Digestive Issues: When to Seek Medical Advice - Gastroenterology and Hepatology

Gastrointestinal issues

Since the start of last school year (September), I have been experiencing mild pain on the sides of my abdomen and in the four corners.
At that time, my bowel movements were not very smooth, and the doctor diagnosed me with constipation, advising me to drink more water and eat vegetables.
They also prescribed a stool softener for me.
I have been eating a fist-sized portion of vegetables daily, drinking 1200cc of water, and running 400 meters every day.
It has been a long time since I finished the medication prescribed by the doctor last year, but I still experience abdominal pain.
Therefore, I bought a new fiber supplement four weeks ago, but I only take it at lunch.
My bowel movement frequency has improved from once every three days to once every one or two days, although I still feel a bit strained during bowel movements and often feel that my bowels are not completely empty.

I also experience itching around the anus and have used over-the-counter creams, as well as completed a full course of medication for pinworms.
My stool has been tested for parasites, and the results were normal, but I still experience daily itching.
Each time I check my stool, it is formed and tubular, with no blood, and it does not clog the toilet when flushed.
The color is brown, and I have not seen anything resembling roundworms or tapeworm segments, only fiber.
However, I feel that the area of abdominal pain seems to be expanding; sometimes it is below the ribs, sometimes near the navel, and in the four corners and sides, but it is always mild pain, occurring in intermittent episodes every few minutes, daily.
Burping and passing gas feel normal; I burp after meals and pass gas daily, neither too much nor too little, and there is no foul odor or continuous gas.
However, on rare occasions, I experience sudden cramping pain in my abdomen that makes me want to pass gas.
Due to the various health issues and symptoms I have, including skin itching, allergies, and pain in different areas, I have been quite anxious for a long time and often overthink things.
Could this just be a simple constipation issue? I need some reasons to discuss with my mother about whether I should see a doctor again, so I would like to ask if I need to seek medical attention, or should I follow my mother's advice to not overthink it and continue to improve my constipation? Thank you, doctor, for reading this! I appreciate your judgment.
🙏

Zeng Tongxue, 10~19 year old female. Ask Date: 2024/04/24

Dr. Luo Yining reply Gastroenterology and Hepatology

If symptoms persist or worsen despite adjustments in lifestyle and dietary habits, it is recommended to consult a pediatrician or a pediatric gastroenterologist for further evaluation and treatment.

Reply Date: 2024/04/24

More Info

When it comes to digestive issues, particularly those involving abdominal pain and changes in bowel habits, it is crucial to understand when to seek medical advice. Based on your description, it seems you have been experiencing persistent abdominal discomfort, irregular bowel movements, and associated symptoms for quite some time. Here are some key points to consider regarding your situation.

Understanding Your Symptoms
1. Abdominal Pain: The pain you describe as being located in various areas of your abdomen (under the ribs, near the navel, and in the corners) can be indicative of several gastrointestinal issues. While mild, intermittent pain can sometimes be attributed to constipation or dietary factors, persistent pain warrants further investigation.

2. Bowel Movements: You mentioned that your bowel movements have improved slightly but still feel incomplete and require effort. This could suggest ongoing constipation or possibly a condition like irritable bowel syndrome (IBS), which is characterized by abdominal pain and altered bowel habits.

3. Itching and Other Symptoms: The itching around the anus and your history of using over-the-counter treatments for potential pinworms, along with normal stool tests, suggest that while parasitic infections have been ruled out, there may be other underlying issues such as hemorrhoids or skin irritations that need to be addressed.

4. Associated Symptoms: The presence of other symptoms such as skin allergies and generalized pain can contribute to anxiety, which may further exacerbate gastrointestinal symptoms. Stress and anxiety can significantly impact digestive health, leading to a cycle of discomfort.

When to Seek Medical Advice
Given the persistence and nature of your symptoms, it is advisable to consult a healthcare professional again. Here are some reasons why:
- Duration of Symptoms: Symptoms lasting for several months, especially with changes in bowel habits and persistent pain, should not be ignored. A thorough evaluation can help rule out more serious conditions.

- Incomplete Relief: Despite dietary changes and the use of medications, if you are still experiencing discomfort and irregular bowel movements, it may be time to reassess your treatment plan with a physician.

- Additional Testing: Your doctor may recommend further tests, such as imaging studies (like an ultrasound or CT scan) or endoscopy, to investigate the cause of your symptoms more thoroughly.

- Mental Health Considerations: If anxiety about your symptoms is affecting your quality of life, discussing this with a healthcare provider can help. They may suggest strategies to manage anxiety, which can, in turn, alleviate some of your gastrointestinal symptoms.

Communicating with Your Family
When discussing your health concerns with your mother, it may be helpful to express how these symptoms are affecting your daily life and mental well-being. Emphasize that seeking further medical advice is not just about addressing physical symptoms but also about ensuring your overall health and peace of mind.

Conclusion
In summary, while dietary changes and increased hydration are essential components of managing constipation, the persistence of your symptoms suggests that further medical evaluation is warranted. It is always better to err on the side of caution when it comes to health issues, especially those involving the digestive system. Seeking a second opinion or further testing can provide clarity and help you find relief from your symptoms.

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