Changes in Stool Consistency: Symptoms and Concerns - Surgery

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Narrowing of stool?


Hello, Director Lin: For the past few days, I have been experiencing noticeable rumbling in my lower abdomen (sometimes quite loudly).
There is a lot of gas moving around, and at times I can pass gas while at other times I cannot (the gas only reaches the anal opening and then stops)...
and I have no urge to have a bowel movement! The next morning, when I went to the bathroom, I noticed that my stool was soft, not much in quantity, but it had become thinner than usual (about slightly thicker than my pinky finger, in a complete long shape).
Am I experiencing enteritis or is this a precursor to colorectal cancer? (Because I read that thinner stools can be one of the signs??!) Additionally, I would like to ask a long-standing puzzling question...
since puberty, every time I reach ovulation or just before my period, I not only have diarrhea but also, every time I pass gas, it seems to travel from the anal opening to the vaginal opening...
why is that? Is this normal, or could there be some kind of anal canal issue that I am unaware of?

kendy, 20~29 year old female. Ask Date: 2004/03/14

Dr. Lin Hongmao reply Surgery


Dear Kendy:
To answer your first question: The rumbling in the lower abdomen is due to gas in the intestines, which is produced by intestinal bacteria breaking down food or by swallowing air.
Some of this gas is absorbed through the intestinal wall, and if it cannot be absorbed, it leads to bloating.
Bloating can cause discomfort, prompting the intestines to contract and expel the gas.
It’s possible that while expelling gas, some absorption occurs, leading to the symptoms you experience.
Secondly, the shape and volume of stool are related to the amount of fiber consumed.
When there is a high amount of non-absorbable fiber in food and adequate moisture, the stool tends to be well-formed, larger in volume, and easier to pass, reducing the likelihood of constipation.
On the other hand, if the stool becomes thinner, it may be due to overly refined food with low fiber content, which is the most common cause.
Rectal cancer can also cause thinner stools, but this is less common and typically occurs in the later stages of cancer when the tumor grows, narrowing the intestinal lumen and losing elasticity, which manifests as a symptom.
Therefore, early-stage cancer often presents no symptoms.
It is generally recommended for individuals over 50 to undergo a colonoscopy for early detection and treatment.
For high-risk groups (such as those with a direct family history of colorectal cancer, familial polyposis, or hereditary cancer syndromes, or those with a diet high in meat), earlier screening is advised.
Thirdly, experiencing diarrhea during ovulation or just before menstruation may be due to stimulation of the rectum, which increases the frequency and intensity of bowel movements, leading to diarrhea.
This can be considered a normal response.
As for the presence of a fistula between the anus and vagina, it is advisable to consult a specialist (gynecologist or colorectal surgeon) for examination to avoid unnecessary worry.
Thank you for your questions!
Hong-Mau

Reply Date: 2004/03/14

More Info


Changes in stool consistency and bowel habits can be concerning, especially when accompanied by other symptoms such as abdominal discomfort, gas, and changes in the frequency or nature of bowel movements. Based on the information provided, it seems you are experiencing a range of gastrointestinal symptoms that may warrant further evaluation.

Firstly, let's define what constitutes a change in bowel habits. Generally, this term refers to any significant alteration in the frequency, consistency, or appearance of stools compared to your normal pattern. For instance, if you typically have regular bowel movements and suddenly experience diarrhea, constipation, or a noticeable change in stool consistency (such as becoming thinner or more liquid), this would be considered a change in bowel habits.

In your case, you mentioned experiencing soft stools that are thinner than usual, along with abdominal noises and gas. These symptoms could be indicative of several conditions, including irritable bowel syndrome (IBS), gastrointestinal infections, or even inflammatory bowel disease (IBD). However, the presence of thin stools can also raise concerns about more serious conditions, such as colorectal cancer, especially if accompanied by other alarming symptoms like blood in the stool or significant weight loss.

It's important to note that while changes in stool consistency can be a symptom of colorectal cancer, they are not definitive on their own. Many benign conditions can cause similar symptoms. For example, stress and anxiety can significantly impact gut health, leading to symptoms like abdominal cramping, gas, and changes in bowel habits. Given your mention of stress and anxiety, it is plausible that these factors could be contributing to your gastrointestinal symptoms.

Regarding your specific question about the occurrence of gas and the sensation of it not fully passing, this can be a common experience. The gastrointestinal tract is designed to handle gas, but sometimes, due to various factors such as diet, stress, or gastrointestinal motility issues, gas can become trapped, leading to discomfort. If you are experiencing gas that seems to "get stuck," it may be beneficial to evaluate your diet and consider whether certain foods are contributing to excessive gas production.

As for the phenomenon you described during your menstrual cycle, it is not uncommon for women to experience gastrointestinal changes related to hormonal fluctuations. Many women report increased bowel activity or changes in stool consistency around their menstrual cycle due to hormonal influences on gut motility. The sensation of gas moving toward the vaginal area is less common but can occur due to anatomical proximity and the way gas moves through the pelvic region.

In conclusion, while your symptoms may be concerning, they are not necessarily indicative of a serious condition like colorectal cancer. However, given the changes in your bowel habits and the presence of other symptoms, it would be prudent to consult with a healthcare professional for a thorough evaluation. This may include a physical examination, a review of your medical history, and possibly further diagnostic tests such as a colonoscopy to rule out any serious underlying conditions. Additionally, managing stress through relaxation techniques, therapy, or medication may help alleviate some of your gastrointestinal symptoms. Always prioritize open communication with your healthcare provider to address your concerns and develop an appropriate management plan.

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