Gastrointestinal Issues: Symptoms and Possible Causes

Gastrointestinal issues

A few days ago, I noticed fresh blood in the toilet after using it, and subsequently experienced constipation and blood when wiping.
I became anxious and researched online, which led me to think it might be colon cancer.
Then I felt nauseous and vomited.
The next day, I saw a doctor who diagnosed me with gastroenteritis.
About two weeks ago, I also had bloating and nausea, but after seeing a doctor and taking medication, it resolved.
However, the symptoms have recurred.
When I noticed symptoms of urgency and tenesmus, I felt I was experiencing them too.
Later, I had some difficulty using the restroom, but there was no blood.
A day later, I took the medication prescribed by the clinic, and I felt less nauseous.
I no longer have the urgency and tenesmus feeling, but occasionally I experience cramping in my lower left abdomen.
My stomach also feels uncomfortable.
Sometimes I have abdominal pain with the urge to defecate, but it requires some straining, and the stool is loose.
After defecating, I don't feel the urge to go again, but after a while, I may experience abdominal pain and the need to use the restroom.
My diet has been irregular in recent months, and I have been going to bed late, although I do exercise regularly.
I would like to ask the doctor what my condition might be.

Li, 10~19 year old female. Ask Date: 2020/07/22

Dr. Chen Jiaming reply Surgery

Given your age, there is currently no need to be overly concerned about colon cancer.
The most common reason for young individuals experiencing blood in their stool (or blood on wiping) is mucosal injury due to constipation or difficulty in bowel movements.
When you experience nausea and visit a general clinic, the commonly used oral antiemetics often not only help with nausea but also promote intestinal motility, which can lead to subsequent abdominal pain symptoms.
If your stool is loose, check if the clinic physician has prescribed any stool softeners for you.

Essentially, your condition should be addressed in stages.
First, you need to restore your intestinal function to its original state.
Gradually reduce the use of medications prescribed by the clinic.
Initially, start with a light, soft diet.
To facilitate natural bowel movements, it is important to soften the stool by increasing your daily water intake (especially since you have a habit of exercising) by about 1000 milliliters more than usual (it is recommended to drink 500 milliliters of warm water on an empty stomach first thing in the morning).
When you feel the urge to have a bowel movement, do not hold it in, and avoid sitting on the toilet for too long (there is no need to force regularity), as this can lead to anal mucosal prolapse, friction-induced bleeding, and may also contribute to hemorrhoids.
Try to adjust your daily routine, and you should see some improvement without excessive anxiety.

Reply Date: 2020/07/22

More Info

Understanding gastrointestinal issues can be quite complex, especially when multiple symptoms present themselves simultaneously. Based on your description, it seems you are experiencing a combination of gastrointestinal discomfort, changes in bowel habits, and some alarming symptoms like blood in your stool. Let's break down your symptoms and possible causes.

Firstly, the presence of fresh blood in your stool can be concerning. It is essential to differentiate between bright red blood, which often indicates bleeding from the lower gastrointestinal tract (such as hemorrhoids or anal fissures), and darker blood, which may suggest bleeding from higher up in the digestive system. Given your mention of blood during wiping, this could suggest an anal fissure or hemorrhoids, especially if you have been experiencing constipation or straining during bowel movements.

Your symptoms of nausea and vomiting, along with a history of bloating and discomfort, may indicate a gastrointestinal infection or inflammation, such as gastroenteritis. This condition can be caused by viral or bacterial infections and often presents with symptoms like nausea, vomiting, diarrhea, and abdominal pain. The fact that you have experienced these symptoms intermittently over the past few weeks suggests that you may be dealing with a recurring issue.

The mention of "urgency" and "tenesmus" (the feeling of needing to pass stool even when the bowels are empty) can be associated with several conditions, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or infections. Given your recent dietary irregularities and late-night eating habits, it is possible that these factors are contributing to your gastrointestinal distress. Stress and anxiety can also exacerbate gastrointestinal symptoms, leading to a cycle of discomfort.

Your description of occasional left lower abdominal pain could be related to several factors, including gas buildup, constipation, or even issues related to the colon, such as diverticulitis. The fact that your stool is sometimes loose and requires straining could indicate a combination of constipation and diarrhea, which is often seen in IBS.

In terms of management, it is crucial to maintain a balanced diet rich in fiber to help regulate your bowel movements. Staying hydrated and avoiding foods that trigger your symptoms (like spicy foods, caffeine, and alcohol) can also be beneficial. Regular exercise, which you mentioned you engage in, can help promote healthy digestion and alleviate some symptoms.

Given the complexity of your symptoms and the potential for serious underlying conditions, it is advisable to follow up with a healthcare provider. They may recommend further diagnostic tests, such as a colonoscopy, especially considering your concerns about colorectal cancer. This procedure can help visualize the colon and rectum, allowing for the identification of any abnormalities.

In summary, while your symptoms may be indicative of functional gastrointestinal disorders like IBS or gastroenteritis, the presence of blood and significant changes in bowel habits warrant a thorough evaluation by a healthcare professional. Early diagnosis and appropriate management are key to addressing your concerns and improving your quality of life.

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