Mucus in Stool and Watery Diarrhea: When to Seek Help

Mucus in stool, watery flatulence (liquid but without feces)?

Hello Doctor: I have been experiencing long-term constipation, which has led to straining during bowel movements and hemorrhoids (both internal and external).
I previously consulted a doctor for my internal hemorrhoids, but the external ones were not treated.
Recently, when my stool has been harder, I noticed blood on the toilet paper after wiping.
Additionally, for the past three mornings, I have suddenly felt a strong urge to have a bowel movement, which I couldn't resist.
I ended up passing gas and releasing a watery substance that wasn't solid stool.
Due to the urgency, I sometimes end up soiling my underwear (it has a foul smell).
After the liquid is expelled, I also pass some pellet-like stools (with mucus), but the amount is not significant.
I would like to ask the doctor about the possible causes of these symptoms.
Should I undergo a colonoscopy? (I am very afraid it might be a polyp or cancer).
Thank you, Doctor.

Dan Dan, 30~39 year old female. Ask Date: 2020/02/17

Dr. Chen Shidian reply Gastroenterology and Hepatology

Fecal occult blood testing can be performed first, and medication/dietary adjustments are often related to irritable bowel syndrome.

Reply Date: 2020/02/17

More Info

The symptoms you are experiencing, including the presence of mucus in your stool, watery diarrhea, and the recent episodes of urgency, can be concerning and warrant further evaluation. Given your history of constipation and hemorrhoids, it is possible that these issues are contributing to your current symptoms. However, the presence of blood when wiping, along with the changes in your bowel habits, raises the need for a thorough investigation.

Understanding Your Symptoms
1. Mucus in Stool: The presence of mucus can be a normal finding in stool, as mucus is produced by the intestines to lubricate the passage of stool. However, excessive mucus, especially when accompanied by changes in stool consistency or the presence of blood, can indicate underlying issues such as inflammation, infection, or even malignancy.

2. Watery Diarrhea: The sudden onset of watery diarrhea, especially if it is accompanied by urgency, can be indicative of an infection or inflammation in the gastrointestinal tract. This could be due to various causes, including viral or bacterial infections, food intolerances, or inflammatory bowel disease (IBD).

3. Blood in Stool: The presence of blood, particularly when wiping, can be associated with hemorrhoids, especially if you have a history of constipation and straining. However, it is crucial to differentiate between blood from hemorrhoids and blood that may originate from higher up in the gastrointestinal tract, which could indicate more serious conditions.

When to Seek Help
Given your symptoms, it is advisable to consult a healthcare professional for a comprehensive evaluation. Here are some reasons why you should seek help:
- Duration and Severity: If your symptoms persist for more than a few days or worsen, it is essential to seek medical attention.

- Blood in Stool: Any new onset of blood in the stool, especially if it is bright red or accompanied by other symptoms, should be evaluated promptly.

- Changes in Bowel Habits: Significant changes in your bowel habits, such as the sudden onset of diarrhea or urgency, warrant further investigation.

- Associated Symptoms: If you experience additional symptoms such as weight loss, fever, or severe abdominal pain, these could indicate a more serious condition that requires immediate attention.

Diagnostic Evaluation
A colonoscopy is a valuable tool in evaluating gastrointestinal symptoms, especially when there are concerns about potential malignancies or inflammatory conditions. During a colonoscopy, the physician can visualize the lining of the colon and rectum, take biopsies if necessary, and assess for conditions such as polyps, cancer, or inflammatory bowel disease.

Conclusion
In summary, your symptoms of mucus in stool, watery diarrhea, and blood when wiping are concerning and should not be ignored. It is crucial to consult with a gastroenterologist who can perform the necessary evaluations, including a colonoscopy, to rule out any serious conditions. Early diagnosis and treatment are key to managing gastrointestinal issues effectively. Please do not hesitate to seek medical attention, as addressing these symptoms promptly can lead to better outcomes and peace of mind.

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