Bowel Issues: Symptoms, Concerns, and When to Seek Help

Bowel issues

Doctor, here are my symptoms: Since the summer vacation, I have been experiencing frequent diarrhea that has lasted a long time.
Even as school was about to start, my diarrhea changed to constipation.
Although the frequency of my bowel movements hasn't changed, it feels very difficult to pass, almost like I'm straining.
I also experience lower abdominal pain, which usually lasts for a few seconds and is located slightly to the left.
What scares me the most is the possibility of colon cancer.
I often think, "I'm only 13 years old, how could it be colon cancer? It must just be irritable bowel syndrome!" However, there was one time after a bowel movement when I noticed a red streak on the toilet paper (strangely, I didn't see any blood in the stool).
There have been a few other instances where I noticed one or two small red spots on the stool or toilet paper, although not as pronounced.
Regarding the anemia issue, I have been feeling a bit dizzy or lightheaded when I stand up, but my lower eyelids and complexion look healthy and rosy! I don't feel particularly out of breath when running, which makes me puzzled.
I found many people online who are under 18 and have been diagnosed with colon cancer, which frightens me.
Should I get a fecal occult blood test or do something else? What should I do?

Li Tongxue, 10~19 year old female. Ask Date: 2022/10/07

Dr. Chen Bingze reply Surgery

Hello, I understand that this may make you very anxious.
The likelihood of developing colorectal cancer at your age is indeed very low.
Experiencing both constipation and diarrhea is more indicative of irritable bowel syndrome.
The presence of blood after a bowel movement may be more related to hemorrhoids that have swollen and ruptured due to straining, or it could be a slight tear in the anal area.
If you're having difficulty with bowel movements, using some stool softeners along with warm sitz baths and topical ointments or suppositories should help improve the situation significantly.

Reply Date: 2022/10/07

More Info

Understanding bowel issues, especially in the context of symptoms like diarrhea, constipation, abdominal pain, and concerns about serious conditions such as colorectal cancer, can be quite overwhelming, particularly for someone as young as you. Let's break down your symptoms and concerns to provide a clearer understanding and guidance on what steps to take next.

Symptoms and Concerns
From your description, it seems you have experienced a significant change in your bowel habits, transitioning from diarrhea to constipation, accompanied by abdominal pain. The pain you describe as being brief and localized to the lower left side could be related to various gastrointestinal issues, including Irritable Bowel Syndrome (IBS), which is common among adolescents and can manifest with alternating symptoms of diarrhea and constipation.

Your concern about colorectal cancer, despite your young age, is understandable but should be contextualized. Colorectal cancer is indeed rare in individuals under 20, but it is not impossible. The presence of blood, even if it appears as red spots on toilet paper or in your stool, warrants attention. Blood in the stool can arise from various causes, including hemorrhoids, anal fissures, or more serious conditions. However, given your age, it is more likely to be related to benign issues.

When to Seek Help
1. Persistent Symptoms: If your bowel issues have persisted for several weeks, it is essential to consult a healthcare professional. Chronic changes in bowel habits, especially when accompanied by pain, should be evaluated to rule out any underlying conditions.

2. Blood in Stool: The appearance of blood, even in small amounts, should not be ignored. It is advisable to have a healthcare provider assess this symptom, as they may recommend a stool test for occult blood or other diagnostic procedures.

3. Associated Symptoms: You mentioned experiencing dizziness and feeling faint upon standing. While this could be related to dehydration or low blood pressure, it is crucial to discuss these symptoms with a doctor, especially if they are new or worsening.

Recommended Actions
1. Consult a Gastroenterologist: Given your symptoms, it would be beneficial to see a gastroenterologist. They can perform a thorough evaluation, which may include a physical examination, stool tests, and possibly imaging studies if necessary.

2. Stool Tests: A stool test for occult blood is a reasonable next step to determine if there is hidden blood in your stool, which could indicate a more serious issue.

3. Diet and Hydration: Focus on maintaining a balanced diet rich in fiber, which can help regulate bowel movements. Staying well-hydrated is also crucial, especially if you have experienced diarrhea.

4. Monitor Symptoms: Keep a diary of your bowel habits, including frequency, consistency, and any associated symptoms like pain or blood. This information can be invaluable for your healthcare provider.

5. Mental Health Considerations: Anxiety about health issues can exacerbate gastrointestinal symptoms. If you find yourself excessively worried about your health, consider discussing these feelings with a trusted adult or mental health professional.

Conclusion
While your symptoms may be concerning, many gastrointestinal issues can be managed effectively with the right approach. It is essential to seek medical advice to ensure that any serious conditions are ruled out and to receive appropriate treatment for your symptoms. Remember, early intervention is key to managing health concerns effectively. Don't hesitate to reach out to a healthcare provider for guidance and support.

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