Changes in Stool Shape: When to Seek Medical Advice

Stool shape

Recently, my stools have been thinner than before (about 2 to 2.5 cm in diameter, irregular shape, sometimes thicker at the front and thinner at the back).
When I have a bowel movement, it often comes out along with gas.
At night, I sometimes experience mild abdominal pain, and the frequency of passing gas has increased.
Occasionally, I have diarrhea with food remnants.
Both my stools and gas have little to no odor.
There is no blood or mucus in my stools, and they come out easily.
I am currently in my senior year of high school and am quite worried.
I had a colonoscopy (full-length) in August this year, and the doctor said everything was fine, possibly due to irritable bowel syndrome, but I am still concerned.
I rarely drink beverages and often eat vegetables and fruits (sometimes I drink yogurt).
Should I see a doctor again? Also, how thin would stools be if caused by polyps or tumors in the colon?

Li Tongxue, 10~19 year old female. Ask Date: 2015/11/02

Dr. Chen Shidian reply Gastroenterology and Hepatology

Dear Student Li,
Your diagnosis is clear; you have Irritable Bowel Syndrome (IBS).
It is advisable to adjust your diet (reduce fats and dairy), and if necessary, take digestive aids.
Colorectal polyps typically do not present symptoms.
A large colorectal tumor may cause obstruction, leading to thinner stools, blood in the stool, abdominal pain, constipation, and weight loss.
Changhua Hospital cares about your health.
Sincerely,
Chen Shidian

Reply Date: 2015/11/02

More Info

When it comes to changes in stool shape, particularly when you notice that your stools have become thinner or irregular, it is essential to pay attention to these changes and consider seeking medical advice. In your case, you mentioned that your stools have become approximately 2 to 2.5 cm in diameter and that they are irregular in shape, sometimes being thicker at one end and thinner at the other. Additionally, you noted experiencing mild abdominal pain, increased flatulence, occasional diarrhea with food remnants, and that your stools and gas have little odor. Importantly, you have not observed any blood or mucus in your stools.

Given your history of undergoing a colonoscopy in August, which reportedly showed no issues, it is understandable that you might feel reassured. However, the symptoms you are experiencing warrant further evaluation. Changes in stool shape can be indicative of various gastrointestinal conditions, including irritable bowel syndrome (IBS), which your doctor suggested might be the case. IBS can lead to symptoms such as abdominal pain, changes in bowel habits, and discomfort, but it is crucial to rule out more serious conditions.

Regarding your question about whether polyps or tumors in the colon can cause changes in stool shape, it is important to note that while polyps can lead to changes in bowel habits, they typically do not cause a significant change in stool diameter unless they are large or obstructive. If a tumor is present, it may lead to a narrowing of the stool, which can result in thinner stools. However, the degree of narrowing can vary widely depending on the size and location of the tumor.

In your case, since you have already had a colonoscopy, the likelihood of having a significant obstruction or tumor is lower, especially if the procedure was thorough and no abnormalities were found. However, if you continue to experience changes in your bowel habits, such as persistent thin stools, abdominal pain, or any new symptoms, it is advisable to consult with your healthcare provider again. They may recommend further testing or monitoring to ensure that there are no underlying issues that need to be addressed.

Additionally, maintaining a healthy diet rich in fiber, as you mentioned you do, is beneficial for digestive health. However, if you are experiencing symptoms like diarrhea or irregular stools, it might be helpful to keep a food diary to identify any potential triggers or patterns related to your diet.

In summary, while your previous colonoscopy results are reassuring, the ongoing changes in your stool shape and associated symptoms should not be ignored. It is advisable to follow up with your healthcare provider to discuss your concerns and possibly undergo further evaluation if necessary. Early detection and intervention are key in managing gastrointestinal health, and your proactive approach to your health is commendable.

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