Changes in Stool Shape: Causes and Concerns

Concerns about having a narrow and short stool?

Hello Doctor: I had a colonoscopy in 2021, which diagnosed me with intestinal adhesions.
I also have a history of internal hemorrhoids and anal fissures.
Recently, I noticed that the end of my stool is narrower while the front is thicker, but I have no discomfort.
Could the swelling of internal hemorrhoids cause this situation, or could there be other reasons? Thank you.

Gu Nana, 40~49 year old female. Ask Date: 2023/03/11

Dr. Zhang Shuhao reply Surgery

Internal hemorrhoids themselves do not affect the shape of bowel movements, but discomfort from hemorrhoids may influence straining, which can further alter the shape of stool.
Intestinal adhesions, if they do not cause bowel obstruction, will not affect the shape of stool.
If a colonoscopy was performed in 2021 and there are no specific risk factors, it may not be necessary to repeat the procedure.

Reply Date: 2023/03/11

More Info

Understanding changes in stool shape can be a significant concern for many individuals, especially when there are underlying gastrointestinal issues. In your case, you have a history of intestinal adhesions, hemorrhoids, and anal fissures, which can all contribute to changes in stool consistency and shape.

When you notice that the end of your stool is thinner than the front, this can be indicative of a few potential issues. One common cause of a change in stool shape is the presence of a constriction or narrowing in the bowel, which can occur due to scarring from previous surgeries, such as your colonoscopy, or from conditions like intestinal adhesions. These adhesions can create bands of fibrous tissue that may pull on the intestines and lead to changes in how stool passes through the digestive tract.

Hemorrhoids, particularly internal hemorrhoids, can also play a role in stool shape. When hemorrhoids become swollen or inflamed, they can create a physical obstruction or alter the way stool is expelled. This can lead to a situation where the stool may be compressed or shaped differently as it passes through the anal canal. Additionally, if you have anal fissures, the pain associated with them may cause you to alter your bowel habits or the way you pass stool, potentially leading to changes in shape.

While the presence of thin stool can sometimes be benign, it is essential to consider other potential causes as well. For instance, persistent changes in stool shape, especially if they are accompanied by other symptoms such as blood in the stool, significant changes in bowel habits, or unexplained weight loss, should prompt further investigation. In some cases, a change in stool shape can be a sign of more serious conditions, including colorectal cancer, particularly if the change is persistent and accompanied by other concerning symptoms.

Given your history of intestinal issues, it would be prudent to monitor your symptoms closely. If the change in stool shape persists or if you experience any new symptoms, I recommend consulting with a healthcare professional for further evaluation. They may suggest additional imaging studies or a follow-up colonoscopy to assess the condition of your intestines and rule out any serious complications.

In summary, while your internal hemorrhoids and history of intestinal adhesions could contribute to the changes in stool shape you are experiencing, it is essential to remain vigilant and seek medical advice if the situation does not improve or if new symptoms arise. Regular check-ups and open communication with your healthcare provider can help ensure that any potential issues are addressed promptly.

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