Bowel Issues: When to Seek Medical Help

Bowel issues

Hello Doctor, for the past 1 to 2 years, my bowel movements have been inconsistent.
Sometimes I go to the bathroom 4 to 5 times a day, and other times I don’t have a bowel movement for a week.
Occasionally, I feel the urge to go immediately after eating, which has been quite troubling, and I’ve been hesitant to seek medical evaluation.
I often thought it might be irritable bowel syndrome, so I didn’t pay much attention to it.
Recently, I’ve experienced significant pain during bowel movements, to the point where I have to grip the armrest beside me.
The stools are not particularly hard, and sometimes I sit on the toilet for a long time without being able to pass anything.
After trying 3 to 5 times, I might finally have a bowel movement, but it’s usually soft.
This issue has been bothering me for almost a year, but I haven’t experienced any bleeding or blood in my stool.
Sometimes my stools are pellet-like, and other times they are more formed (though rarely), but generally, they are either soft or mushy.
Should I get a stool test? Is it normal for my weight to drop from 49 kg to 46 kg in the past six months?

Li, 30~39 year old female. Ask Date: 2022/07/18

Dr. Chen Bingze reply Surgery

Hello, based on the above, it is still recommended to undergo a colonoscopy under general anesthesia to ensure everything is fine, which will give you more peace of mind.

Reply Date: 2022/07/18

More Info

When it comes to bowel issues, understanding when to seek medical help is crucial for maintaining overall health. Your symptoms, which include irregular bowel movements, abdominal pain, and significant weight loss, warrant a thorough evaluation by a healthcare professional.
Firstly, the variability in your bowel habits—ranging from frequent trips to the bathroom to prolonged periods without a bowel movement—could suggest a condition known as Irritable Bowel Syndrome (IBS). IBS is characterized by a combination of symptoms including abdominal pain, bloating, and changes in bowel habits. However, the presence of severe pain during bowel movements, especially if it is new or worsening, raises concerns that should not be overlooked.

The fact that you are experiencing pain during bowel movements, even when the stools are not hard, could indicate several potential issues. These may include anal fissures, hemorrhoids, or even more serious conditions such as inflammatory bowel disease (IBD) or infections. The pain you describe, which is severe enough to make you grasp onto the sides of the toilet, is particularly concerning and should be evaluated by a physician.

Additionally, the significant weight loss you mentioned—from 49 kg to 46 kg over six months—should not be taken lightly. Unintentional weight loss can be a sign of underlying health issues, including malabsorption syndromes, chronic infections, or malignancies. It is essential to address this with your healthcare provider, as they may recommend tests to rule out these serious conditions.

Given your symptoms, it is advisable to undergo a stool test. A stool analysis can help identify infections, the presence of blood, or other abnormalities that may not be visible to the naked eye. Furthermore, a comprehensive evaluation may include blood tests, imaging studies, or even a colonoscopy, depending on your physician's assessment.

In summary, while it is common to experience fluctuations in bowel habits, the combination of severe pain, significant weight loss, and prolonged symptoms over the past year suggests that you should seek medical attention. A healthcare professional can provide a proper diagnosis and treatment plan tailored to your specific needs. Do not hesitate to reach out for help; early intervention can lead to better outcomes and improved quality of life.

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