Bowel Issues: When to Consider a Colonoscopy - Gastroenterology and Hepatology

Bowel issues

Hello Doctor, I am currently 27 years old and have a habit of daily bowel movements.
In the past, my stools were often thick and long, but now the frequency has decreased significantly; the last time I had a bowel movement was at the beginning of last month.
This month, my stools have been thin and short, sometimes wider at one end and narrower at the other, with small amounts.
They are sometimes formed but break apart when they come into contact with water, appearing mushy.
I had a negative fecal occult blood test in June of last year.
Given this situation, do you think I need to undergo a colonoscopy? I am hesitant to take that step.
Thank you.

Lin, 20~29 year old female. Ask Date: 2023/11/08

Dr. Lin Minghui reply Gastroenterology and Hepatology

Abnormal bowel movements and normal fecal occult blood test results from last June—should a colonoscopy be performed? Abnormal bowel movements could be related to anxiety-induced irritable bowel syndrome, irregular diet, dietary changes, or gastroenteritis.
It is recommended to adjust the diet to avoid fried and spicy foods, and to maintain a gentle diet with adequate hydration.
Fecal tests can be repeated.
A colonoscopy is an invasive procedure that examines the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, and ileocecal valve for any lesions.
Prior to the procedure, a low-residue diet should be followed for three days, and bowel preparation is necessary.
For those undergoing a painless colonoscopy, fasting for about six hours after bowel preparation is required.
If there is a family history of polyps or colorectal cancer, unexplained weight loss, blood in the stool, or anemia, further examination is recommended.
It is advisable to adjust the diet and have outpatient follow-up to understand the underlying causes.
Wishing you good health! Dr.
Lin's response!

Reply Date: 2023/11/08

More Info

When it comes to bowel issues, particularly changes in bowel habits and stool characteristics, it is essential to take a proactive approach to your health. Given your age of 27 and the changes you've described in your bowel movements, it is understandable to feel uncertain about whether a colonoscopy is necessary. However, there are several factors to consider that can help guide your decision.

Firstly, the changes in your stool consistency and frequency are noteworthy. You mentioned that your stools have become thinner, shorter, and sometimes mushy, which can indicate a potential underlying issue. Normal stool is typically well-formed and should not disintegrate upon contact with water. The fact that you have experienced these changes consistently over the past month is a signal that further evaluation may be warranted.

In general, a colonoscopy is recommended in several scenarios, including:
1. Persistent Changes in Bowel Habits: If you notice a significant and persistent change in your bowel habits, such as a decrease in frequency, changes in stool shape, or consistency, it is advisable to consult a healthcare provider. In your case, the transition from well-formed stools to those that are thin and mushy could be indicative of an underlying condition that needs to be investigated.

2. Accompanying Symptoms: If you experience additional symptoms such as abdominal pain, weight loss, changes in appetite, or blood in your stool, these could be red flags that necessitate further investigation. While you mentioned that you had a negative fecal occult blood test last year, ongoing changes in bowel habits should not be overlooked.

3. Family History: A family history of colorectal cancer or other gastrointestinal diseases can increase your risk. If there is a history of such conditions in your family, it may be prudent to discuss this with your doctor and consider a colonoscopy earlier than the standard screening age.

4. Age and Risk Factors: While routine screening for colorectal cancer typically begins at age 45, younger individuals with concerning symptoms should not hesitate to seek evaluation. Your age does not exempt you from potential gastrointestinal issues, especially if you are experiencing significant changes.

5. Previous Findings: Since you had a negative fecal occult blood test last year, it is a positive sign, but it does not rule out all potential issues. If your symptoms persist or worsen, further investigation through a colonoscopy may still be necessary.

In conclusion, while it is natural to feel hesitant about undergoing a colonoscopy, especially if you have not experienced severe symptoms, the changes in your bowel habits warrant a discussion with your healthcare provider. They can assess your symptoms in the context of your overall health and determine whether a colonoscopy is appropriate. It is always better to err on the side of caution when it comes to gastrointestinal health. Early detection of any potential issues can lead to more effective treatment and better outcomes. If you are feeling anxious about the procedure, discussing your concerns with your doctor can also help alleviate some of that apprehension.

Similar Q&A

Understanding Bowel Issues: When to Consider a Colonoscopy

Hello Doctor, I have noticed that for the past two to three weeks, my stools have become thinner and have indentations. Sometimes I also experience diarrhea and some mucus in my stool. Do you think I need to get a colonoscopy? Thank you.

Dr. Ke Fangxu reply Surgery
There is no need to worry at 19 years old; such conditions are caused by hemorrhoids. It is advisable to avoid constipation and shorten the time spent during bowel movements. If you are still concerned, you may consult a physician for a digital rectal examination.

Understanding Recent Digestive Issues: When to Consider a Colonoscopy

I have been experiencing frequent bloating in my lower abdomen, along with lower back pain and discomfort. My stools have been soft and not formed, and recently I have noticed undigested food in my stool. I had a stool occult blood test done at a clinic recently, and the results ...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Lower back pain is not necessarily related to gastrointestinal issues. However, gastroenteritis and indigestion do exist. It is recommended to consult a gastroenterologist. Wishing you safety and health. Dr. Chen Qi-Feng, Gastroenterology Department, Taoyuan General Hospit...

Understanding Bowel Issues: When to Consider a Colonoscopy

Hello, doctor: Recently, my stools are formed but appear to be composed of loose pieces. There have been some black specks in my stool for several days, and I feel a bit uncomfortable in my abdomen with a frequent urge to use the restroom. What could be the issue? Is my age appro...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Recently, pay attention to your food choices and aim for a balanced diet. Try to avoid consuming dark-colored foods or animal blood products, and observe if similar symptoms occur. There is no age restriction for undergoing a colonoscopy; the consideration is whether it is...

Understanding Gut Issues: Should You Get a Colonoscopy for IBS Symptoms?

I'm sorry to hear that you're experiencing these symptoms. It sounds like you may be dealing with some gastrointestinal issues, such as irritable bowel syndrome (IBS). The presence of mucus in your stool and the varying consistency of your bowel movements can be indicat...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Based on your description, it is possible that you are experiencing abnormal intestinal motility, which may be caused by psychological stress and should be carefully analyzed. As for whether it is irritable bowel syndrome (IBS), a key characteristic of IBS is its periodic ...