Bloating and Changes in Stool Consistency: When to Seek Help

Q: Bloating and Changes in Stool Consistency: When to Seek Help

Hello： When treating symptoms of gastroenteritis, it is important to pay attention to diet and prevent dehydration. <br>After gastroenteritis, it takes some time for gastrointestinal function to recover. <br>A fecal occult blood test should be meaningful. <br>For those with a fam

Inquire about the issue of bloating and changes in stool diameter?

I would like to ask the doctor a few questions.
Twelve days ago, before the Lunar New Year, I had a big meal at a hot pot restaurant and used about half a jar of satay sauce.
After returning home, I started experiencing severe diarrhea, going to the bathroom four times.
I visited a clinic where the doctor diagnosed me with gastroenteritis and prescribed medication for it.
After finishing the medication, I did not have a bowel movement for three days.
My usual bowel habit is to have one to two bowel movements a day, typically after breakfast.
After three days, I felt a sense of urgency and incomplete evacuation.
A week later, around the sixth day of the New Year, I went back to the clinic, and the doctor diagnosed me with diarrhea leading to internal hemorrhoids and prescribed a suppository.
After using the suppository, the urgency and incomplete evacuation improved, and I did not have strong urges, but I experienced diarrhea that was not watery.
Later, when I stopped using the suppository, my bowel movements returned to being unformed but not diarrhea.
However, after three days, I started experiencing abdominal bloating, which has persisted for about three days.
I visited the clinic again, and the doctor prescribed medication that alleviated some discomfort, but I still feel bloated.
My bowel movement frequency has returned to normal, but the stools have become thinner and less in volume.
My only family member with a history of colon cancer is my uncle, who is 65 years old; my grandparents and parents do not have these symptoms.
I requested the clinic doctor to perform a fecal occult blood test, which returned normal at 52, but I only collected a small amount of stool and scraped it several times with the collection stick, so I am unsure if the results are accurate.
I usually have bowel movements that are not formed after breakfast, often experiencing abdominal pain that sends me rushing to the bathroom.

I would like to ask the doctor a few points:
1.
Given my current symptoms, do I need to urgently schedule a colonoscopy at a major hospital?
2.
Is it possible that I have colon cancer or a tumor based on my current condition?
3.
Could the accuracy of my stool test results be affected, and should I undergo another screening or go directly for a colonoscopy?
4.
Based on my current situation, should I just observe for another month or two and only visit a major hospital if there is no improvement?

Mr. Zhou, 20~29 year old female. Ask Date: 2021/02/23

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: When treating symptoms of gastroenteritis, it is important to pay attention to diet and prevent dehydration.
After gastroenteritis, it takes some time for gastrointestinal function to recover.
A fecal occult blood test should be meaningful.
For those with a family history of colorectal cancer and a tendency for loose stools or irritable bowel syndrome, further follow-up is recommended.
Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/02/23

More Info

Bloating and changes in stool consistency can be concerning symptoms, especially when accompanied by a history of gastrointestinal issues. Based on your description, it seems you have experienced a series of gastrointestinal disturbances following a heavy meal, which led to diarrhea, constipation, and now bloating. Here’s a breakdown of your concerns and recommendations on how to proceed.

1. Urgency of Seeing a Specialist: Given your symptoms, especially the recent onset of bloating and changes in stool consistency, it would be prudent to consult a gastroenterologist. While your symptoms may not indicate an emergency, they warrant further investigation to rule out any serious underlying conditions. A colonoscopy may be recommended, especially considering your family history of colorectal cancer. It’s essential to address any potential issues early on.

2. Concerns About Colorectal Cancer or Tumors: While your symptoms could be indicative of various gastrointestinal issues, including irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), the possibility of colorectal cancer cannot be entirely dismissed, especially given your family history. However, the presence of blood in the stool, significant weight loss, or persistent changes in bowel habits would be more concerning signs. Since your stool tests returned normal, this is reassuring, but it does not completely eliminate the need for further evaluation.

3. Accuracy of Stool Tests: The accuracy of stool tests can be influenced by how the sample is collected. If the sample was small and not representative of your typical bowel movements, it could potentially lead to misleading results. If you have ongoing concerns, it may be worth repeating the stool tests or proceeding with a colonoscopy for a more comprehensive evaluation.

4. Observation Period: While it is reasonable to monitor your symptoms for a short period, given the complexity of your situation, I would recommend not waiting too long. If your symptoms persist or worsen, or if you develop new symptoms such as significant abdominal pain, changes in appetite, or unexplained weight loss, you should seek medical attention sooner rather than later.

In addition to these points, here are some general recommendations for managing your symptoms:
- Dietary Adjustments: Consider keeping a food diary to identify any potential triggers for your bloating and changes in stool consistency. Foods high in fiber, probiotics, and adequate hydration can help regulate bowel movements. However, be cautious with high-fat or spicy foods, which may exacerbate your symptoms.

- Stress Management: Stress can significantly impact gastrointestinal health. Techniques such as mindfulness, yoga, or gentle exercise may help alleviate some of your symptoms.

- Follow-Up Care: Ensure you have a follow-up plan with your healthcare provider. Regular check-ins can help monitor your condition and adjust treatment as necessary.

In conclusion, while your symptoms may not indicate an immediate emergency, they do require careful evaluation. Consulting with a gastroenterologist for a thorough assessment, including the possibility of a colonoscopy, would be a wise step to ensure your gastrointestinal health is properly managed.

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