Bowel Issues: When to Seek Help for Digestive Health - Gastroenterology and Hepatology

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Bowel-related issues?


I used to have pellet-like stools, and I have tried taking probiotics, which sometimes help me have a bowel movement.
My lower abdomen often feels bloated and sometimes painful, but the discomfort usually goes away after I have a bowel movement.
I haven't had normal, long, banana-shaped stools in a while.
There was one occasion when I noticed a little blood in my stool, and another time when my stool appeared slightly black.
I previously had an endoscopy that revealed a gastric ulcer, and I'm only 30, so I shouldn't have colon cancer, right? Sometimes I get worried about minor symptoms, and I'm hesitant to undergo a colonoscopy.
Should I first do a fecal occult blood test?

Xiao Chen, 30~39 year old female. Ask Date: 2022/06/06

Dr. Lin Minghui reply Gastroenterology and Hepatology


Hello: You are experiencing bowel movements that are hard and pellet-like, along with bloating and pain despite taking probiotics.
The symptoms improve after defecation, but you have noticed dark stools or blood, which raises concerns about colorectal cancer.
You are hesitant to undergo a colonoscopy.
It is advisable to first conduct a stool test.
However, if symptoms persist, you should follow up in an outpatient setting, as gastrointestinal bleeding requires investigation for the underlying cause.
If you have a history of peptic ulcers, it is important to ensure they are properly treated, and if Helicobacter pylori is present, it should be eradicated.
Wishing you peace and good health.
Sincerely, Dr.
Lin Ming-Hui, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2022/06/06

More Info


When it comes to bowel issues, it's essential to understand the signs and symptoms that may indicate a need for medical attention. Based on your description, it seems you are experiencing a range of gastrointestinal symptoms, including irregular bowel movements, abdominal bloating, discomfort, and occasional blood in your stool. Let's break down these symptoms and discuss when it might be necessary to seek help.


Understanding Your Symptoms
1. Bowel Movement Patterns: You mentioned having pellet-like stools, which can indicate constipation. Constipation is often caused by a lack of dietary fiber, insufficient fluid intake, or a sedentary lifestyle. The presence of hard, pellet-like stools can lead to straining during bowel movements, which may cause discomfort and even anal fissures.

2. Abdominal Discomfort: The sensation of bloating and pain in the lower abdomen can be associated with various conditions, including irritable bowel syndrome (IBS), food intolerances, or even gastrointestinal infections. It's important to monitor these symptoms, especially if they are persistent or worsening.

3. Blood in Stool: The presence of blood in your stool, even if it's just a small amount, should not be ignored. Blood can indicate several issues, ranging from hemorrhoids to more serious conditions like diverticulitis or colorectal cancer. The fact that you also mentioned having black stools could indicate the presence of digested blood, which is a more serious concern and warrants immediate medical evaluation.

4. Previous Medical History: Given your history of gastric ulcers and your age (30), while the likelihood of colorectal cancer is lower, it is not impossible. Family history, lifestyle factors, and previous gastrointestinal issues can increase your risk.


When to Seek Help
1. Persistent Symptoms: If your symptoms persist for more than a few weeks, it is advisable to consult a healthcare provider. Chronic constipation, bloating, and abdominal pain can significantly impact your quality of life and may require intervention.

2. Blood in Stool: Any occurrence of blood in your stool should prompt a visit to a healthcare professional. Even if the amount is small, it is crucial to determine the underlying cause.

3. Changes in Bowel Habits: If you notice a significant change in your bowel habits, such as a sudden increase in frequency, changes in stool consistency, or the presence of mucus, these could be signs of an underlying condition that needs to be addressed.

4. Screening Tests: Given your concerns about colorectal cancer, discussing screening options with your doctor is essential. A fecal occult blood test (FOBT) can be a good initial screening tool to check for hidden blood in the stool. If results are concerning, a colonoscopy may be recommended for a more thorough examination.


Recommendations
- Dietary Changes: Increasing your fiber intake through fruits, vegetables, and whole grains can help regulate your bowel movements. Staying hydrated is also crucial for preventing constipation.

- Probiotics: While you mentioned trying probiotics, it's important to find the right strain that works for you. Probiotics can help balance gut bacteria and improve digestive health.

- Regular Exercise: Engaging in regular physical activity can stimulate bowel function and help alleviate constipation.

- Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

In conclusion, while some of your symptoms may be benign, the presence of blood in your stool and significant changes in bowel habits are red flags that should not be overlooked. It is advisable to consult with a healthcare provider to discuss your symptoms, undergo appropriate testing, and receive personalized recommendations for managing your digestive health. Taking proactive steps now can help ensure your long-term well-being.

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