Gastrointestinal Issues: Anxiety, Bowel Changes, and Symptoms

Bowel issues, sensation of anal foreign body, gastrointestinal problems?

Hello Doctor, about two weeks ago, I started experiencing diarrhea every morning for six consecutive days.
On some days, I also had to go after meals, but there were no accompanying symptoms like fever or vomiting.
After researching online, I became very anxious about the symptoms of colorectal cancer.

1.
In the following days, I began to have bowel movements two to three times a day, sometimes even four times, with each time producing only a small amount (previously, I would usually go once a day at a fixed time in the evening, occasionally every two days).
Additionally, I have experienced some constipation over the past three days.

2.
After meals, I feel very bloated and occasionally have a dull pain, along with a strong urge to have a bowel movement.

3.
I also feel the urge to pass gas but cannot, and I have difficulty burping.

4.
Over the past few days, I have observed that my stools are thin and short, about the width of a thumb, and have a brownish color.

5.
During this period, I noticed slight traces of blood on toilet paper twice, but none in the toilet bowl.
Today, I also observed small red dots in my stool (which were not easily visible to the naked eye and were only noticed after taking a photo and enlarging it).
I am very worried that this might be blood in my stool.
I had carrots for lunch yesterday and wonder if that could have caused this phenomenon.

6.
For the past few days, I have felt a sensation of something being stuck in my anus, as if stool is lodged there, and shortly after having a bowel movement, I experience this feeling again.
I would like to ask if this could be caused by psychological factors.

These symptoms have not occurred frequently in the past.
I also have symptoms of anxiety and would like to know if some of these issues could be related to anxiety.
Thank you, Doctor.

xiang huo zhe de ren, 10~19 year old female. Ask Date: 2021/01/06

Dr. Ke Fangxu reply Surgery

The likelihood of developing colorectal cancer at the age of 18 can be considered negligible.
Based on your description, it seems more like hemorrhoidal bleeding.
It is recommended to start with a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber can be beneficial.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.
As I am not a psychiatrist, it is best to have a mental health professional evaluate which symptoms may be related to anxiety.

Reply Date: 2021/01/06

More Info

Understanding gastrointestinal issues can be complex, especially when symptoms are intertwined with psychological factors such as anxiety. Based on the symptoms you've described, it appears that you are experiencing a range of gastrointestinal disturbances, including changes in bowel habits, abdominal discomfort, and anxiety-related symptoms. Let's break down these issues and explore potential causes and solutions.

Firstly, the symptoms of frequent bowel movements, particularly if they have increased from your usual pattern, can indicate a functional gastrointestinal disorder, such as Irritable Bowel Syndrome (IBS). IBS is characterized by abdominal pain, bloating, and changes in bowel habits, which can include diarrhea, constipation, or alternating between both. Stress and anxiety are known triggers for IBS, as they can affect gut motility and sensitivity. Your experience of increased bowel movements, particularly after meals, along with feelings of bloating and discomfort, aligns with this condition.

The presence of blood in your stool, even if it is minimal, should always be taken seriously. While it could be related to hemorrhoids or anal fissures, especially if you have been experiencing constipation, it is crucial to rule out any serious conditions. The small red dots you observed could be food particles, especially if you recently consumed foods like carrots, which can sometimes appear as small flecks in the stool. However, if you notice any persistent changes in your stool color or consistency, or if the blood reappears, it is essential to consult a healthcare professional for further evaluation.

Your description of feeling a sense of incomplete evacuation and the sensation of an "object" in the rectum can also be linked to anxiety. Anxiety can lead to heightened awareness of bodily sensations, causing you to feel discomfort that may not be present in a non-anxious state. This phenomenon is often referred to as somatic symptom disorder, where psychological distress manifests as physical symptoms.
To address these gastrointestinal issues, consider the following strategies:
1. Dietary Adjustments: Focus on a balanced diet rich in fiber, which can help regulate bowel movements. Incorporate fruits, vegetables, whole grains, and adequate hydration. Avoid excessive caffeine, alcohol, and spicy foods, as these can exacerbate symptoms.

2. Stress Management: Since anxiety appears to be a significant factor in your symptoms, implementing stress-reduction techniques can be beneficial. Practices such as mindfulness, meditation, yoga, or even regular physical exercise can help alleviate anxiety and improve gut health.

3. Regular Routine: Establishing a regular eating and bowel routine can help your body adjust and may reduce the urgency and frequency of bowel movements. Try to eat meals at consistent times and allow yourself time to relax after eating.

4. Medical Consultation: Given the complexity of your symptoms, including the presence of blood and changes in bowel habits, it is advisable to consult a gastroenterologist. They may recommend tests such as a colonoscopy or stool analysis to rule out any serious conditions.

5. Psychological Support: If anxiety is significantly impacting your gastrointestinal health, consider seeking support from a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to be effective in managing anxiety and can also help with gastrointestinal symptoms.

In summary, your gastrointestinal symptoms may be influenced by a combination of dietary factors, anxiety, and possibly an underlying functional gastrointestinal disorder. It is essential to monitor your symptoms closely and seek medical advice to ensure that any serious conditions are ruled out. By addressing both the physical and psychological aspects of your health, you can work towards achieving better gastrointestinal function and overall well-being.

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