Constipation: Symptoms, Causes, and When to Seek Help

Bowel movement issues

I have been experiencing constipation more frequently lately.
I have had constipation issues in the past, but it seems to have worsened recently.
I usually stay up late, especially during exam weeks when I often sleep around 4 AM.
I also tend to eat spicy foods, but I have been increasing my intake of fruits and vegetables recently.
However, my water intake is relatively low, sometimes less than 1000 ml, and I wonder if this is related to my lifestyle.
I often feel like I haven't fully emptied my bowels or have the urge to go but can't.
My stools vary; sometimes they are small, hard, and dark like little stones, while other times they are normal, yellow-brown, and resemble short sausages.
I also occasionally feel a dull pain and some bloating in my lower abdomen.
Although I haven't experienced any blood in my stools, I am still worried about the possibility of colorectal cancer.
Do you think I should undergo a colonoscopy to check for cancer? Thank you for taking the time to respond amidst your busy schedule.

Xiao Fang, 10~19 year old female. Ask Date: 2018/11/16

Dr. Xu Kaixi reply Surgery

Based on your description, your symptoms are more likely caused by constipation.
It is recommended that you first visit a surgical outpatient clinic.
You can start by adjusting your diet and lifestyle to improve constipation.
Additionally, you may also consider testing your stool for occult blood as a preliminary screening for colorectal cancer.

Reply Date: 2018/11/16

More Info

Constipation is a common gastrointestinal issue that can significantly affect one's quality of life. It is characterized by infrequent bowel movements, difficulty passing stools, or a sensation of incomplete evacuation. Understanding the symptoms, potential causes, and when to seek medical help is crucial for managing this condition effectively.

Symptoms of Constipation
The symptoms of constipation can vary from person to person but typically include:
1. Infrequent Bowel Movements: Having fewer than three bowel movements per week is often considered a sign of constipation.

2. Difficulty Passing Stools: Straining during bowel movements or feeling as though you cannot pass stool despite the urge.

3. Hard or Lumpy Stools: Stools that are hard, dry, or resemble small stones can indicate constipation.

4. Abdominal Discomfort: This may include bloating, cramping, or a sensation of fullness in the abdomen.

5. Feeling of Incomplete Evacuation: A persistent feeling that you still need to have a bowel movement even after going.

Causes of Constipation
Several factors can contribute to constipation, including:
1. Dietary Choices: A diet low in fiber and high in processed foods can lead to constipation. While you mentioned increasing your intake of fruits and vegetables, it’s essential to ensure you’re consuming enough fiber overall.

2. Dehydration: Insufficient fluid intake can lead to harder stools, making them more difficult to pass. You noted that your water intake is sometimes below 1000ml, which may not be adequate.

3. Lifestyle Factors: Irregular sleep patterns, such as staying up late during exam weeks, can disrupt your body's natural rhythms and affect bowel function.

4. Physical Inactivity: A sedentary lifestyle can contribute to constipation. Regular physical activity helps stimulate intestinal function.

5. Stress and Anxiety: Psychological factors can also play a role in bowel health. Stressful periods, like exam weeks, can lead to gastrointestinal disturbances.

When to Seek Help
While occasional constipation is common and often manageable with lifestyle changes, there are specific situations where you should seek medical advice:
1. Persistent Symptoms: If you experience constipation that lasts for more than three weeks despite making dietary and lifestyle changes, it’s time to consult a healthcare professional.

2. Severe Abdominal Pain: If you have significant discomfort or pain in your abdomen, especially if it’s accompanied by other symptoms like vomiting or fever.

3. Blood in Stool: While you mentioned not having blood in your stool, any presence of blood should prompt immediate medical attention.

4. Unexplained Weight Loss: If you notice significant weight loss without trying, this could indicate a more serious underlying condition.

5. Changes in Bowel Habits: If you notice a sudden change in your bowel habits, such as a shift from constipation to diarrhea or vice versa, it’s essential to seek evaluation.

Concerns About Colorectal Cancer
Your concerns about colorectal cancer are understandable, especially given your symptoms. However, it’s important to note that constipation alone is not a definitive sign of cancer. The symptoms you describe, such as hard stools and abdominal discomfort, can often be attributed to dietary and lifestyle factors. Nonetheless, if you have a family history of colorectal cancer or other risk factors, discussing these with your healthcare provider is advisable.

A colonoscopy is a procedure that allows for direct visualization of the colon and can help identify any abnormalities. If your doctor deems it necessary based on your symptoms and medical history, they may recommend this procedure for further evaluation.

Conclusion
In summary, while your symptoms may be concerning, they are often manageable with dietary adjustments, increased hydration, and lifestyle changes. However, if your symptoms persist or worsen, or if you experience any alarming signs, it’s crucial to seek medical advice. A healthcare professional can provide a thorough evaluation and guide you on the best course of action for your health. Remember, taking proactive steps towards your health is always beneficial, and seeking help is a sign of strength.

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