Bowel Issues: Concerns About Constipation and Colon Health

Bowel issues

Hello, doctor.
I have a few questions to ask you.

Q1: Two years ago, I would often feel the urge to have a bowel movement around two or three in the afternoon at school, but I don't like to use the restroom there.
Additionally, I have evening study sessions, so I would wait until I got home around nine o'clock to go.
However, my bowel movements have been smooth, and I haven't experienced constipation.
Could this lead to any health issues?
Q2: In April of this year, I had a fecal occult blood test (the kind where a sample is taken with a stick), and the results were normal.
However, I have noticed that the sides of my stool have grooves (most of the time, it is soft stool), as if something has cut through it.
This has been happening for about one to two years.
Q3: I tend to get nervous easily.
I was told in middle school that I have irritable bowel syndrome, and I often experience soft stools or diarrhea (without abdominal pain, but I feel the urge to go, resulting in soft stools).
After a bowel movement, my anus feels warm.
Last year, there was an instance where I couldn't fully evacuate, but when I wiped, there was blood.
I later had another bowel movement, and the stool was a cocoa color, but this only happened once.
Q4: What organ is located one centimeter to the left of the navel? Is it the sigmoid colon? Where is the sigmoid colon approximately located? I feel like I have touched something hard there, and I am worried it might be colon cancer.
I haven't had an increase in bowel movement frequency, but I still feel the urge to go without being able to fully evacuate.
In summary: I am concerned about the possibility of colon cancer because these issues occurred after I held in my bowel movements.
Thank you for taking the time to read this lengthy message, and I apologize for the inconvenience.

Guo Tongxue, 10~19 year old female. Ask Date: 2015/06/28

Dr. Ke Fangxu reply Surgery

1.
No, it's not a healthy habit to maintain this long-term, as it can easily lead to hemorrhoid swelling and bleeding.

2.
The likelihood of hemorrhoids causing changes in stool shape is higher.

3.
Hemorrhoidal bleeding.

4.
At 18 years old, instead of worrying about the possibility of colon cancer, it's better to focus on developing good bowel and dietary habits.
The chance of developing colon cancer at this age is extremely low; however, if one continues to maintain unusual bowel habits, health issues will eventually arise.
The location of one centimeter to the left of the navel may vary depending on individual body type; for thinner individuals, it could be the sigmoid colon, while for heavier individuals, it is likely just fat.

Reply Date: 2015/06/28

More Info

Understanding bowel issues, particularly concerns about constipation and colon health, can be quite complex, especially when symptoms like abdominal pain, changes in bowel habits, and the presence of blood in stool are involved. Based on your questions and the symptoms you've described, it seems you may be experiencing a combination of functional bowel disorders, possibly including Irritable Bowel Syndrome (IBS) and other gastrointestinal issues.

Q1: Timing and Regularity of Bowel Movements
It's not uncommon for individuals to develop a routine around their bowel movements, such as waiting until they are home to relieve themselves. While this behavior itself may not directly cause disease, consistently delaying bowel movements can lead to issues like constipation or fecal impaction over time. The colon can become accustomed to certain patterns, and if you frequently ignore the urge to go, it may lead to more significant problems down the line, such as chronic constipation or even hemorrhoids.

Q2: Stool Characteristics
The presence of grooves or indentations in your stool, particularly if it is mostly soft, can be indicative of several factors. This could be due to the stool passing through the intestines and being shaped by the colon's walls, which can occur in conditions like IBS. However, if you notice persistent changes in your stool shape, especially if accompanied by other symptoms like blood or significant discomfort, it is essential to consult a healthcare professional. While a normal fecal occult blood test is reassuring, ongoing changes in bowel habits warrant further investigation.

Q3: Anxiety and Bowel Health
Your history of anxiety and IBS can significantly impact your bowel health. Stress and anxiety are known to exacerbate gastrointestinal symptoms, leading to irregular bowel movements, including diarrhea and soft stools. The sensation of heat after a bowel movement could be related to increased blood flow or inflammation in the anal area, possibly due to hemorrhoids or anal fissures, especially if you have experienced blood during bowel movements. It’s crucial to address both the psychological and physical aspects of your symptoms.

Q4: Location of Organs
Regarding your question about the anatomy near your navel, the area to the left of the umbilicus (belly button) does correspond to the sigmoid colon, which is the last part of the colon before it connects to the rectum. If you feel a hard mass in this area, it could be stool that is impacted or a sign of other gastrointestinal issues. While the risk of colon cancer at a young age is low, any persistent changes in bowel habits, especially with concerning symptoms like a hard mass or blood, should be evaluated by a healthcare provider.

Conclusion
Given your symptoms and concerns, it is advisable to seek medical attention. A gastroenterologist can provide a thorough evaluation, which may include a physical examination, imaging studies, or even a colonoscopy if deemed necessary. They can help rule out serious conditions and provide a tailored treatment plan that may include dietary changes, stress management techniques, and possibly medications to help regulate your bowel movements.

In the meantime, maintaining a high-fiber diet, staying hydrated, and engaging in regular physical activity can support bowel health. Additionally, managing stress through relaxation techniques or therapy may also alleviate some of your gastrointestinal symptoms. Remember, early intervention is key to preventing more severe complications, so don’t hesitate to reach out to a healthcare professional.

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