Abnormal Bowel Movements: When to Seek Further Testing

Abnormal bowel movements?

In May 2009, a colonoscopy was performed and the results were normal.
In October 2012, a polyp was found in the sigmoid colon.
In the same month, due to occasional blood-tinged mucus in the stool, another colonoscopy was performed, and the results were normal (both the colon and rectum were examined that year).
In October 2013, due to frequent diarrhea, sometimes accompanied by mucus or blood-tinged mucus, another colonoscopy was conducted, and the results were normal.
I still experience frequent diarrhea, often with mucus.
Is it necessary to perform such invasive examinations frequently? After examining my sigmoid colon polyp, the doctor told me not to worry for ten years.
Should I still undergo a colonoscopy every two years? My stools are often loose or unformed, sometimes falling apart, and I occasionally feel like I haven't completely emptied my bowels, with some vegetable remnants present.
What should I do?

cindy, 40~49 year old female. Ask Date: 2015/05/03

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, regarding the polyps, it is recommended to just monitor them.
Since you are 45 years old, you can start receiving fecal tests for colorectal cancer every two years starting at age 50.
The diarrhea with mucus is likely a digestive function issue; it is advisable to reduce oil and dairy intake, and taking digestive enzymes if necessary should help improve the condition.
Wishing you peace and health.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/05/03

More Info

When it comes to understanding abnormal bowel movements and determining when to seek further testing, it is essential to consider a variety of factors, including the nature of the symptoms, the results of previous examinations, and any changes in your health status.

Based on your history of undergoing colonoscopies, it appears that you have had a thorough evaluation of your gastrointestinal tract. The fact that your previous colonoscopies have returned normal results, despite the presence of a polyp in the sigmoid colon, is reassuring. Polyps are common and can vary in significance; many are benign, but they can sometimes develop into cancer over time. Your doctor’s advice to not worry for ten years suggests that they believe the polyp is not currently a cause for concern.

However, the ongoing symptoms you describe—frequent diarrhea, mucus in your stool, and occasional blood—are noteworthy. The presence of mucus and blood can indicate several conditions, including infections, inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS). It is important to differentiate between these conditions, as they may require different management strategies.

1. Frequency of Colonoscopies: Given your history, the recommendation for a colonoscopy every two years may be excessive unless there are new symptoms or changes in your health. Typically, if you have a history of polyps, follow-up colonoscopies are recommended at intervals based on the type and number of polyps found. Since your last colonoscopy was normal, and if your doctor has assessed your risk as low, you might not need to repeat the procedure so frequently. It’s crucial to have a discussion with your healthcare provider about the appropriate schedule based on your individual risk factors.

2. Nature of Symptoms: The symptoms you are experiencing—loose stools, a feeling of incomplete evacuation, and the presence of food particles—could be indicative of several gastrointestinal issues. Conditions such as IBS can cause changes in bowel habits and may lead to mucus production. If you notice a significant change in your bowel habits, especially if accompanied by weight loss, persistent abdominal pain, or changes in appetite, it would be prudent to seek further evaluation.

3. When to Seek Further Testing: You should consider seeking further testing if:
- Your symptoms persist or worsen.

- You experience significant weight loss.

- You have severe abdominal pain.

- There is a change in the character of your stool (e.g., more blood, more mucus).

- You develop new symptoms such as fever or night sweats.

4. Lifestyle and Dietary Considerations: Sometimes, dietary changes can significantly impact bowel habits. Keeping a food diary to track what you eat and any corresponding symptoms may help identify potential triggers. Additionally, ensuring adequate hydration and a balanced diet rich in fiber can help regulate bowel movements.

5. Consultation with a Specialist: If your symptoms continue despite normal colonoscopy results, it may be beneficial to consult a gastroenterologist. They can provide further insight and may recommend additional tests, such as stool studies, imaging studies, or even a trial of dietary changes or medications to manage your symptoms.

In conclusion, while your previous colonoscopy results are reassuring, the persistence of your symptoms warrants further attention. Regular communication with your healthcare provider is essential to ensure that any changes in your condition are appropriately addressed. If you have concerns about the frequency of invasive procedures or the nature of your symptoms, do not hesitate to discuss these with your doctor, who can provide personalized recommendations based on your medical history and current health status.

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