Changes in Stool: Potential Signs of Serious Issues - Gastroenterology and Hepatology

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Bowel issues


Hello, doctor.
In the past few weeks, my stools have become thinner (about the thickness of a finger) and sometimes there is red blood settled at the bottom of the toilet.
I have a bowel movement about every two days, roughly four times a week.
I would like to know what possible issues this could indicate, especially considering that a family member was diagnosed with colon cancer at around 60 years old.

Haha, 10~19 year old female. Ask Date: 2021/03/28

Dr. Zhang Kebin reply Gastroenterology and Hepatology


Hello, Ms.
HaHa: You have a family history of colorectal cancer and are reporting that in the past few weeks, your stools have become thinner (about the thickness of a finger) and sometimes there is red blood settled at the bottom of the toilet.
Given your family history and the changes in your bowel habits with blood in the stool, it is advisable to see a gastroenterologist for an evaluation and the possibility of a colonoscopy.
Thank you for your inquiry.

Reply Date: 2021/03/28

More Info


When it comes to changes in bowel habits, especially concerning the size and appearance of stools, it is essential to take these symptoms seriously, particularly in light of your family history of colorectal cancer. The narrowing of your stools to the size of a finger, along with the presence of red blood in the toilet bowl, can be indicative of several potential issues, some of which may require immediate medical attention.

Firstly, the narrowing of stools can be a sign of a blockage or narrowing in the colon, which can occur due to various reasons, including polyps, strictures, or tumors. In individuals with a family history of colorectal cancer, any significant changes in bowel habits, such as the size of stools, should be evaluated by a healthcare professional. Tumors can sometimes cause a change in the shape of stools as they grow and obstruct the passage of stool through the intestines.

The presence of red blood in the stool can also be concerning. Blood can originate from various parts of the gastrointestinal tract, and its appearance can vary depending on the source. Bright red blood typically suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or anus. This could be due to hemorrhoids, anal fissures, diverticular disease, or more serious conditions like colorectal cancer. Given your family history, it is crucial to rule out any serious conditions.

In addition to these symptoms, it is important to consider other accompanying signs that may indicate a more serious issue. These can include:
1. Changes in bowel habits: Any significant changes in frequency, consistency, or appearance of stools should be noted.

2. Abdominal pain: Persistent or severe abdominal pain can indicate underlying issues that need to be addressed.

3. Weight loss: Unexplained weight loss can be a red flag for various gastrointestinal conditions, including cancer.

4. Fatigue: Feeling unusually tired or weak can be a sign of anemia, which may result from chronic blood loss.

Given your symptoms and family history, I strongly recommend that you schedule an appointment with a healthcare provider as soon as possible. They may suggest a colonoscopy, which is a procedure that allows for direct visualization of the colon and rectum, and can help identify any abnormalities, such as polyps or tumors. Additionally, they may perform blood tests to check for anemia or other underlying issues.

In the meantime, it is essential to maintain a healthy diet rich in fiber, stay hydrated, and avoid any known irritants that could exacerbate gastrointestinal symptoms. However, do not delay seeking medical advice based on dietary changes alone, especially given the concerning symptoms you are experiencing.

In summary, the changes in your bowel habits, particularly the narrowing of stools and the presence of blood, warrant a thorough evaluation by a healthcare professional. Early detection and intervention are crucial in managing potential gastrointestinal issues, especially with a family history of colorectal cancer. Please prioritize your health and seek medical attention promptly.

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