Chronic Constipation: Symptoms, Causes, and When to Seek Help

Q: Chronic Constipation: Symptoms, Causes, and When to Seek Help

Hello： The symptoms you listed could be associated with various conditions, including Functional Gastrointestinal Disorders, Irritable Bowel Syndrome, Inflammatory Bowel Disease (such as Ulcerative Colitis or Crohn's Disease), or even colorectal cancer. <br>As for whether further

Bowel issues

Hello Doctor: I would like to ask about my constipation symptoms, which have persisted for almost two years.
I usually drink plenty of water, eat fruits and vegetables, take probiotics, and exercise, but I am still troubled by constipation.
I often have bowel movements every four to five days, but the stools are not the typical hard and dry stools associated with constipation; instead, they are small, soft, and thin.
I also frequently experience diarrhea after being constipated for several days, and sometimes I have diarrhea for several consecutive days after a period of constipation.
Recently, I have noticed blood in my stool as well.

1.
What diseases could these symptoms possibly indicate? (Hemorrhoids? Colonic dysfunction? Colorectal cancer?)
2.
Is it necessary to undergo a colonoscopy? Thank you.

Ms. S, 20~29 year old female. Ask Date: 2015/03/10

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: The symptoms you listed could be associated with various conditions, including Functional Gastrointestinal Disorders, Irritable Bowel Syndrome, Inflammatory Bowel Disease (such as Ulcerative Colitis or Crohn's Disease), or even colorectal cancer.
As for whether further colonoscopy is necessary, I recommend consulting a healthcare professional to get their advice.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun

Reply Date: 2015/03/10

More Info

Chronic constipation can be a frustrating and uncomfortable condition, and it sounds like you've been dealing with it for quite some time. Your symptoms, including infrequent bowel movements, the nature of your stools, and the presence of blood, warrant careful consideration and possibly further investigation.
1. Possible Conditions: The symptoms you've described could be indicative of several gastrointestinal issues. Here are a few possibilities:
- Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like constipation, diarrhea, and abdominal discomfort. The alternating pattern of constipation and diarrhea you mentioned could fit this diagnosis.

- Functional Constipation: This is a diagnosis often given when constipation is present without any identifiable medical cause. It can be related to dietary habits, lifestyle, or even psychological factors.

- Hemorrhoids: The presence of blood in your stool could be due to hemorrhoids, which are swollen veins in the lower rectum and anus that can bleed, especially if straining occurs during bowel movements.

- Colonic Obstruction or Stricture: A narrowing of the colon can lead to constipation and changes in stool consistency. This can be caused by various factors, including previous surgeries, inflammatory bowel disease, or tumors.

- Colon Cancer: While less common, especially in younger individuals, any change in bowel habits, especially with the presence of blood, should be taken seriously. It's essential to rule out this possibility.

2. Need for Colonoscopy: Given your symptoms, particularly the blood in your stool and the significant changes in your bowel habits, a colonoscopy may be warranted. A colonoscopy allows for direct visualization of the colon and can help identify any abnormalities, such as polyps, tumors, or signs of inflammatory bowel disease. It is generally recommended for individuals over 50 or younger individuals with concerning symptoms, such as yours.

In addition to a colonoscopy, your healthcare provider may recommend other tests, such as blood tests or imaging studies, to further evaluate your gastrointestinal health.
Management Strategies: While you are already taking steps to manage your constipation through hydration, fiber intake, probiotics, and exercise, it may be beneficial to consult with a gastroenterologist. They can provide tailored advice and may suggest additional treatments, such as:
- Medications: Laxatives or medications specifically designed to treat chronic constipation may be recommended.

- Dietary Adjustments: A dietitian can help you optimize your fiber intake and ensure you are consuming the right types of fiber (soluble vs. insoluble) to promote regular bowel movements.

- Behavioral Therapy: Sometimes, addressing lifestyle factors, including stress management and bowel habits, can significantly improve symptoms.

In conclusion, your symptoms are concerning enough to warrant further evaluation. It is essential to seek medical attention promptly to rule out serious conditions and to receive appropriate treatment for your chronic constipation. Remember, early intervention can lead to better outcomes and improved quality of life.

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