Constipation: Signs, Symptoms, and When to Worry - Gastroenterology and Hepatology

Bowel-related issues?

Hello doctor, my girlfriend has been experiencing constipation since her freshman year.
Recently, she had an X-ray that showed fecal impaction.
I would like to ask you, because she often has pellet-like stools, I have encouraged her to drink more water and eat more fruits, and her bowel movements normalized for two to three days with smooth stools.
If it were colon cancer, would the stool consistency fluctuate frequently, such as alternating between pellet-like stools, normal stools, and diarrhea? Thank you for your explanation, doctor.

Benny, 20~29 year old female. Ask Date: 2022/06/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely just an abnormality in peristalsis.
Drink plenty of water, consume more fruits and vegetables, take walks after meals, and keep some laxatives on hand as needed.

Reply Date: 2022/06/06

More Info

Constipation is a common gastrointestinal issue characterized by infrequent bowel movements, difficulty passing stools, or a feeling of incomplete evacuation. It can significantly impact a person's quality of life, leading to discomfort and distress. Understanding the signs, symptoms, and when to seek medical attention is crucial for effective management.

Signs and Symptoms of Constipation
1. Infrequent Bowel Movements: Generally, having fewer than three bowel movements per week is considered constipation.

2. Hard or Lumpy Stools: Stools that are hard, dry, or lumpy can indicate constipation.

3. Straining: Difficulty or pain during bowel movements often accompanies constipation.

4. Feeling of Incomplete Evacuation: A sensation that the bowel has not been fully emptied after a movement.

5. Abdominal Discomfort: This may include bloating, cramping, or general discomfort in the abdomen.

Causes of Constipation
Constipation can arise from various factors, including:
- Dietary Habits: Low fiber intake, dehydration, and inadequate consumption of fruits and vegetables can contribute to constipation.

- Lifestyle Factors: Sedentary lifestyle, lack of physical activity, and ignoring the urge to have a bowel movement can exacerbate the condition.

- Medications: Certain medications, such as opioids, antacids containing aluminum, and some antidepressants, can lead to constipation.

- Medical Conditions: Conditions such as hypothyroidism, diabetes, irritable bowel syndrome (IBS), and neurological disorders can affect bowel function.

When to Worry
While occasional constipation is common and often manageable with lifestyle changes, certain signs warrant medical attention:
1. Persistent Symptoms: If constipation lasts for more than three weeks despite dietary changes and increased fluid intake.

2. Severe Abdominal Pain: Intense pain that does not subside may indicate a more serious condition.

3. Blood in Stool: The presence of blood can signify a serious issue, such as hemorrhoids, anal fissures, or even colorectal cancer.

4. Unexplained Weight Loss: Significant weight loss without trying can be a red flag for underlying health issues.

5. Change in Bowel Habits: A sudden change in bowel habits, especially if accompanied by other concerning symptoms, should be evaluated by a healthcare provider.

Constipation and Colorectal Cancer
Regarding your concern about colorectal cancer, it is essential to note that while changes in bowel habits can be a symptom of colorectal cancer, they are not definitive indicators. Colorectal cancer may present with various symptoms, including:
- Changes in stool consistency or shape (narrowing)
- Blood in the stool (either bright red or dark)
- Unexplained abdominal discomfort or bloating
- Unexplained weight loss
In your girlfriend's case, the presence of "sheep-like" stools (which are typically small, hard, and lumpy) suggests chronic constipation rather than a direct indication of cancer. However, the intermittent nature of her bowel movements, switching between normal and constipated states, can be concerning. It is crucial to monitor her symptoms closely and maintain open communication with a healthcare provider.

Recommendations
1. Dietary Adjustments: Continue encouraging a high-fiber diet, including fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stools and promote regular bowel movements.

2. Hydration: Ensure she drinks plenty of water throughout the day, as adequate hydration is vital for preventing constipation.

3. Physical Activity: Encourage regular exercise, as physical activity can stimulate bowel function.

4. Medical Evaluation: If symptoms persist or worsen, it is advisable for her to consult a healthcare provider for further evaluation. This may include a physical examination, lab tests, or imaging studies to rule out any underlying conditions.

In conclusion, while constipation can often be managed with lifestyle changes, it is essential to remain vigilant for any concerning symptoms that may require medical intervention. Regular check-ups and open communication with healthcare professionals can help ensure that any potential issues are addressed promptly.

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