Bowel Issues: Constipation, Diarrhea, and Health Concerns

Bowel-related issues?

I have been experiencing frequent constipation or diarrhea, with bowel movements occurring about 2 to 3 times a day.
Based on my observations, my stools can be categorized into three types: 1.
Normal stool shape, which can be formed but is somewhat hard, with a yellow-brown color.
2.
Also shaped like a log but watery, presenting a yellow-brown color.
3.
Thin, elongated stools that are about the thickness of my thumb.
Sometimes they are very hard and brown, while other times they are soft and golden yellow.
Occasionally, I experience abdominal pain when using the restroom, but most of the time, I just feel the urge to go.
After researching online, I found that these symptoms could indicate colorectal cancer or ulcerative colitis, but I am unclear about the term "urgency with incomplete evacuation." I usually have normal bowel movements like everyone else.
Lastly, I have lost about 2 kilograms in a month, but I am not sure if this is due to not going to school during the pandemic and not visiting the cafeteria as often.
With the upcoming college entrance exams, I am worried that this could be colorectal cancer or ulcerative colitis.

A Q, 10~19 year old female. Ask Date: 2021/08/02

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is just some irritable bowel syndrome, which is often related to diet and stress, so there is no need to overthink it.

Reply Date: 2021/08/02

More Info

Understanding bowel issues such as constipation, diarrhea, and associated health concerns can be quite complex, especially when symptoms fluctuate between different forms of bowel movements. Based on your description, it seems you are experiencing a range of bowel habits that may indicate an underlying gastrointestinal issue.

Firstly, let's break down what you are experiencing. You mentioned having bowel movements that vary in consistency and frequency, which can be indicative of several conditions, including Irritable Bowel Syndrome (IBS), functional bowel disorders, or even more serious conditions like inflammatory bowel disease (IBD) or colorectal cancer. However, it is essential to approach this systematically.

1. Bowel Movement Characteristics: The three types of stool you described—hard, watery, and thin—suggest that your bowel function is not consistent. The Bristol Stool Chart is often used to classify stool types, and it can help you understand whether your stool is normal or indicative of a problem. Type 1 and 2 (hard and lumpy) suggest constipation, while Type 5 (soft blobs) and Type 6 (mushy) indicate diarrhea.

2. Symptoms of Concern: You mentioned experiencing abdominal pain occasionally when trying to have a bowel movement. This could be due to several factors, including constipation, which can cause discomfort, or it could be related to IBS, where abdominal pain is often relieved after a bowel movement. The term "urgency" or "tenesmus" (which you referred to as "裏急後重") describes the feeling of needing to pass stool but not being able to do so effectively, which is common in IBS and can also occur in inflammatory conditions.

3. Weight Loss: A weight loss of about 2 kilograms over a month can be concerning, especially if it is unintentional. Weight loss can occur due to malabsorption, dietary changes, or increased metabolic demands due to stress or illness. It is crucial to monitor this closely.

4. Potential Conditions: While your symptoms could be related to IBS, it is essential to rule out more serious conditions like IBD (which includes Crohn's disease and ulcerative colitis) or colorectal cancer, especially if you have a family history of these diseases or if your symptoms persist or worsen. The presence of blood in the stool, significant weight loss, or severe abdominal pain should prompt immediate medical evaluation.

5. Next Steps: Given your concerns, it is advisable to consult a healthcare professional, preferably a gastroenterologist. They may recommend diagnostic tests such as blood tests, stool tests, or imaging studies to rule out any serious conditions. A colonoscopy may also be warranted, especially if there are concerning symptoms.

6. Lifestyle and Dietary Modifications: In the meantime, consider keeping a food diary to identify any potential triggers related to your diet. Increasing fiber intake gradually, staying hydrated, and managing stress through relaxation techniques or regular exercise can help improve bowel regularity. Avoiding known irritants such as caffeine, alcohol, and spicy foods may also be beneficial.

In conclusion, while your symptoms may suggest a functional bowel disorder like IBS, it is crucial to seek professional medical advice to rule out any serious underlying conditions. Early intervention can lead to better management of your symptoms and overall health. Remember, maintaining open communication with your healthcare provider about your symptoms and concerns is key to finding an effective treatment plan.

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