Long-Term Constipation and Unusual Stool Symptoms: A Surgical Perspective

Q: Long-Term Constipation and Unusual Stool Symptoms: A Surgical Perspective

Hello： In response to your questions. <br>1. <br>Some plant seed coats or fruit skins are not easily digested, which is why they may appear in the stool. <br>In addition to chili peppers, tomatoes, sweet peppers, and corn are commonly seen during colonoscopy. <br>Sometimes, these

Consultation

I have been suffering from chronic constipation for 24 years.
I am 163 cm tall and weigh 50 kg.
Because I used to endure it when I was younger, I often strained during bowel movements (of course, I controlled my diet and tried other methods).

1: However, there is something strange; I do not eat chili peppers, yet occasionally I find pieces in my stool that look like red chili skin.
What could this be?
2: For a period, I was passing mucus, and after visiting a doctor and undergoing a digital rectal examination, I was diagnosed with internal and external hemorrhoids.
I also had a barium enema, which showed no significant issues.
However, the day before the barium test, I took a laxative, and the next morning I passed a large amount of mucus without any stool.
What could be the reason for this? Additionally, after the examination, I often feel discomfort around my navel!

Yu, 40~49 year old female. Ask Date: 2007/10/12

Dr. Ke Fangxu reply Surgery

Hello: In response to your questions.
1.
Some plant seed coats or fruit skins are not easily digested, which is why they may appear in the stool.
In addition to chili peppers, tomatoes, sweet peppers, and corn are commonly seen during colonoscopy.
Sometimes, these food residues may change color due to staining by bile pigments, which is not a cause for concern.
2.
The principle of barium imaging involves introducing a contrast agent into the colon for imaging examination.
Therefore, it is normal to expel the contrast agent the day after the examination.
Additionally, the process of the enema may cause slight peritoneal irritation, which can result in mild abdominal pain or bloating, also considered normal.
It is recommended to drink plenty of water and consume dietary fiber to help expel the contrast agent, and normal bowel function should resume within 2-3 days.

Reply Date: 2007/10/12

More Info

Long-term constipation can be a challenging condition that affects many aspects of a person's health and quality of life. In your case, having experienced constipation for 24 years, it is essential to understand the potential underlying causes, symptoms, and treatment options available. Additionally, the unusual stool symptoms you described warrant further exploration.

1. Unusual Stool Symptoms: The presence of red, pepper-like pieces in your stool can be concerning. While you mentioned not consuming spicy foods, it is possible that these could be remnants of undigested food, such as tomato skins or other fibrous materials. However, if the red pieces are consistent and you have not eaten anything that could resemble them, it is crucial to consult a healthcare professional. Blood in the stool, even if it appears as red specks, can indicate various conditions, including hemorrhoids, anal fissures, or more serious gastrointestinal issues. A thorough examination, including a colonoscopy, may be necessary to rule out any significant pathology.

2. Mucus in Stool: The occurrence of mucus in your stool can be associated with several conditions. Mucus is a normal component of stool, but an increase in its quantity can indicate inflammation in the intestines. Given your history of hemorrhoids and the results from the barium enema, it is possible that the mucus is related to irritation or inflammation in the rectal area. The fact that you experienced a large amount of mucus without any solid stool during your bowel preparation for the barium study suggests that your intestines may be reacting to the changes in diet or the laxatives used. This can sometimes happen in individuals with chronic constipation, as the bowel may become accustomed to certain stimuli and react differently when those stimuli change.

3. Post-Examination Discomfort: Feeling discomfort around the navel area after the barium study could be due to several factors. The barium enema itself can cause temporary irritation in the intestines, and the bowel preparation may have altered your normal bowel function, leading to discomfort. If the discomfort persists or worsens, it is advisable to follow up with your healthcare provider to ensure that there are no complications from the procedure.

Treatment Options
For long-term constipation, treatment often involves a combination of dietary changes, lifestyle modifications, and possibly medications. Here are some strategies that may help:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, whole grains, and legumes can help promote regular bowel movements. Aim for at least 25-30 grams of fiber per day. Additionally, staying well-hydrated is crucial, as fluids help soften the stool.

- Physical Activity: Regular exercise can stimulate bowel function. Aim for at least 30 minutes of moderate activity most days of the week.

- Medications: If dietary changes and lifestyle modifications are insufficient, over-the-counter laxatives or prescription medications may be necessary. Options include osmotic laxatives (e.g., polyethylene glycol), stimulant laxatives (e.g., bisacodyl), or prescription medications like lubiprostone or linaclotide.

- Behavioral Techniques: Establishing a regular bowel routine, such as setting aside time each day to attempt a bowel movement, can be beneficial. Avoiding straining and allowing adequate time for bowel movements can also help.

Prognosis
The prognosis for chronic constipation varies depending on the underlying cause and the effectiveness of treatment. Many individuals can achieve significant improvement with appropriate interventions. However, it is essential to work closely with a healthcare provider to monitor symptoms and adjust treatment as needed.

Resources for Further Information
For more information on constipation and gastrointestinal health, consider visiting reputable medical websites such as:
- The American Gastroenterological Association (AGA)
- The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- The Mayo Clinic
These resources provide valuable insights into managing constipation and understanding gastrointestinal health. If your symptoms persist or worsen, please seek medical attention promptly.

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