Bowel Issues: When to Seek Help for Digestive Health

Q: Bowel Issues: When to Seek Help for Digestive Health

Hello Ms. <br>Yeh： It is recommended to visit the hospital to consult with a physician for an evaluation to determine if further examinations are necessary. <br>Director Cai Jin-ji of the Gastroenterology and Hepatology Department at Nantou Hospital.

Bowel-related issues?

Hello, doctor.
For about 3-4 or 4-5 weeks, my stools have been approximately the thickness of my index or thumb.
I'm not sure if they were always like this before, as they were mostly unformed, possibly due to anxiety or other reasons, so I didn't pay much attention.
Recently, as mentioned, they have been about the thickness of my index or thumb.
On May 18, they have varied between occasionally thick and thin, sometimes flat, and sometimes a combination of thick and flat.
Occasionally, they appear normal in thickness but are unformed (this has happened only a few times).
There have been instances where the stool was thick and unformed, and once I felt constipated, straining in the bathroom produced a thick stool at the front, while the back was in small segments resembling pencil shapes, but the next day there was none.
Last Friday, my second bowel movement was unformed and in one lump, but the surrounding area was red.
I'm not sure if it was blood; I stirred it with toilet paper, and it disappeared.
Other than this instance, the color of my stools has appeared normal.
The day before yesterday, the first piece of stool looked thick but felt irregular in shape, and the following pieces were also about the thickness of my index finger.
Today, my stool was thick and flat.
After finishing, I felt like I still needed to go but couldn't, as if there was still stool in my abdomen.
On Sunday morning, after my first bowel movement, I had a second one that was slightly loose and watery.
After that, I felt uncomfortable for a while but then felt better.
Currently, my abdomen does not have any significant discomfort, though I occasionally feel a sharp pain (in various locations), but it is not very severe.
Recently, I usually have two bowel movements, with the second one being unformed.
I tend to be quite anxious, and since childhood, I have often experienced stomach pain due to stress or anxiety.
I found some alarming information online and wanted to consult you first.

Ye, 20~29 year old female. Ask Date: 2021/05/18

Dr. Cai Jinji reply Gastroenterology and Hepatology

Hello Ms.
Yeh: It is recommended to visit the hospital to consult with a physician for an evaluation to determine if further examinations are necessary.
Director Cai Jin-ji of the Gastroenterology and Hepatology Department at Nantou Hospital.

Reply Date: 2021/05/18

More Info

It sounds like you're experiencing a range of bowel issues that can be quite distressing. Based on your description, it seems you may be dealing with symptoms that could be associated with Irritable Bowel Syndrome (IBS) or other gastrointestinal conditions. Let's break down your symptoms and discuss when it might be appropriate to seek medical help.

Understanding Your Symptoms
1. Bowel Consistency and Shape: You mentioned that your stools vary in size and shape, sometimes being as thick as a finger and at other times being thin or flat. This inconsistency can be indicative of a functional bowel disorder, such as IBS, where the bowel's normal function is disrupted. IBS is characterized by abdominal pain or discomfort associated with changes in bowel habits, including diarrhea, constipation, or alternating between the two.

2. Presence of Blood: You noted that there was some red coloration around your stool on one occasion. While this could be due to hemorrhoids, especially if you have been straining during bowel movements, any presence of blood in the stool should be taken seriously. It’s essential to differentiate between bright red blood (which may indicate hemorrhoids or anal fissures) and darker blood (which could suggest more serious conditions).

3. Abdominal Discomfort: The feelings of discomfort and occasional sharp pains you experience could be related to your anxiety, as stress is known to exacerbate gastrointestinal symptoms. However, persistent or severe abdominal pain warrants further investigation to rule out any underlying conditions.

4. Bowel Movement Frequency: You mentioned having bowel movements that are sometimes loose or watery, which can be a sign of diarrhea. This can be triggered by dietary factors, stress, or infections.

When to Seek Medical Help
Given your symptoms, here are some guidelines on when to seek medical attention:
- Persistent Symptoms: If your bowel irregularities persist for more than a few weeks, it’s advisable to consult a healthcare provider. Chronic changes in bowel habits can indicate underlying conditions that may require treatment.

- Blood in Stool: If you notice blood in your stool, even if it appears only occasionally, you should seek medical advice. A healthcare professional can perform the necessary tests to determine the cause.

- Severe Abdominal Pain: If you experience severe or worsening abdominal pain, especially if it is accompanied by other symptoms like fever, vomiting, or significant changes in appetite, you should seek immediate medical attention.

- Weight Loss or Anemia: Unexplained weight loss or signs of anemia (such as fatigue or pallor) should prompt a visit to a healthcare provider, as these can be signs of more serious gastrointestinal issues.

Recommendations for Management
1. Dietary Changes: Consider keeping a food diary to identify any potential triggers for your symptoms. Increasing fiber intake can help regulate bowel movements, but be cautious with sudden changes, as this can sometimes worsen symptoms.

2. Hydration: Ensure you are drinking enough fluids, especially if you experience diarrhea, to prevent dehydration.

3. Stress Management: Since you mentioned anxiety, incorporating stress-reduction techniques such as mindfulness, yoga, or therapy could be beneficial for both your mental health and digestive health.

4. Regular Check-ups: Given your family history of gastrointestinal issues, including colorectal cancer, it may be wise to discuss with your doctor the possibility of screening tests, such as a colonoscopy, especially if you are over the age of 45 or have other risk factors.

Conclusion
In summary, while some of your symptoms may be related to anxiety or dietary factors, it’s crucial to monitor your condition closely. If you experience any alarming symptoms, such as blood in your stool or severe abdominal pain, do not hesitate to seek medical attention. A healthcare provider can help you navigate these issues and develop a management plan tailored to your needs.

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