Common Gastrointestinal Concerns: When to Seek Medical Attention

Q: Common Gastrointestinal Concerns: When to Seek Medical Attention

Hello： In response to your question, if you have already undergone a colonoscopy and a barium study, both of which showed no abnormalities, then performing a fecal occult blood test would not be meaningful. <br>If the test result is negative, that is naturally good; if it is posi

I have a few questions regarding intestinal issues?

Hello, doctor.
I have a few questions to ask:
1.
About a year ago, I experienced abdominal pain and noticed blood in my stool.
I underwent a colonoscopy at Medical Center A (approximately 60 cm), but I had to stop due to pain.
I then had a barium enema, which showed normal results.
Two months ago, I had blood when wiping and switched to Medical Center B for another colonoscopy (which was also incomplete).
I had another barium enema, which again showed no abnormalities, but the doctor mentioned I have mild internal hemorrhoids.
Now, I suspect that hard stools have caused a drop of fresh blood at the tip of my stool.
Do I need to undergo a fecal occult blood test again?
2.
A few days ago, after a bowel movement, I experienced anal pain and a feeling of tightness.
Now, my stools have been flat, and there are grooves present.
Should I address this immediately or just observe for now? Thank you.

fan, 20~29 year old female. Ask Date: 2010/08/05

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, if you have already undergone a colonoscopy and a barium study, both of which showed no abnormalities, then performing a fecal occult blood test would not be meaningful.
If the test result is negative, that is naturally good; if it is positive, would you need to undergo another colonoscopy or barium study? If these advanced examinations have been completed and no abnormalities were found, there is no need for further concern.
The symptoms mentioned should be confirmed as being caused by hemorrhoids, which are not severe and do not require special examinations or treatment.

Reply Date: 2010/08/05

More Info

When it comes to gastrointestinal concerns, particularly those involving symptoms like abdominal pain, blood in stool, and changes in bowel habits, it is essential to approach the situation with caution and awareness. Based on your description, it seems you have been experiencing a range of symptoms that warrant further evaluation and possibly immediate medical attention.

1. Blood in Stool and Abdominal Pain: The presence of blood in your stool, especially if it is bright red, can be indicative of several conditions, including hemorrhoids, anal fissures, or more serious issues like diverticular disease or colorectal cancer. Given that you have undergone colonoscopy and barium studies that returned normal results, it is reassuring, but the fact that you are still experiencing blood in your stool suggests that further investigation may be necessary. Since you mentioned having a history of hemorrhoids, it is possible that the blood is related to that condition. However, the appearance of hard stools leading to bleeding could also indicate anal fissures, which are painful and can cause significant discomfort.

2. Flat and Grooved Stools: The change in the shape of your stools to flat or ribbon-like can be concerning. While variations in stool shape can occur due to dietary changes or hydration levels, persistent changes, especially those that include grooves or a flat appearance, should not be ignored. These changes can sometimes indicate a narrowing of the bowel, which could be due to conditions such as strictures or tumors.
3. Need for Further Testing: Given your history and current symptoms, it would be prudent to consider a fecal occult blood test (FOBT) to check for hidden blood in your stool. This test can help determine if there is ongoing bleeding that may not be visible to the naked eye. Additionally, if your symptoms persist or worsen, a repeat colonoscopy may be warranted, especially if you continue to experience abdominal pain or changes in bowel habits.

4. When to Seek Immediate Attention: You should seek immediate medical attention if you experience severe abdominal pain, significant changes in bowel habits, persistent blood in your stool, or any signs of anemia (such as fatigue, weakness, or dizziness). These could be signs of a more serious underlying condition that requires prompt intervention.

5. Management of Symptoms: In the meantime, managing your diet can help alleviate some symptoms. Increasing fiber intake, staying hydrated, and avoiding straining during bowel movements can help prevent hard stools and reduce the risk of hemorrhoids and fissures. Over-the-counter stool softeners may also be beneficial.

In conclusion, while some of your symptoms may be related to benign conditions like hemorrhoids, the persistence of blood in your stool and changes in stool shape warrant further investigation. It is advisable to consult with a gastroenterologist who can provide a thorough evaluation and recommend appropriate tests or treatments based on your specific situation. Remember, it is always better to err on the side of caution when it comes to gastrointestinal health.

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