Bowel Issues: When to Seek Medical Advice

Bowel issues

Hello Dr.
Ko: I am a working professional with normal bowel habits.
Occasionally, after bowel movements, I notice blood on the toilet paper, which I assumed was due to anal fissures and did not pay much attention to it.
Additionally, I have gastrointestinal issues, experiencing bloating and loss of appetite every couple of months.
Recently, my father was diagnosed with colon cancer, which has prompted me to pay closer attention to my own health.
I have noticed pink spots on the surface of my stool and have also seen black streaks mixed in with my stool, although the overall color is mud yellow.
Is this normal? Furthermore, I sometimes experience pain in my lower abdomen, but it doesn’t last long.
After eating, I also feel discomfort in my lower abdomen, which goes away after successfully passing gas.
Given these symptoms, would you recommend a colonoscopy, or would a stool occult blood test suffice? Thank you, doctor.

wing, 20~29 year old female. Ask Date: 2016/01/23

Dr. Ke Fangxu reply Surgery

The likelihood of developing colorectal cancer at the age of 24 is not zero, but generally, it is very low.
Based on your description, the probability of irritable bowel syndrome (IBS) seems higher.
It is recommended to start with a light diet and maintain a good lifestyle.
If symptoms persist without improvement, you may consult a physician for medication.
If there is still no improvement or if you are very concerned, a colonoscopy can be arranged.

Reply Date: 2016/01/23

More Info

When it comes to bowel issues, understanding when to seek medical advice is crucial for maintaining overall health, especially in light of family medical history, such as your father's recent diagnosis of colon cancer. Your symptoms, including blood on toilet paper, changes in stool color, and abdominal discomfort, warrant careful consideration.

Firstly, the presence of blood in your stool or on toilet paper can be concerning. While it may be attributed to common issues like hemorrhoids or anal fissures, it can also indicate more serious conditions, including colorectal cancer, especially given your family history. The pink spots and black streaks in your stool are particularly noteworthy. Pink spots could suggest the presence of fresh blood, while black streaks might indicate digested blood, which can arise from bleeding higher up in the gastrointestinal tract.

Your symptoms of bloating and loss of appetite, along with the abdominal discomfort that resolves after passing gas, suggest that there may be underlying gastrointestinal issues that need to be addressed. These could range from benign conditions like irritable bowel syndrome (IBS) to more serious concerns such as inflammatory bowel disease (IBD) or even malignancies.

Given your father's diagnosis of colon cancer, it is essential to take your symptoms seriously. The recommendation for a colonoscopy is particularly pertinent in your case. A colonoscopy allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities such as polyps, tumors, or signs of inflammation. It is generally advised that individuals with a family history of colorectal cancer begin screening at an earlier age than the standard recommendation of 45 years. Depending on your age and risk factors, your doctor may suggest a colonoscopy sooner than usual.

In addition to a colonoscopy, a stool occult blood test (FOBT) can be a useful screening tool. This test checks for hidden blood in the stool, which can be an early indicator of colorectal cancer or other gastrointestinal issues. However, it is important to note that while FOBT can be a helpful screening tool, it does not replace the need for a colonoscopy, especially given your symptoms and family history.

In summary, based on your symptoms and family history, it is advisable to consult a healthcare professional for a thorough evaluation. A colonoscopy would likely be the most appropriate next step to rule out any serious conditions, including colorectal cancer. Additionally, discussing your symptoms in detail with your doctor will help them determine the best course of action, which may include dietary changes, medication, or further testing.

In conclusion, do not hesitate to seek medical advice. Early detection and intervention are key in managing bowel issues and ensuring your health. Your symptoms are significant enough to warrant further investigation, and being proactive about your health is the best approach.

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