Gastrointestinal Issues: When to Seek Medical Advice

Regarding the gastrointestinal tract..?

I have been suffering from abdominal pain recently.
Around mid-September, I developed acute gastroenteritis, experienced stomach cramps, and had one episode of diarrhea, followed by a fever.
After some time, I felt better and returned to my usual diet, but now I sometimes feel nauseous, and my lower abdomen, below the navel, feels very bloated and painful.
I often pass gas, and I feel somewhat relieved after doing so or having a bowel movement.
My stools vary in shape; sometimes they are formed, and other times they are loose, but I haven't had diarrhea.
Occasionally, I notice small dark remnants on the toilet paper after wiping, just one or two spots.
Once, after a bowel movement, I saw something dark red and dirty on my hand (I'm not sure if it was blood, and I don't recall touching anything during the bowel movement; it wouldn't wash off easily, and I had to scrub it off with toilet paper).
I haven't seen that again.

I have visited a gastroenterologist several times and consulted different doctors.
However, since I had a colonoscopy at the end of July last year, which revealed hemorrhoids but otherwise healthy results, the doctors have mostly told me not to worry and that I only need a colonoscopy every five years.
They suggested that I might have irritable bowel syndrome, but I am still quite anxious.
Should I really not be concerned? I've also heard that frequent colon cleansing is not good for the colon.
My gastrointestinal condition is poor, and I'm hesitant to undergo another colonoscopy.

I am particularly troubled by the dark red and dirty substance because I've heard that blood from colon cancer can appear this way.
However, I had a colonoscopy last year.
For context, no one in my family has a history of colon cancer, and I have gastroesophageal reflux disease.
I regularly take multivitamins and have daily bowel movements.
I tend to be a very anxious person.
I apologize for asking so many questions, doctor.

Tuo Er, 20~29 year old female. Ask Date: 2010/10/06

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, post-acute gastroenteritis can sometimes lead to irritable bowel syndrome.
It is recommended to maintain a light diet for a period of time, avoiding oily, dairy, and irritating spicy foods.
Wishing you good health.
Dr.
Chi-Feng Chen, Taoyuan General Hospital, Department of Health.

Reply Date: 2010/10/06

More Info

It sounds like you are experiencing a complex set of gastrointestinal symptoms that can be quite distressing. Based on your description, it seems you have gone through a series of evaluations and treatments, but you are still feeling uncertain about your condition. Let's break down your concerns and provide some clarity.

Firstly, your history of acute gastroenteritis in September, followed by ongoing symptoms such as abdominal pain, bloating, and changes in bowel habits, suggests that you may be dealing with a functional gastrointestinal disorder, possibly irritable bowel syndrome (IBS). IBS is characterized by symptoms like abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or both) without any identifiable structural abnormalities. The fact that you have seen multiple gastroenterologists and had a colonoscopy that revealed only hemorrhoids is reassuring, as it indicates that serious conditions like colorectal cancer have been ruled out.

The presence of dark or red stains on toilet paper or your hands can understandably cause concern. However, if these occurrences are infrequent and you have not seen any significant blood in your stool, it is likely related to hemorrhoids or minor anal fissures rather than a sign of colorectal cancer. Hemorrhoids can cause bleeding, especially during bowel movements, and can also lead to discomfort and changes in bowel habits. If the bleeding persists or worsens, it would be prudent to follow up with your healthcare provider.

Regarding your gastrointestinal symptoms, the feeling of bloating and the need to pass gas for relief are common in IBS. Stress and anxiety can exacerbate these symptoms, and since you mentioned being a nervous person, it may be beneficial to explore stress management techniques such as mindfulness, yoga, or cognitive behavioral therapy. Dietary modifications can also play a significant role in managing IBS. Keeping a food diary to identify potential triggers (such as dairy, gluten, or high-fat foods) can be helpful. Additionally, a diet high in fiber may improve bowel regularity, but it should be introduced gradually to avoid exacerbating bloating.

You mentioned concerns about frequent colon cleansing and its effects on your colon health. While occasional cleansing may not be harmful, frequent use can disrupt the natural flora of the gut and lead to dependency on laxatives for bowel movements. It is essential to maintain a healthy balance and focus on a diet rich in whole foods, fruits, vegetables, and adequate hydration.

As for your concern about needing another colonoscopy, the general recommendation is to follow up with your gastroenterologist based on your symptoms and risk factors. Since you had a normal colonoscopy last year and no family history of colorectal cancer, the recommendation of every five years is standard for average-risk individuals. However, if your symptoms persist or worsen, discussing the need for further evaluation with your doctor is warranted.

In summary, while your symptoms are concerning, they are more likely related to functional gastrointestinal issues rather than a serious underlying condition. Continue to communicate openly with your healthcare providers, and don't hesitate to seek a second opinion if you feel your concerns are not being adequately addressed. Managing stress, dietary adjustments, and regular follow-ups with your gastroenterologist will be key in navigating your gastrointestinal health.

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