Digestive Issues: Abdominal Pain and Bowel Changes - Gastroenterology and Hepatology

Bowel issues and abdominal pain?

Since last year, I have frequently experienced abdominal cramps after breakfast, followed by diarrhea.
This issue seemed to disappear after nearly a year.
However, two months ago, I started staying up late every day to finish assignments, and I began to notice that I was passing small, short, golden stools that were low in volume and somewhat difficult to expel.
After a few days, I passed stools that were of a normal volume but had a darker, patchy appearance, which lasted for about a month.

Next, I began to experience abdominal pain, with my intestines often making noises, and my bowel movements increased from once a day to twice a day.
The stools were fragmented and contained visible food remnants, and the volume was greater than a month ago.
After wiping, I noticed a slimy feeling, and there were times when I experienced diarrhea.
My weight dropped from 76 kg to 73 kg within this month.

I often eat noodles and drink water normally.
I walk daily from Nanhai Road to Taipei Station, and my exercise habits are relatively normal.
I am unsure what the problem could be.
Could it be gastroenteritis, colorectal cancer, or irritable bowel syndrome? What should I do?

yh, 10~19 year old female. Ask Date: 2020/11/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

Due to weight loss (if not due to reduced food intake), it is recommended to seek medical evaluation.

Reply Date: 2020/11/14

More Info

Understanding digestive issues, particularly abdominal pain and changes in bowel habits, can be complex and multifaceted. Based on your description, it seems you have been experiencing a range of gastrointestinal symptoms over the past year, including abdominal cramping, changes in stool consistency and frequency, and weight loss. These symptoms can be indicative of several underlying conditions, including but not limited to Irritable Bowel Syndrome (IBS), gastrointestinal infections, or even more serious conditions like inflammatory bowel disease (IBD) or colorectal cancer.

Possible Conditions
1. Irritable Bowel Syndrome (IBS): This is a common functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits (diarrhea, constipation, or both). Symptoms often improve after a bowel movement, and the condition is often triggered by stress, dietary changes, or infections. Given your history of abdominal pain after meals and changes in stool consistency, IBS could be a possibility.

2. Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by infections (viral or bacterial). Symptoms typically include diarrhea, vomiting, abdominal cramps, and sometimes fever. If your symptoms were acute and resolved, this could have been a possibility.

3. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, diarrhea (which may be bloody), weight loss, and fatigue. The presence of mucus in your stool and food remnants could suggest an inflammatory process.

4. Colorectal Cancer: While less common in younger individuals, changes in bowel habits, weight loss, and the presence of mucus can be concerning. Given your family history of colorectal cancer, it is essential to consider this possibility seriously.

Recommended Actions
1. Consult a Gastroenterologist: Given the complexity of your symptoms and the duration of your issues, it is crucial to seek a specialist's opinion. A gastroenterologist can perform necessary diagnostic tests, including blood tests, stool tests, and imaging studies, to rule out serious conditions.

2. Colonoscopy: Given your symptoms and family history, a colonoscopy may be warranted. This procedure allows direct visualization of the colon and can help identify any abnormalities, including polyps or signs of cancer.

3. Dietary Modifications: Keeping a food diary may help identify any dietary triggers. Consider reducing intake of high-fat foods, caffeine, and dairy products, which can exacerbate symptoms in some individuals. Increasing fiber intake through fruits, vegetables, and whole grains can also help regulate bowel movements.

4. Stress Management: Since stress can significantly impact gastrointestinal health, incorporating stress-reducing techniques such as mindfulness, yoga, or regular physical activity may be beneficial.

5. Hydration and Nutrition: Ensure you are adequately hydrated, especially if experiencing diarrhea. Maintaining a balanced diet rich in nutrients will support overall health and recovery.

6. Monitor Symptoms: Keep track of your symptoms, including their frequency, duration, and any associated factors (like food intake or stress levels). This information will be valuable for your healthcare provider.

Conclusion
Your symptoms warrant thorough evaluation and monitoring. While conditions like IBS are common and manageable, the presence of alarming features (such as significant weight loss and changes in stool) necessitates further investigation to rule out more serious conditions. Early diagnosis and intervention can significantly improve outcomes and quality of life. Please prioritize seeking medical attention to address your concerns comprehensively.

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