Changes in Bowel Movements: When to See a Specialist

Colorectal issues

Hello Doctor, for the past two months, my stools have been consistently thin, about 1.5 cm in width, and they are mostly short, around 8 cm long.
Previously, my stools were thicker and longer, and I would often have multiple stools at once, including some that were even thinner and shorter, just a small amount.
Additionally, I have been experiencing constipation for about two years now, but the change in stool shape has only occurred recently.
I am concerned that my irregular schedule over the past two months, along with my two years of constipation, may have caused some issues with my intestines.
Should I see a colorectal surgeon or a gastroenterologist? Also, what are the possible causes of my stools becoming thinner? Thank you for your guidance.

Niming, 20~29 year old female. Ask Date: 2022/10/18

Dr. Zhang Shuhao reply Surgery

For issues related to constipation and bowel movements, you can consult either a colorectal specialist or a gastroenterologist, as both specialties can perform colonoscopies.
Rectal lesions can sometimes cause changes in stool shape, but most cases are related to dietary and functional intestinal issues.
It is recommended to increase fluid and dietary fiber intake, engage in moderate exercise to strengthen the lower body and promote gastrointestinal motility, relax to avoid stress and late nights, and consider supplementing with probiotics.
If there are concerns about colorectal issues, a colonoscopy can be performed directly.

Reply Date: 2022/10/18

More Info

Changes in bowel movements can be concerning, and it’s important to understand what these changes may indicate about your health. In your case, you’ve described a significant change in the shape and consistency of your stools, which have become narrower and shorter over the past two months. This is particularly notable given your history of constipation over the last two years.
Firstly, it’s essential to recognize that bowel habits can be influenced by a variety of factors, including diet, hydration, stress, and overall lifestyle. The fact that you have experienced irregular sleep patterns may also contribute to gastrointestinal issues, as sleep is crucial for maintaining a healthy digestive system. Stress and anxiety can lead to changes in gut motility, which might explain the recent changes in your bowel movements.

The narrowing of stools, particularly if they are consistently thin (like a pencil), can sometimes be a sign of an underlying issue, such as a blockage or narrowing in the colon. This could be due to conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even more serious conditions like colorectal cancer. However, it’s important to note that not all changes in stool shape are indicative of serious conditions, especially if they are accompanied by other symptoms like abdominal pain, weight loss, or blood in the stool.

Given your symptoms, it would be prudent to consult with a healthcare professional. In your case, you may consider seeing a gastroenterologist (肝膽胃腸科) first. They specialize in digestive health and can perform the necessary evaluations, including a thorough history, physical examination, and possibly imaging or endoscopic studies if indicated. A colonoscopy may be recommended to visualize the colon and rule out any significant pathology, especially given your history of constipation and recent changes in stool characteristics.

In terms of the potential causes for your changes in bowel movements, here are a few possibilities:
1. Irritable Bowel Syndrome (IBS): This is a common condition that can cause changes in bowel habits, including constipation and diarrhea. Stress and dietary factors often play a significant role in IBS.

2. Dietary Factors: A diet low in fiber can lead to constipation and changes in stool consistency. Ensure you are consuming adequate fruits, vegetables, and whole grains.

3. Dehydration: Insufficient fluid intake can lead to harder stools and constipation. Make sure you are drinking enough water throughout the day.

4. Structural Issues: Conditions such as strictures or polyps in the colon can lead to changes in stool shape. These are more serious and would need to be evaluated by a specialist.

5. Medication Effects: If you are taking any medications, some can affect bowel habits and stool consistency.

In conclusion, while changes in bowel movements can be benign, given your history of constipation and the recent changes in stool shape, it is advisable to seek medical attention. A gastroenterologist will be able to provide a comprehensive evaluation and guide you on the next steps, including potential diagnostic tests. Early intervention can be crucial in addressing any underlying issues effectively.

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