Abdominal Pain: When to Seek Further Gastrointestinal Evaluation

Localized abdominal pain?

Hello Doctor, I have a family history of colorectal cancer.
I had a normal colonoscopy two years ago, but in the past few months, I've been experiencing occasional mild cramping in my lower left abdomen, especially after eating spicy food or when I haven't had a bowel movement for three to four days.
Would you recommend that I undergo another examination? Additionally, I started drinking black date juice a year ago, gradually increasing from once every month or two to once a week recently.
I’ve noticed that the effectiveness of the black date juice for bowel movements seems to have decreased by half compared to the first time I drank it (the time from drinking to the urge to have a bowel movement has increased from twenty minutes to one hour, and my bowel movements have decreased from six times to three times).
Is this normal? Will relying on black dates and using a bidet to flush water into the rectum to assist with bowel movements put a strain on my gastrointestinal system in the long term? Thank you.

A, 20~29 year old female. Ask Date: 2021/09/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can first check for occult blood in the stool.
Dietary adjustments should focus on increasing fruits and vegetables, staying hydrated, and incorporating post-meal walks while minimizing prolonged sitting.
If necessary, a laxative may be used based on the situation (for example, if there is discomfort after not having a bowel movement for 2-3 days).

Reply Date: 2021/09/24

More Info

Understanding abdominal pain, especially in the context of a family history of colorectal cancer, is crucial for timely diagnosis and treatment. Given your symptoms and concerns, it’s important to consider several factors that may warrant further gastrointestinal evaluation.

Firstly, your family history of colorectal cancer is significant. Individuals with a family history of colorectal cancer are at a higher risk for developing the disease themselves. The fact that you had a normal colonoscopy two years ago is reassuring, but it does not completely rule out the possibility of developing new polyps or cancerous lesions since then. The symptoms you describe—localized pain in the left lower abdomen, particularly after consuming spicy foods or during periods of constipation—could be indicative of several gastrointestinal issues, including irritable bowel syndrome (IBS), diverticulitis, or even early signs of colorectal pathology.

The intermittent nature of your pain, especially in relation to dietary habits and bowel movements, suggests that it could be functional in nature, possibly related to diet or bowel habits. However, given your family history, it is advisable to err on the side of caution. If the pain persists or worsens, or if you experience any changes in bowel habits, such as blood in your stool, significant weight loss, or persistent changes in your bowel patterns, you should definitely seek further evaluation. A repeat colonoscopy may be warranted, especially if you have not had one in the last few years, or if your symptoms change.

Regarding your consumption of black date juice, it’s important to note that while it may have beneficial effects on digestion for some individuals, the decrease in its effectiveness over time could be due to a variety of factors, including changes in your body’s response to the juice or dietary habits. The fact that you are experiencing a delay in bowel movements after consuming the juice suggests that your body may be adapting to it, or that your digestive system may be experiencing some form of dysregulation.

Long-term reliance on any single food or supplement for bowel regularity can lead to dependency, where your bowel may become less responsive to natural stimuli. This can potentially lead to a cycle of constipation and reliance on external aids for bowel movements. Additionally, using a bidet or water to assist with bowel movements is generally safe, but it’s essential to ensure that it does not become a crutch that prevents your body from functioning normally.

In summary, given your family history and current symptoms, it would be prudent to consult with a gastroenterologist for a thorough evaluation. They may recommend further diagnostic tests, including imaging studies or a repeat colonoscopy, to rule out any serious conditions. Additionally, consider discussing your dietary habits and the use of black date juice with a nutritionist or your healthcare provider to ensure that you are supporting your digestive health without creating dependency on specific foods or habits. Maintaining a balanced diet rich in fiber, staying hydrated, and engaging in regular physical activity can also aid in promoting healthy bowel function.

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