Stool Shape Changes: Is It Hemorrhoids or Something More?

Stool shape?

Hello, doctor.
I have a history of both internal and external hemorrhoids.
Recently, about three weeks ago, I experienced some constipation, which made me pay more attention to my condition.
I noticed that after bowel movements, there is swelling at the anal opening that subsides after a while.
My bowel movements have been smooth since two weeks ago, but I have observed that my stools have grooves.
The color of the stools is a natural light brown.
When the stools are harder, the grooves are not very noticeable; conversely, when they are softer, the grooves are more pronounced.
I have not experienced any blood in my stools, mucus, or other symptoms.
I would like to ask if this condition could be caused by internal hemorrhoids, or is there a possibility of rectal cancer? If a check-up is needed, should I prioritize a fecal occult blood test or do you have a recommended order for examinations?

Lao Wu, 30~39 year old female. Ask Date: 2022/10/26

Dr. Chen Ronghong reply Surgery

Hello, Lao Wu.
You mentioned that the shape of the stool has grooves.
The most direct way to assess this is through a digital rectal examination performed by a physician, which can help detect any tumors or internal hemorrhoids in the lower rectum.
Additionally, a fecal occult blood test can be arranged simultaneously to check for any bleeding in the intestines that cannot be felt by the finger.

Reply Date: 2022/10/26

More Info

When it comes to changes in stool shape and the associated symptoms you are experiencing, it is essential to approach the situation with a comprehensive understanding of gastrointestinal health. Given your history of hemorrhoids and recent constipation, it is reasonable to consider that your current symptoms may be related to these conditions. However, it is also prudent to rule out any more serious issues, such as rectal cancer.

Understanding Your Symptoms
1. Hemorrhoids: Hemorrhoids can cause swelling and discomfort around the anal area, especially after bowel movements. The fact that you have a history of both internal and external hemorrhoids suggests that they could be contributing to the swelling you are experiencing post-defecation. Hemorrhoids can also lead to changes in stool shape, particularly if they are inflamed or if there is straining during bowel movements.

2. Stool Shape Changes: The presence of grooves or ridges in your stool can sometimes be attributed to the way the stool passes through the rectum and anus, especially if there is any obstruction or narrowing due to hemorrhoids or other factors. It is important to note that while changes in stool shape can be benign, they can also be indicative of more serious conditions, including rectal cancer, particularly if accompanied by other symptoms.

3. Constipation: Your recent experience with constipation can exacerbate hemorrhoidal symptoms and may lead to straining, which can further irritate the anal area. Hard stools can also contribute to the formation of fissures, which may cause discomfort and swelling.

Evaluating the Risk of Rectal Cancer
While your symptoms may be related to hemorrhoids, it is crucial to remain vigilant about the possibility of rectal cancer, especially given the changes in stool shape. Rectal cancer can sometimes present with changes in bowel habits, including the shape and consistency of stool. However, the absence of blood, mucus, or other alarming symptoms is a positive sign.

Recommended Steps for Evaluation
1. Stool Test: A fecal occult blood test (FOBT) is a good starting point to rule out any hidden blood in the stool, which can be a sign of colorectal issues. If this test is positive, further evaluation, such as a colonoscopy, would be warranted.

2. Colonoscopy: If you have any concerning symptoms or if the stool test indicates potential issues, a colonoscopy is the gold standard for visualizing the colon and rectum. This procedure allows for direct examination and the possibility of biopsies if any suspicious lesions are found.

3. Consultation with a Specialist: Given your history of hemorrhoids and current symptoms, it may be beneficial to consult with a gastroenterologist or a colorectal surgeon. They can provide a thorough evaluation and recommend appropriate management strategies.

Conclusion
In summary, while your symptoms may be related to your history of hemorrhoids, it is essential to take a proactive approach to your gastrointestinal health. Monitoring your symptoms, conducting appropriate tests, and consulting with a healthcare professional will help ensure that any potential issues are identified and managed promptly. Maintaining a high-fiber diet, staying hydrated, and avoiding straining during bowel movements can also help alleviate some of your symptoms. If you notice any new symptoms or if your current symptoms worsen, do not hesitate to seek medical attention. Your health is paramount, and addressing these concerns early can lead to better outcomes.

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