Gastrointestinal Issues: Symptoms and Concerns Explained

Q: Gastrointestinal Issues: Symptoms and Concerns Explained

To Xiao Qi： You have described your symptoms very clearly, which are evidently related to issues around the anal area. <br>An anoscopy should be the starting point for examination. <br>There may be inflammation and swelling in your anal tissue, which could be causing the frequent

Gastrointestinal and bowel issues?

Hello Dr.
Chang, thank you for taking the time to respond to my lengthy question.
To save your time, I will directly describe my situation: I have been experiencing gastrointestinal and bowel issues for over a year.
Recently, I have had more noticeable symptoms, including intermittent diarrhea, which consists of soft stools (similar to mud) rather than watery stools, occurring about once a week.
During bowel movements, I experience extreme burning in the anal area, almost like being scalded with hot water.
The color of my stools is greenish-yellow, and after a bowel movement, I often feel a burning sensation and soreness in the anal and rectal area for a while (similar to muscle fatigue).
When I am not experiencing diarrhea, I find it somewhat difficult to pass stools, and they tend to come out in "multiple segments." The first bowel movement of the day is the hardest, and sometimes I sit on the toilet but cannot pass anything until the second or third attempt.
However, once I have completed the first bowel movement of the day, I will definitely have at least one more bowel movement later that day, and subsequent movements are usually thin, elongated soft stools.
This has almost become my regular bowel pattern.
I often worry that I might have colorectal cancer or a similar condition, but I underwent a 30-centimeter colonoscopy about six months ago, and the doctor reported no abnormalities.
The reason for only performing a 30-centimeter scope was that I was very anxious at the time, which made the procedure somewhat difficult for the doctor, who ultimately decided that the 30 centimeters would be sufficient and terminated the exam.
Additionally, I notice blood streaks on the toilet paper when wiping, but not in the stool itself (at least not visible to the naked eye).
This situation has persisted for nearly six months; it does not happen every time, but the likelihood of seeing blood is quite high.
Sometimes I go a day or two without seeing blood, but then it reappears.
Furthermore, I occasionally experience pain on both sides of my abdomen, approximately 5 to 8 centimeters from my navel.
I find it hard to describe, but it feels like a sharp pain or a sensation similar to an electric shock.
It is not very intense but is a persistent, dull ache that can last an entire afternoon.
This pain usually occurs more on the right side, but occasionally on the left, and the right-sided pain tends to last longer.
The pains do not occur simultaneously.
I am unsure how related this is to the previously described symptoms.
That's about it.
I am currently studying in the UK, which makes it very inconvenient for me to seek medical care, so I would greatly appreciate your response and any advice you can provide.
Thank you.
Lastly, I would like to add that I had the colonoscopy around May, and before I left the country, I visited the hospital again and mentioned the issues with bowel movements and blood when wiping.
The doctor performed a digital rectal exam and found no abnormalities.
This was around early October last year.
Finally, I did not experience the symptoms of soft stools, burning, and yellowish color mentioned in the first part while I was still in my home country.

Xiao Qi, 30~39 year old female. Ask Date: 2009/01/12

Dr. Zhang Siyuan reply Gastroenterology and Hepatology

To Xiao Qi: You have described your symptoms very clearly, which are evidently related to issues around the anal area.
An anoscopy should be the starting point for examination.
There may be inflammation and swelling in your anal tissue, which could be causing the frequent urge to defecate throughout the day.
If necessary, the physician may administer a local anesthetic before performing the anoscopy to check for conditions such as hemorrhoids, anal fissures, anal canal issues, or mucosal lesions.
If no abnormalities are found, a bowel preparation should be done to arrange for a colonoscopy for a more thorough examination.
From Dr.
Zhang Siyuan, Gastroenterology Department, Lesheng Rehabilitation Hospital.

Reply Date: 2009/01/12

More Info

Understanding gastrointestinal issues can be quite complex, especially when symptoms are multifaceted and persistent. Based on your detailed description, it seems you are experiencing a combination of gastrointestinal symptoms that may be indicative of several underlying conditions, including irritable bowel syndrome (IBS), potential food intolerances, or even inflammatory bowel disease (IBD), among others.
Firstly, the symptoms you describe—such as intermittent diarrhea with soft, clay-like stools, burning sensations during bowel movements, and the presence of blood on toilet paper—are concerning and warrant further investigation. While you mentioned that a colonoscopy showed no abnormalities, it's important to note that some conditions may not be easily detectable through standard procedures, especially if the examination is limited to only a portion of the colon.
The burning sensation you experience during bowel movements could be attributed to several factors. One possibility is anal fissures, which can occur due to hard stools or straining during bowel movements. These fissures can cause pain and bleeding, particularly when wiping. Additionally, the presence of soft stools and the sensation of incomplete evacuation may suggest that your bowel movements are not entirely regular, which is a common symptom of IBS. IBS is characterized by a range of symptoms, including abdominal pain, bloating, and changes in bowel habits, which can fluctuate between diarrhea and constipation.

Your mention of abdominal pain, particularly on the sides of your abdomen, could also be related to IBS or other gastrointestinal conditions. The pain you describe, which feels like a sharp or electric sensation, may be linked to intestinal spasms or inflammation. It’s also worth considering dietary factors that could be contributing to your symptoms. For example, certain foods can trigger IBS symptoms, including high-fat foods, dairy products, and spicy foods. Keeping a food diary may help identify any correlations between what you eat and your symptoms.

Given that you are currently studying in the UK and finding it challenging to seek medical care, I recommend a few strategies to manage your symptoms. Firstly, consider adjusting your diet to include more fiber, which can help regulate bowel movements. Foods rich in soluble fiber, such as oats, bananas, and apples, can be particularly beneficial. Additionally, staying well-hydrated is crucial, as it can help soften stools and ease bowel movements.

Moreover, it might be helpful to avoid known irritants such as caffeine, alcohol, and spicy foods, as these can exacerbate gastrointestinal symptoms. You may also want to explore the possibility of food intolerances, such as lactose or gluten intolerance, which can lead to similar symptoms. If you suspect this might be the case, consider eliminating these foods from your diet for a period to see if your symptoms improve.

Lastly, stress management techniques can also play a significant role in managing gastrointestinal symptoms. Practices such as mindfulness, yoga, or regular physical activity can help reduce stress and improve overall gut health.

In conclusion, while your symptoms may not indicate a severe underlying condition, they are certainly bothersome and warrant attention. If your symptoms persist or worsen, I strongly encourage you to seek a gastroenterologist's opinion, even if it requires some effort to find a suitable healthcare provider in your area. They may recommend further testing, such as a more comprehensive colonoscopy or imaging studies, to rule out any serious conditions. Remember, your health is paramount, and addressing these symptoms early can lead to better outcomes.

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