Gastrointestinal Issues: IBS or Colon Cancer? - Gastroenterology and Hepatology

Gastrointestinal issues (Irritable Bowel Syndrome or Colorectal Cancer?)

A few months ago, I noticed blood in my stool each time I had a bowel movement, and my stools were somewhat hard.
Occasionally, I found blood on the surface.
The shape of the stool varied, sometimes being quite thick and other times normal.
I also experienced occasional abdominal pain.
Since 1-2 months ago, I have been alternating between constipation and slightly loose stools.
After eating, in addition to bloating, I frequently experience prolonged bowel sounds, and it feels like gas is moving up through my intestines, leading to persistent belching.
I have gas in my intestines and feel the urge to pass gas, but I am unable to do so.

Liu Xiaojie, 10~19 year old female. Ask Date: 2021/02/03

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Ms.
Liu, based on your age and description, it seems more like you may be experiencing impaired gastrointestinal motility or irritable bowel syndrome.
However, since there is blood in your stool, I recommend that you see a gastroenterologist for evaluation.
They may suggest a routine stool test or a colonoscopy.
Thank you for your inquiry.

Reply Date: 2021/02/03

More Info

When it comes to gastrointestinal issues, particularly symptoms like alternating constipation and diarrhea, abdominal pain, and the presence of blood in stool, it is essential to consider a range of potential causes, including Irritable Bowel Syndrome (IBS) and more serious conditions such as colon cancer.
Based on your description, it seems you have been experiencing a variety of gastrointestinal symptoms for several months. The presence of blood in your stool, even if it is occasional and not consistently visible, is a significant symptom that warrants further investigation. Blood in the stool can arise from various sources, including hemorrhoids, anal fissures, or more serious conditions like inflammatory bowel disease (IBD) or colorectal cancer.
The alternating pattern of constipation and diarrhea is characteristic of IBS, a common functional gastrointestinal disorder. IBS is often triggered by dietary factors, stress, and changes in gut motility. Symptoms can include abdominal pain, bloating, and changes in bowel habits. However, the presence of blood in the stool is not typical for IBS and should be evaluated further.

Your symptoms of bloating, excessive gas, and the sensation of incomplete evacuation can also be associated with IBS. The feeling of gas moving through the intestines and the urge to pass gas without success can be quite uncomfortable and is often reported by individuals with IBS.
Given your concerns about colon cancer, it is crucial to consider your age, family history, and any other risk factors. While the likelihood of developing colon cancer at a younger age is lower, it is not impossible, especially if there are risk factors such as a family history of colorectal cancer or polyps, or personal history of inflammatory bowel disease.

To differentiate between IBS and more serious conditions like colon cancer, a thorough evaluation is necessary. This typically includes a detailed medical history, physical examination, and possibly diagnostic tests such as a colonoscopy. A colonoscopy allows for direct visualization of the colon and rectum and can help identify any abnormalities, such as polyps or tumors. If you have not had a colonoscopy recently, especially given your symptoms, it would be advisable to discuss this with your healthcare provider.

In addition to medical evaluation, lifestyle and dietary modifications can play a significant role in managing IBS symptoms. Increasing fiber intake through fruits, vegetables, and whole grains can help regulate bowel movements. Staying well-hydrated is also essential. Avoiding trigger foods, which can vary from person to person, may help alleviate symptoms. Common triggers include high-fat foods, dairy products, caffeine, and artificial sweeteners.

Stress management techniques, such as mindfulness, yoga, or cognitive-behavioral therapy, can also be beneficial in managing IBS symptoms. Regular physical activity can help improve gut motility and reduce stress.

In summary, while your symptoms may suggest IBS, the presence of blood in your stool is a concerning sign that should not be ignored. It is essential to seek medical attention for a comprehensive evaluation to rule out any serious conditions, including colon cancer. Early detection and intervention are key to managing gastrointestinal health effectively.

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You can first check for occult blood in the stool as a reference.