Changes in Bowel Habits and Mucus in Stool

Changes in bowel habits with mucus present?

Hello, doctor! I am 20 years old, and I have noticed that for about a year, my stools have been accompanied by mucus, which seems to occur only after drinking alcohol.
However, in the past three weeks, I have observed that every bowel movement has mucus, resembling nasal mucus.
Additionally, there has been a change in my bowel habits; I have never had issues with bowel movements before, but in the last three weeks, I have experienced difficulty.
Often, when I feel the urge to go, I sit on the toilet and only pass a small amount (once, I only passed mucus), and my stools often lack form.
During my most recent bowel movement, I also noticed yellowish clumps in my stool and am unsure what they are.
However, there is no occult blood in my stool (I have had chronic anal fissures for several years, but the blood should not be from the stool).
I also smoke and occasionally drink alcohol.
Therefore, I would like to ask the doctor a few questions:
1.
Is occult blood always present in stool for colorectal cancer? Could my symptoms indicate colorectal cancer?
2.
I have generally consumed fewer vegetables, but the feeling of urgency and incomplete evacuation is something I have only recently experienced.
Could this simply be constipation?
3.
Besides colorectal cancer, could there be other issues with my intestines?
4.
Is there a need for a colonoscopy, or how can I improve my condition?
Thank you for your assistance!

Tiāntiān, 20~29 year old female. Ask Date: 2019/06/10

Dr. Ke Fangxu reply Surgery

1.
There is a possibility of false negatives in fecal occult blood tests.
Although the risk of developing colorectal cancer at the age of 20 is not zero, it is generally very low.
Based on your description, it seems more likely to be hemorrhoids.
It is recommended to maintain a light diet and good lifestyle habits, avoiding spicy, irritating, and greasy foods.
Increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.
2.
Based on your letter, it appears that your lifestyle and dietary habits are not very good.
3.
It is mostly likely irritable bowel syndrome (IBS).
4.
There is generally no need to worry about the colonoscopy; you can also ask your physician to arrange it.

Reply Date: 2019/06/10

More Info

Understanding changes in bowel habits and the presence of mucus in stool can be quite concerning, especially when accompanied by other symptoms. Based on your description, it seems you have experienced a significant change in your bowel habits over the past three weeks, including the presence of mucus, difficulty in passing stool, and the occasional formation of yellowish lumps in your stool. Let's address your questions one by one while providing some context regarding bowel health.

1. Does colorectal cancer always present with blood in the stool?
Not all cases of colorectal cancer present with visible blood in the stool. While blood can be a significant indicator, many patients with colorectal cancer may not experience this symptom, especially in the early stages. The presence of mucus alone, particularly if it is not accompanied by blood, does not necessarily indicate cancer. However, it is essential to consider other risk factors, such as family history, age, and lifestyle choices, when assessing your risk for colorectal cancer.

2. Could your recent symptoms simply be constipation?
The sensation of urgency followed by the inability to pass a substantial amount of stool can be indicative of several conditions, including constipation. However, given that you also mentioned the presence of mucus and yellow lumps, it is essential to consider other gastrointestinal issues. A diet low in fiber, which seems to be the case since you mentioned eating fewer vegetables, can lead to constipation and related symptoms. Increasing your fiber intake through fruits, vegetables, and whole grains can help improve your bowel movements.

3. Are there other potential gastrointestinal issues?
Yes, there are several gastrointestinal conditions that could explain your symptoms. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or infections can lead to changes in bowel habits, mucus production, and the sensation of incomplete evacuation. IBS, in particular, is characterized by a combination of abdominal discomfort and altered bowel habits, which may include diarrhea, constipation, or both.

4. Is a colonoscopy necessary?
Given your symptoms, particularly the persistent mucus and changes in bowel habits, a colonoscopy may be warranted to rule out any serious conditions, including colorectal cancer or other gastrointestinal disorders. This procedure allows for direct visualization of the colon and can help identify any abnormalities. It is especially important considering your age and the changes you've experienced.

To improve your situation, consider the following recommendations:
- Dietary Changes: Increase your intake of fiber-rich foods, such as fruits, vegetables, and whole grains. This can help regulate your bowel movements and reduce the feeling of urgency.

- Hydration: Ensure you are drinking enough water throughout the day, as hydration is crucial for healthy digestion.

- Regular Exercise: Physical activity can promote regular bowel movements and improve overall gastrointestinal health.

- Stress Management: Since you mentioned anxiety, practicing stress-reduction techniques such as mindfulness, yoga, or meditation may help alleviate some gastrointestinal symptoms.

In conclusion, while your symptoms may not immediately suggest a severe condition, they warrant further investigation, especially given the changes you've experienced. Consulting with a gastroenterologist for a thorough evaluation, including a possible colonoscopy, would be a prudent step to ensure your gastrointestinal health. Remember, early detection and intervention are key to managing any potential health issues effectively.

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