step toward healing.

Changes in Stool Shape: You mentioned that your stool has become very thin, resembling the size of a finger. This change can be concerning, as it may suggest a potential obstruction in the bowel or other underlying issues. However, it is also important to note that stress and dietary changes can significantly impact bowel habits. Stress can lead to conditions like irritable bowel syndrome (IBS), which can cause variations in stool consistency and shape.

2. Factors Influencing Bowel Movements
Diet and Hydration: A diet low in fiber can lead to constipation and harder stools, which may contribute to the development of fissures. Increasing your intake of fruits, vegetables, and whole grains can help promote regular bowel movements. Additionally, staying well-hydrated is crucial for maintaining stool consistency.

Stress and Sleep: As you mentioned, stress and poor sleep can affect your digestive health. Stress can alter gut motility and lead to symptoms such as diarrhea or constipation. It’s essential to find ways to manage stress, whether through relaxation techniques, exercise, or talking to a professional.

3. When to Seek Further Evaluation
Stool Consistency: While variations in stool shape can occur, particularly during periods of stress or dietary changes, persistent changes, especially if they are accompanied by other symptoms (like significant pain, weight loss, or changes in appetite), warrant further investigation. If your stool remains consistently thin or if you experience any alarming symptoms, it would be prudent to follow up with your healthcare provider.

Colonoscopy: You mentioned that you have a colonoscopy scheduled. This is an important diagnostic tool that can help rule out any serious conditions, such as polyps or colorectal cancer, especially given your symptoms. It’s essential to follow through with this procedure for a comprehensive evaluation.

Conclusion
In summary, while your symptoms may be related to anal fissures and stress, it’s crucial to monitor your condition closely. Maintain a fiber-rich diet, stay hydrated, and manage stress effectively. If your symptoms persist or worsen, or if you have any new concerning symptoms, do not hesitate to seek medical attention. Your health is paramount, and proactive management is key to addressing these gastrointestinal issues.

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Hello, sir. You may have irritable bowel syndrome. It is important to adjust your lifestyle and dietary habits. If you continue to experience bleeding, please visit a gastroenterology clinic for an examination. Changhua Hospital cares about your health. Chen Shidian.

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