Screening for Colorectal Issues: Symptoms and Recommended Tests

Screening for Colorectal Pathologies

Hello Dr.
Chen, my symptoms are that I have bowel movements once or twice every one to two days, but sometimes I have difficulty passing stool, and I notice a small amount of blood on the toilet paper when I wipe.
Last month, there was also bleeding.
Occasionally, the color of my stool is brownish.
What should I pay attention to or what kind of tests should I undergo? Thank you.

james, 30~39 year old female. Ask Date: 2009/09/12

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, the most common cause of rectal bleeding is hemorrhoids.
The blood is usually bright red and may disperse in water.
If a colonoscopy has already been performed and no issues were found, it is advisable to observe for a few days, drink plenty of water, eat fruits, and reduce the intake of fried and grilled foods, which should help improve the condition.
If there is a family history of colorectal cancer or if symptoms persist, a colonoscopy should be considered.
Wishing you good health.
Response from Dr.
Liu Li-Kuang, Taoyuan Hospital, Department of Health.

Reply Date: 2009/09/12

More Info

When it comes to screening for colorectal issues, your symptoms warrant careful consideration and prompt medical evaluation. The symptoms you've described—having bowel movements every one to two days, occasional difficulty passing stool, the presence of blood on toilet paper, and changes in stool color—can be indicative of several conditions, some of which may require immediate attention.

Symptoms to Watch For
1. Blood in Stool: The presence of blood, whether visible on toilet paper or mixed with stool, is a significant symptom that should not be ignored. It can be a sign of hemorrhoids, anal fissures, or more serious conditions such as diverticulosis, polyps, or colorectal cancer.

2. Changes in Bowel Habits: While having bowel movements every one to two days can be normal for some individuals, any significant change in your usual pattern, especially if accompanied by discomfort or pain, should be evaluated.

3. Stool Color: The color of your stool can provide important clues about your digestive health. Coffee-colored stool may indicate bleeding in the upper gastrointestinal tract, while red or maroon stool often suggests bleeding from the lower gastrointestinal tract.

Recommended Tests
Given your symptoms, the following tests may be recommended by your healthcare provider:
1. Digital Rectal Exam (DRE): This is a simple and quick examination where the doctor checks for abnormalities in the rectum and lower colon.

2. Fecal Occult Blood Test (FOBT): This test checks for hidden blood in the stool, which can be an early sign of colorectal cancer or other gastrointestinal issues.

3. Colonoscopy: This is a more comprehensive test that allows the doctor to view the entire colon and rectum. It can help identify polyps, tumors, and areas of inflammation. If necessary, biopsies can be taken during this procedure.

4. Flexible Sigmoidoscopy: Similar to a colonoscopy but focuses on the lower part of the colon. It may be used if your symptoms are localized to that area.

5. Imaging Tests: In some cases, imaging studies such as a CT scan may be used to get a better view of the abdominal organs and detect any abnormalities.

When to Seek Immediate Care
You should seek immediate medical attention if you experience:
- Significant or persistent abdominal pain
- Severe rectal bleeding (more than a small amount)
- Unexplained weight loss
- Changes in appetite
- Symptoms of anemia (fatigue, weakness, pale skin)

Conclusion
It's crucial to address your symptoms with a healthcare professional who can conduct a thorough evaluation and recommend appropriate tests. Early detection and intervention can significantly improve outcomes for colorectal issues. Do not hesitate to reach out to your doctor, especially given the presence of blood and changes in your bowel habits. They will guide you through the necessary steps to ensure your health and well-being.

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