Two Weeks Without Normal Bowel Movements: Should I Get Another Colonoscopy?

Q: Two Weeks Without Normal Bowel Movements: Should I Get Another Colonoscopy?

Hello, Ying. <br>Your situation may be divided into two parts： changes in bowel habits and the presence of dark red stools. <br>It is true that sometimes hormonal fluctuations caused by menstrual regulation medications can lead to changes in bowel habits, which may include diarrh

It has been two weeks since I last had a normal bowel movement?

Hello Doctor: I haven't had normal bowel movements for the past two weeks and have no urge to go.
I've only gone a few times, producing small amounts.
Previously, I had one or two instances of watery stools that were dark red in color.
I visited a clinic, and the doctor diagnosed me with gastrointestinal bleeding and referred me to a larger hospital.
Two weeks ago, I took medication for menstrual regulation.
Could this medication be causing my constipation? I had a colonoscopy in October 2019, which was normal.
Earlier this month, I noticed blood in my stool, mixed in with it.
Given my current condition, do you think I need to undergo another colonoscopy? Thank you.
🙏

Ying, 30~39 year old female. Ask Date: 2022/10/04

Dr. Hu Guozheng reply Gastroenterology and Hepatology

Hello, Ying.
Your situation may be divided into two parts: changes in bowel habits and the presence of dark red stools.
It is true that sometimes hormonal fluctuations caused by menstrual regulation medications can lead to changes in bowel habits, which may include diarrhea or constipation.
Given that you mentioned a strong temporal correlation between starting the medication and the changes in bowel habits (both occurring about two weeks ago), it is possible that the medication is influencing these changes.
As for the dark red stools, we need to determine whether this occurs occasionally or every time.
It could be related to the consumption of certain colored foods or medications that contain pigments.
If the dark red stools persist, it is important to be cautious about the possibility of bleeding, and an endoscopy may be necessary if needed.

Reply Date: 2022/10/04

More Info

Based on your description, it sounds like you are experiencing significant gastrointestinal issues, including a lack of normal bowel movements for two weeks, occasional dark red watery stools, and a history of gastrointestinal bleeding. Given these symptoms, it is understandable that you are concerned about your health and whether you should undergo another colonoscopy.

First, it is important to recognize that changes in bowel habits, particularly a prolonged absence of normal bowel movements, can be indicative of underlying gastrointestinal issues. The fact that you have experienced dark red stools, which may suggest bleeding, is particularly concerning. While it is possible that the menstrual regulation medication you mentioned could contribute to constipation, the presence of blood in your stool warrants further investigation.

In your case, since you had a colonoscopy in October 2019 that was reported as normal, it is reasonable to consider that the findings from that procedure may not be the cause of your current symptoms. However, the emergence of new symptoms, especially those involving blood, should not be ignored. The gastrointestinal tract can develop new issues over time, and the presence of blood can indicate conditions such as hemorrhoids, diverticular disease, or even more serious conditions like colorectal cancer or inflammatory bowel disease.

Given your symptoms and the potential for serious underlying conditions, it would be prudent to consult with a gastroenterologist. They may recommend another colonoscopy to investigate the cause of your symptoms, especially since you have had a recent history of gastrointestinal bleeding. The decision to perform a colonoscopy will depend on a thorough evaluation of your symptoms, medical history, and possibly additional diagnostic tests such as blood work or imaging studies.

In addition to the colonoscopy, it may also be beneficial to discuss your current medication with your healthcare provider. If the menstrual regulation medication is contributing to your constipation, your doctor may suggest alternatives or additional treatments to alleviate this side effect.

In summary, given your current symptoms of constipation, dark red stools, and a history of gastrointestinal bleeding, it is advisable to seek further evaluation from a healthcare professional. A repeat colonoscopy may be warranted to rule out any serious conditions and to address your gastrointestinal concerns effectively. It is always better to err on the side of caution when it comes to gastrointestinal health, especially with the presence of alarming symptoms such as blood in the stool.

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