Changes in Bowel Habits: When to Seek Gastrointestinal Care

Bowel-related issues

Hello, doctor.
I have previously undergone fecal occult blood tests during my health check-ups (three times), and all results were normal.
This month, I have experienced a change in my bowel habits, going from having a bowel movement once a day (or once every two days) to three times a day.
However, after a few days, it returned to normal, with one to three bowel movements per day.
Typically, I experience abdominal pain after meals, which prompts the bowel movements, but the stool shape remains normal.
After each bowel movement, I notice mucus.
Recently, I have been eating spicy food frequently (which I did not do before), and I wonder if this is related.
Last month, I was still able to have perfect bowel movements (thick and long), with normal frequency and color.
I have concerns because, since the beginning of this year, I have experienced intermittent sharp pain in the lower right abdomen each month.
I have already undergone a gynecological examination, which was normal, but the sharp pain only lasts for a few days each month (usually 2-3 days, sometimes up to a week), and I do not feel any abnormal sensations at other times.
The doctor currently suspects it may be related to soft stool pain, but since the pain does not occur consistently (not necessarily during ovulation) and seems to be increasing in intensity each month, I have been advised to see a gastroenterologist.
Could you please advise what this situation might indicate? Is it necessary for me to undergo a colonoscopy? Thank you for your patient response.
I also have issues with autonomic nervous system dysregulation.

Miss Lu, 20~29 year old female. Ask Date: 2022/10/04

Dr. Hu Guozheng reply Gastroenterology and Hepatology

Hello, Miss Lu.
The reasons for changes in your bowel habits can be numerous, including diet, lifestyle, and stress.
However, since this phenomenon has only occurred in the past month, and if there are no issues with appetite or weight loss, it is advisable to observe for three months.
Regarding your abdominal pain, it is uncertain whether it is related to the change in your bowel habits, as you mentioned that the cramping has been ongoing for over six months, while the change in bowel habits has only been recent.
Additionally, there are many potential causes of abdominal pain, and a detailed inquiry during an outpatient visit may be necessary.
Lastly, a colonoscopy carries certain risks (such as bowel perforation), and it would only be considered if your condition does not improve and there is a strong suspicion of a disease that requires a colonoscopy for diagnosis.

Reply Date: 2022/10/04

More Info

Understanding changes in bowel habits is crucial for maintaining gastrointestinal health, and it can often be a source of concern for many individuals. Your description of experiencing fluctuations in bowel habits, including an increase in frequency from once a day to three times a day, along with the presence of mucus and abdominal pain, warrants careful consideration.

Firstly, it's important to recognize that changes in bowel habits can be influenced by various factors, including diet, stress, and underlying medical conditions. In your case, you mentioned an increase in spicy food consumption, which can irritate the gastrointestinal tract and lead to changes in bowel movements. Spicy foods can stimulate the intestines, potentially resulting in more frequent bowel movements or diarrhea for some individuals. Additionally, the presence of mucus in your stool can indicate irritation or inflammation in the intestines, which may be related to dietary changes or other gastrointestinal issues.

The abdominal pain you described, particularly in the lower right quadrant, is also noteworthy. While you have already consulted with a gynecologist and received normal results, it is essential to consider that gastrointestinal issues can sometimes mimic gynecological problems. The intermittent nature of your pain, along with its increasing intensity, suggests that further evaluation may be necessary to rule out any underlying gastrointestinal conditions, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional gastrointestinal disorders.

Given your history of autonomic nervous system dysregulation, it's also possible that stress and anxiety could be contributing to your gastrointestinal symptoms. The gut-brain connection is well-documented, and stress can significantly impact digestive health, leading to symptoms such as abdominal pain, changes in bowel habits, and increased sensitivity to gastrointestinal discomfort.

In terms of whether you should undergo a colonoscopy, this decision should be based on several factors, including the duration and severity of your symptoms, any alarming features (such as significant weight loss, persistent abdominal pain, or blood in the stool), and your healthcare provider's recommendations. A colonoscopy can be a valuable diagnostic tool to assess the health of your colon and rule out any serious conditions, especially if your symptoms persist or worsen.

In summary, while changes in bowel habits can sometimes be benign and related to dietary changes or stress, your symptoms warrant further investigation. It would be prudent to consult with a gastroenterologist who can perform a thorough evaluation, including a detailed history, physical examination, and possibly recommend diagnostic tests such as a colonoscopy if deemed necessary. In the meantime, maintaining a balanced diet, staying hydrated, and managing stress through relaxation techniques or counseling may help alleviate some of your symptoms. Remember, early intervention is key to addressing gastrointestinal issues effectively, so don't hesitate to seek care if your symptoms persist or worsen.

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