Persistent Diarrhea and Anal Pain: Should I Get a Colonoscopy?

For two weeks, the stools have been loose, and there is anal pain with a constant urge to defecate?

Hello, doctor.
I am a freshman at Chung Yuan University.
I have irritable bowel syndrome and experienced diarrhea for a month when the semester started.
However, it returned to normal afterward.
Recently, for the past two weeks, I have been experiencing diarrhea again, or my stools are very thin and not solid.
When I pass stool, it feels hot and spicy, even though I haven't eaten anything spicy.
The color is a bit dark brown, and I also experience pain and discomfort in my anus.
After having a bowel movement, I still feel the urge to go again.
I do not have abdominal pain.
Do you think I need to undergo a colonoscopy? Previously, when I visited a clinic, they did not perform an ultrasound.

Ang, 10~19 year old female. Ask Date: 2015/11/25

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, it is recommended to visit a gastroenterologist for stool and colon examinations.
A diagnosis of irritable bowel syndrome (IBS) can only be made if the results are normal.
An ultrasound examination is not very helpful.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/11/25

More Info

Based on your symptoms and medical history, it is advisable to consider a colonoscopy. Persistent diarrhea, especially when accompanied by anal pain and changes in stool consistency, can indicate underlying gastrointestinal issues that warrant further investigation. While you have a history of irritable bowel syndrome (IBS), the recurrence of diarrhea and the presence of anal pain suggest that a more thorough examination may be necessary to rule out other potential causes.

The symptoms you describe, such as the frequent urge to defecate, the sensation of burning during bowel movements, and the dark brown color of your stools, could be indicative of several conditions. These may include inflammatory bowel disease (IBD), infections, or even dietary intolerances. Although you mentioned that you have not consumed spicy foods, it is important to consider other dietary factors that could be contributing to your symptoms.
A colonoscopy allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities such as inflammation, polyps, or lesions. Additionally, biopsies can be taken during the procedure to further analyze any suspicious areas. Given your symptoms and the fact that they have persisted for two weeks, a colonoscopy could provide valuable insights into your condition.

It is also important to note that while IBS can cause symptoms similar to what you are experiencing, the presence of anal pain and changes in stool characteristics may suggest that there is more going on than just IBS. The burning sensation you feel during bowel movements could be due to irritation or inflammation in the anal region, which may require treatment.
In terms of your previous medical evaluations, if you have not had an ultrasound or other imaging studies, it may be beneficial to discuss this with your healthcare provider. They may recommend additional tests to rule out other conditions that could be contributing to your symptoms.

In summary, given your persistent diarrhea, anal pain, and the changes in your bowel habits, it is advisable to pursue a colonoscopy. This procedure can help identify any underlying issues and guide appropriate treatment. Additionally, maintaining open communication with your healthcare provider about your symptoms and any concerns you have is crucial in managing your gastrointestinal health. If you feel that your current provider is not addressing your concerns adequately, seeking a second opinion may also be a wise choice.

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