Colonic Health: Concerns About Symptoms and Diagnosis

Gastrointestinal issues

Hello, doctor.
May I ask where the sigmoid colon is located? About three centimeters to the left of my belly button, when I press down with my fingernail, I feel a hard lump (it's been there for about two years).
I am quite thin, 178 cm and 52.6 kg, and I have difficulty gaining weight.
Two years ago, I often felt 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, and with evening study sessions, I would wait until I got home around nine o'clock.
However, my bowel movements have been smooth, and I haven't experienced constipation.
I'm wondering if this could lead to any diseases.
In April of this year, I had a stool test for occult blood (the kind with a stick), and the results were normal.
However, my stool often has grooves on the sides (mostly soft stool), as if something has cut through it, and this has been ongoing for about one to two years.
It also seems to be thinner.
I tend to get nervous easily; I was told I had irritable bowel syndrome in middle school, and I often have soft stools or diarrhea (without abdominal pain, but it feels like diarrhea, resulting in soft stools).
After a bowel movement, my anus feels warm.
Last year, there was an incident where I couldn't fully evacuate, but when I wiped, there was blood.
I went again, and the stool color was like cocoa, but that only happened once.
In summary, I'm worried about colon cancer because this occurred after holding in my bowel movement, and I'm only 18 years old.
Thank you for reading all of this, and I apologize for the lengthy message.

Guo Tongxue, 10~19 year old female. Ask Date: 2015/09/06

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, it is recommended to consult a gastroenterologist or a colorectal surgeon.
If it were cancer, it would not take this long without other symptoms.
Sincerely, Dr.
Chen Chi-Feng, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/09/06

More Info

Understanding colonic health is crucial, especially when experiencing symptoms like changes in bowel habits, abdominal discomfort, or rectal bleeding. Your concerns about the sigmoid colon and the symptoms you've described warrant careful consideration and possibly further investigation.

The sigmoid colon is located in the lower left quadrant of the abdomen, just before the rectum. It plays a significant role in the digestive process, particularly in the storage of fecal matter before it is expelled. The hard lump you mentioned, located about three centimeters to the left of your belly button, could be a variety of things, including muscle tension, a benign growth, or even a lymph node. However, given your history of gastrointestinal symptoms, it’s essential to have this evaluated by a healthcare professional.

Your experience with bowel movements, including the presence of grooves in your stool and occasional rectal bleeding, is concerning. The grooves could indicate that the stool is passing through a narrowed area of the colon, which can occur due to various reasons, including inflammation or the presence of polyps. The rectal bleeding, especially if it is bright red, could be due to hemorrhoids or anal fissures, but it is essential to rule out more serious conditions, including colorectal cancer, even at a young age.

While it is less common for someone your age to develop colorectal cancer, it is not impossible, especially if there are risk factors present, such as a family history of colorectal cancer or inflammatory bowel disease. The fact that you have experienced changes in your bowel habits, such as alternating between soft stools and diarrhea, along with the history of anxiety and stress, suggests that you may be dealing with a functional bowel disorder, such as irritable bowel syndrome (IBS). IBS can cause symptoms like abdominal pain, bloating, and changes in bowel habits, but it does not typically cause rectal bleeding.

The normal fecal occult blood test you had done is reassuring, as it suggests that there is no significant bleeding in the gastrointestinal tract at that time. However, the presence of blood during bowel movements, especially if it occurs again, should be evaluated further. It is advisable to consult with a gastroenterologist who can perform a thorough examination, which may include a colonoscopy, to visualize the colon and rectum directly and take biopsies if necessary.

In summary, while your symptoms may be related to IBS or another benign condition, the presence of rectal bleeding and changes in stool shape should not be ignored. It is essential to have a comprehensive evaluation to rule out any serious conditions. Early detection and diagnosis are key to managing any potential issues effectively. Please consider scheduling an appointment with a healthcare provider to discuss your symptoms in detail and explore the need for further diagnostic testing. Your health is important, and addressing these concerns proactively is the best approach.

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