Changes in Bowel Habits and Mucus in Stool - Gastroenterology and Hepatology

Changes in bowel habits with mucus?

Hello Dr.
Chen: Around June or July, my bowel habits changed to constipation (every 2-3 days) → normal (every 2 days) → alternating with loose, watery stools (for 2 days).
I also noticed that my stools became thinner and sometimes had mucus.
In August, I visited a clinic where the doctor conducted an interview and an abdominal ultrasound, diagnosing me with irritable bowel syndrome (IBS) and prescribing medication.
During the medication period, my bowel movements returned to normal (once a day) and the stool consistency was also normal.
However, after finishing the medication, I experienced a week of unformed, loose stools daily, often accompanied by mucus, with a strong urge to defecate mostly after breakfast, which subsided after bowel movements.
Given that both my grandmother and father have a history of colorectal cancer, and I have had annual fecal occult blood tests for the past 3-4 years that were all negative, I am very concerned about whether I might also have a similar condition.
I am unsure if this is IBS or colitis, and I wonder if I need to undergo a colonoscopy.
Thank you, Dr.
Chen.

Niming, 20~29 year old female. Ask Date: 2018/09/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, please first check for occult blood in your stool.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/09/03

More Info

Understanding changes in bowel habits, particularly the presence of mucus in stool, can be quite complex and often requires a thorough evaluation of various factors, including diet, stress levels, and underlying health conditions. Based on your description, it seems you have experienced a significant fluctuation in your bowel habits, transitioning from constipation to normal stools, and then to loose, mucus-laden stools. This pattern can be indicative of several gastrointestinal issues, including irritable bowel syndrome (IBS), which has been suggested by your healthcare provider.

Bowel Habit Changes: Definition and Implications
Changes in bowel habits refer to any significant alteration in the frequency, consistency, or appearance of stools. Normal bowel habits can vary widely among individuals, but generally, a range of three times a week to three times a day is considered normal. Your experience of alternating between constipation and diarrhea, along with the presence of mucus, suggests a potential functional gastrointestinal disorder, such as IBS. IBS is characterized by abdominal pain and altered bowel habits without any identifiable organic cause.

Mucus in Stool: What It Means
The presence of mucus in stool can be concerning for many individuals. Mucus is a normal component of stool, produced by the intestines to lubricate and protect the lining of the gut. However, an increase in mucus production can indicate irritation or inflammation in the gastrointestinal tract. In the context of IBS, mucus may be more prevalent due to the heightened sensitivity and motility of the intestines.
Potential Causes of Your Symptoms
1. Irritable Bowel Syndrome (IBS): Given your history and the symptoms you describe, IBS is a likely diagnosis. It often presents with alternating patterns of diarrhea and constipation, along with abdominal discomfort. Stress and anxiety can exacerbate these symptoms, which aligns with your mention of anxiety and autonomic nervous system dysregulation.

2. Dietary Factors: Your diet plays a crucial role in bowel health. A diet low in fiber or high in processed foods can lead to changes in stool consistency. Incorporating more fruits, vegetables, and whole grains may help regulate your bowel movements.

3. Family History of Colorectal Cancer: Your family history is significant and warrants careful monitoring. While your previous stool tests for occult blood were negative, it is essential to remain vigilant. The presence of mucus and changes in bowel habits can sometimes mimic more serious conditions, including inflammatory bowel disease (IBD) or colorectal cancer.

4. Stress and Anxiety: As you noted, your anxiety may contribute to gastrointestinal symptoms. The gut-brain axis is a well-established concept in medicine, indicating that psychological stress can significantly impact gut function.

Next Steps and Recommendations
1. Consult a Gastroenterologist: Given your symptoms and family history, it would be prudent to consult a gastroenterologist for a comprehensive evaluation. They may recommend further testing, including a colonoscopy, to rule out any serious conditions.

2. Dietary Adjustments: Focus on a balanced diet rich in fiber, and consider keeping a food diary to identify any potential triggers for your symptoms. Avoiding high-fat and processed foods may also be beneficial.

3. Stress Management: Implementing stress-reduction techniques such as mindfulness, yoga, or cognitive-behavioral therapy may help alleviate some of your gastrointestinal symptoms.

4. Medication Review: If you are currently on medication for IBS, discuss with your healthcare provider whether adjustments are necessary, especially if your symptoms have returned after stopping the medication.

In summary, while your symptoms may align with IBS, the presence of mucus and changes in bowel habits, especially with a family history of colorectal cancer, necessitate further investigation. A proactive approach involving dietary changes, stress management, and consultation with a specialist will be essential in managing your symptoms and ensuring your gastrointestinal health.

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