Changes in Stool Size and Abdominal Pain: Possible Causes

The stool has become thinner, and there are occasional feelings of abdominal pain?

I would like to ask about my situation.
A doctor previously diagnosed me with an anal fissure, but after more than a year, I have recently been experiencing frequent abdominal pain, specifically in the lower left abdomen.
However, my bowel movements have been smooth.
Just this week, I felt abdominal pain before a bowel movement but did not feel anything during it.
I passed a large amount of stool at once; it started out quite thick but gradually became thinner until it was the size of a chopstick.
I am someone who regularly eats vegetables, and aside from when I was younger and consumed more meat, I have a particularly slim physique.
If I were truly losing weight, it would not be noticeable.
Could the change in stool size be due to fiber intake, or could it indicate other issues such as polyps or colorectal cancer? Additionally, I would like to mention that my stool was greenish at the beginning and then returned to a normal color, but it has become thin and flat.

Mr. Zhou, 10~19 year old female. Ask Date: 2021/01/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Further observation is recommended; if concerns persist, a fecal occult blood test can be performed.

Reply Date: 2021/01/11

More Info

When it comes to changes in stool size and abdominal pain, there are several potential causes that need to be considered. Your symptoms, including left lower abdominal pain, changes in stool consistency, and the observation that your stool has become thinner, raise several important points for discussion.

Firstly, the fact that you have a history of anal fissures is significant. Anal fissures can cause pain during bowel movements, which may lead to changes in bowel habits as individuals may subconsciously avoid straining. This avoidance can lead to harder stools, which can exacerbate the fissure, creating a cycle of pain and avoidance. However, you mentioned that your bowel movements have been smooth recently, which suggests that the fissure may not currently be the primary issue.

The change in stool size, particularly the transition from normal to thinner stools, is noteworthy. Thinner stools can sometimes indicate a narrowing of the intestinal passage, which can be caused by several factors, including:
1. Dietary Factors: While you mentioned that you consume a lot of vegetables, which is generally beneficial for digestive health, it’s essential to ensure that your diet is balanced and includes adequate fiber. Insufficient fiber can lead to changes in stool consistency. However, if your diet is high in fiber and you are still experiencing these changes, it may warrant further investigation.

2. Intestinal Obstruction: A narrowing of the intestines can occur due to various reasons, including inflammation, scarring from previous surgeries, or conditions like Crohn's disease. This can lead to changes in stool size and abdominal pain.

3. Polyps or Tumors: The presence of polyps or tumors in the colon can also cause changes in stool size. Polyps can create a physical obstruction that leads to thinner stools. While colorectal cancer is a concern, especially with changes in bowel habits, it is important to note that many benign conditions can also cause similar symptoms.

4. Irritable Bowel Syndrome (IBS): IBS can cause a variety of gastrointestinal symptoms, including abdominal pain and changes in stool consistency. Stress and anxiety can exacerbate these symptoms, leading to fluctuations in bowel habits.

5. Infections or Inflammatory Conditions: Conditions such as diverticulitis or infections can lead to abdominal pain and changes in bowel habits. These conditions often present with additional symptoms, such as fever or changes in appetite.

Given your symptoms, it is crucial to consult a healthcare provider for a thorough evaluation. This may include a physical examination, a review of your medical history, and possibly imaging studies or a colonoscopy to visualize the intestines and rule out any serious conditions.
In summary, while dietary factors and anal fissures may play a role in your symptoms, the changes in stool size and persistent abdominal pain warrant further investigation to rule out more serious conditions such as intestinal obstructions, polyps, or inflammatory bowel diseases. It is essential to communicate all your symptoms clearly to your healthcare provider to facilitate an accurate diagnosis and appropriate treatment plan.

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