Changes in Bowel Habits: When to Seek Medical Advice - Gastroenterology and Hepatology

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Bowel issues


Hello, doctor.
I used to have a very regular bowel habit of once a day, but in the past six months, my bowel habits have changed.
I often go several times a day, sometimes 3 to 4 times, and the time spent in the bathroom has increased.
I also experience a feeling of incomplete evacuation or have the urge to go but cannot.
Occasionally, I have issues with bloating or abdominal pain.
The consistency of my stools varies; sometimes they are very hard, and other times I have diarrhea.
I have had a few instances of blood in my stool, but I often pass thin, long, soft stools.
Sometimes I only go to the bathroom after getting out of bed, and after breakfast, I feel the urge to go again.
I have a habit of drinking coffee, and regardless of whether I have gone to the bathroom before drinking it, I always feel the need to go afterward.
I also swim regularly and have noticed that sometimes I feel the need to go right before swimming, but halfway through, I might need to go again.
There are times when I feel the urge before swimming but cannot go.
I would like to know if there is a problem with this and if any tests are necessary.
Could this possibly be colon cancer?

Kevin, 30~39 year old female. Ask Date: 2008/01/21

Dr. Chen Shidian reply Gastroenterology and Hepatology


Hello Mr.
Kevin: The symptoms you described are mostly indicative of "Irritable Bowel Syndrome" (IBS).
However, due to your history of blood in the stool, it is recommended that you visit a gastroenterology clinic for a colonoscopy (you may request a sedation option for an additional fee).
Additionally, please take medication as prescribed and avoid irritating foods to help reduce stress.
Changhua Hospital cares about your health.
Best regards, Chen Shidian.

Reply Date: 2008/01/21

More Info


Changes in bowel habits can be concerning, especially when they deviate from what is considered normal for an individual. In your case, the shift from a consistent daily bowel movement to multiple times a day, along with feelings of incomplete evacuation, bloating, abdominal pain, and the presence of blood in your stool, warrants careful consideration and possibly further evaluation.

Firstly, it’s essential to understand what constitutes a change in bowel habits. Generally, a change is defined as a significant alteration in the frequency, consistency, or ease of bowel movements. For instance, if you previously had regular bowel movements once a day and now find yourself going three to four times a day, this is a notable change. Additionally, the sensation of incomplete evacuation and variations in stool consistency—ranging from hard to loose—can also indicate underlying gastrointestinal issues.

The symptoms you describe, such as bloating and abdominal pain, can be associated with several gastrointestinal conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional gastrointestinal disorders. The presence of blood in your stool, even if infrequent, is a symptom that should not be overlooked, as it can indicate conditions ranging from hemorrhoids to more serious issues like colorectal cancer.

Regarding your concerns about colorectal cancer, it is important to note that while changes in bowel habits can be a symptom of this disease, they are not definitive indicators on their own. Colorectal cancer often presents with a combination of symptoms, including changes in bowel habits, blood in the stool, unexplained weight loss, and persistent abdominal discomfort. Given your age and the nature of your symptoms, it is prudent to discuss these concerns with your healthcare provider. They may recommend diagnostic tests such as a colonoscopy or imaging studies to rule out any serious conditions.

In terms of lifestyle factors, your coffee consumption may also play a role in your bowel habits. Caffeine is known to stimulate bowel activity, which could explain the urgency you feel after drinking coffee. However, if you find that your bowel habits are significantly affected by your coffee intake, you might consider moderating your consumption to see if it alleviates some of your symptoms.

Additionally, maintaining a balanced diet rich in fiber, staying hydrated, and engaging in regular physical activity can help regulate bowel movements. Since you mentioned swimming as part of your routine, it’s beneficial to continue with physical activities, as they can promote healthy digestion.

In summary, while some changes in bowel habits can be benign, the combination of your symptoms—particularly the presence of blood and the feeling of incomplete evacuation—suggests that it would be wise to seek medical advice. A thorough evaluation by a healthcare professional, including a detailed history and possibly diagnostic testing, can help determine the underlying cause of your symptoms and guide appropriate management. Remember, early detection and intervention are key in addressing any potential gastrointestinal issues effectively.

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