Increased Bowel Movements: Concerns and Insights - Gastroenterology and Hepatology

Increased frequency of bowel movements?

Hello Dr.
Chen,
In the past, I had a bowel movement about 1 to 2 times a day.
Recently, due to elevated blood sugar and cholesterol levels, I have been taking medications to lower them.
Additionally, I have started to eat more fruits regularly (which I didn't consume much before), and my bowel movement frequency has changed to an average of about 3 to 4 times a day.
The first two bowel movements have a larger volume, with a thickness of about 2 to 3 centimeters, while the later ones also have some volume, with a thickness of around 2 centimeters.
After each bowel movement, I sometimes feel a slight urge to go again while sitting, and after a while, there is still some volume.
The stool is well-formed, and there is no blood, but I am worried whether there might be an issue with my intestines.
I have read that changes in bowel movement frequency and the sensation of urgency can be symptoms of colorectal cancer, which makes me concerned about possible serious issues.
There is no family history of colorectal cancer.
Additionally, I had a colonoscopy nearly three years ago, during which a polyp of about 0.3 centimeters was found, and the biopsy results were normal.
Recently, I also had a fecal occult blood test, and the results were normal.
I would like to ask you a few questions:
1.
Is it possible that my current symptoms indicate colorectal cancer?
2.
How often should a colonoscopy be performed?
3.
Approximately how long does it take for colorectal cancer to develop?
I apologize for the many questions, and I appreciate your help, Doctor.

PING, 40~49 year old female. Ask Date: 2023/07/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

A fecal occult blood test can be performed first.
The follow-up interval depends on individual circumstances and the physician's workload, typically ranging from 1 to 3 years.
The precursors to colorectal cancer often take more than 5 to 10 years to develop.

Reply Date: 2023/07/31

More Info

Increased bowel movements can be a source of concern for many individuals, especially when accompanied by changes in stool consistency, frequency, and associated symptoms. Your recent experience of having an increased frequency of bowel movements, now averaging 3 to 4 times a day, is understandably alarming, particularly given your history of elevated blood sugar and cholesterol, for which you are taking medication.
Firstly, it’s important to recognize that changes in bowel habits can be influenced by various factors, including dietary changes, medication side effects, and underlying gastrointestinal conditions. The introduction of more fruits into your diet may contribute to increased fiber intake, which can stimulate bowel movements. Fiber is known to promote digestive health and can lead to more frequent and bulkier stools. However, if this change is sudden or accompanied by other concerning symptoms, it warrants further investigation.

1. Concerns about Colorectal Cancer: Your concern about colorectal cancer is valid, especially since changes in bowel habits can be a symptom. However, the absence of blood in your stool and the normal results from your recent fecal occult blood test are reassuring signs. Additionally, your previous colonoscopy, which revealed a small polyp that was benign, further reduces the likelihood of immediate concern regarding colorectal cancer. While it is essential to remain vigilant, the symptoms you describe—particularly the absence of blood and the normal consistency of your stools—are less indicative of cancer.
2. Frequency of Colonoscopies: As for how often you should undergo a colonoscopy, guidelines typically recommend that individuals with a history of polyps have a follow-up colonoscopy every 3 to 5 years, depending on the number and type of polyps found. Since your last colonoscopy was nearly three years ago and showed only a small, benign polyp, it may be appropriate to schedule another one soon, especially given your current concerns. However, if you have no new symptoms or significant changes, your healthcare provider may suggest waiting a bit longer. It’s best to discuss this with your gastroenterologist, who can provide personalized recommendations based on your medical history.

3. Development of Colorectal Cancer: The timeline for the development of colorectal cancer can vary significantly among individuals. Generally, it is believed that it can take several years for polyps to develop into cancer. Most colorectal cancers arise from adenomatous polyps, which can take about 10 to 15 years to progress to cancer. However, this timeline can be influenced by various factors, including genetics, lifestyle, and the presence of other medical conditions. Regular screenings are crucial for early detection, as they can identify precancerous changes before they develop into cancer.

In conclusion, while your increased bowel movements may be concerning, the absence of blood and your previous normal colonoscopy results are encouraging. It is essential to maintain open communication with your healthcare provider about your symptoms and concerns. They can help determine whether further evaluation is necessary and guide you on the appropriate timing for your next colonoscopy. Additionally, consider keeping a symptom diary to track your bowel habits, dietary changes, and any other symptoms, which can provide valuable information for your healthcare provider.

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