Loose Stools: Is It Inflammatory Bowel Disease or Something More?

Loose stools for several consecutive weeks?

Two years ago, I frequently experienced loose stools accompanied by blood, so I underwent a colonoscopy in February of last year.
The diagnosis was anal fissure and nonspecific colitis.
During this period, the anal fissure kept recurring, and I had follow-up visits until recently when I consulted another doctor and noticed improvement, as there has been no blood.
However, I have had loose stools for the past two to three weeks, which disperse quickly in the toilet, and the water gets stained.
I have been taking probiotics for two weeks, but the symptoms have not improved.
Could this be a recurrence of colitis? Even though I had a colonoscopy last year, is it possible that these symptoms could indicate cancer?

Lin, 20~29 year old female. Ask Date: 2020/04/01

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 21-year-old female with a history of anal fissures and nonspecific colitis.
The bleeding from the anal fissures has improved after recurrent episodes.
She has experienced loose stools for several weeks and is advised to pay attention to her diet, reducing fried, greasy, spicy foods, and sweets to help form her stools.
Colorectal cancer is associated with genetics and diet.
A colonoscopy last year showed no polyps or cancer.
It is important to maintain good lifestyle habits and diet.
There is no need to worry about cancer development.
If diarrhea persists, or if there is blood in the stool or changes indicative of colitis, it is recommended to seek medical attention.
Wishing you peace and health! Sincerely, Dr.
Lin Ming-Hui, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/04/01

More Info

Loose stools can be a concerning symptom, especially when accompanied by other signs such as blood or mucus. Given your history of anal fissures and non-specific colitis, it is understandable to be worried about the possibility of inflammatory bowel disease (IBD) or even colorectal cancer. However, it's essential to consider various factors before jumping to conclusions.

Firstly, the presence of loose stools can be attributed to several causes, including infections, dietary changes, stress, or underlying gastrointestinal conditions. In your case, since you have a history of non-specific colitis, it is plausible that your symptoms may be related to a recurrence of inflammation in the intestines. Non-specific colitis can lead to symptoms such as diarrhea, abdominal pain, and changes in bowel habits. The fact that you have been experiencing loose stools for two to three weeks, along with the previous diagnosis, suggests that it could be a flare-up of your colitis.

The concern about cancer is valid, especially given your symptoms. However, it is important to note that colorectal cancer typically presents with more specific symptoms, such as significant weight loss, persistent abdominal pain, changes in bowel habits (such as alternating between diarrhea and constipation), and blood in the stool that is more pronounced than what you might see with fissures or inflammation. While your symptoms warrant further investigation, the likelihood of cancer, especially after a recent colonoscopy, is relatively low. Colonoscopies are effective at detecting abnormalities, including polyps and tumors, and if your last one showed no signs of malignancy, it is reassuring.

The fact that you have been taking probiotics for two weeks without improvement may indicate that your symptoms are not solely due to a bacterial imbalance in your gut. Probiotics can help restore gut flora, but they may not be sufficient if there is underlying inflammation or another issue at play. It might be beneficial to consult with a gastroenterologist again, especially if your symptoms persist or worsen. They may recommend further testing, such as stool studies to check for infections or inflammatory markers, or even a repeat colonoscopy if deemed necessary.

In summary, while your symptoms could be indicative of a recurrence of colitis, it is essential to rule out other potential causes, including infections or more serious conditions. Regular follow-ups with your healthcare provider are crucial in managing your symptoms and ensuring that any underlying issues are addressed promptly. If you experience any alarming symptoms, such as severe abdominal pain, significant blood in your stool, or unintentional weight loss, seek medical attention immediately. Your health is paramount, and staying proactive about your symptoms will help in achieving better outcomes.

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