Change in stool

I am a 49 year old (perimenopausal) female.  For about a month and a half, I've been experiencing stomach cramps that are not necessarily related to eating or the urge to use the bathroom.  I occasionally get them in the middle of the night.  I've noticed that my stools are more "flat" in shape, and the softer ones give the appearance as if they've been "pressed" through something.  Some of the really soft stools even look "rectangular".  Could internal or external hemorrhoids cause the change in shape?  I also have a vague sensation in my left upper abdomen near my last rib that comes and goes---more noticeable the last month or so.  My FOBT of a month ago was negative.  I don't have diarrhea or bleeding.  I had a colonoscopy 7 years ago (the prep was inadequate, so nothing was really determined at that time).  I'm on Prilosec once a day for gastric reflux.   Thanks, in advance, for addressing this issue.

[Kevin Pho, MD]

Any change in the shape or caliber of the stool should lead to further investigation.

A colon mass, polyp or cancer can all lead to these symptoms.

I am not aware of hemorrhoids leading to change in stool shape.

I would consider repeating the colonoscopy for a comprehensive evaluation of polyps or colonic masses.

This option can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[Anne B]

I forgot to mention that I also have a "small" hiatal hernia.  Could this be a part of the upper left abdominal discomfort?  Thanks.

[Stacy4450]

I had the same problem right after Christmas. This has happened at the same time of year for the past 3 years. We eat alot of foods, cookies, pies that all contain nuts durig Christmas. So I thought I might have diverticulitus. My PCP said I was too young...34. It was a terible pain under my left rib w/ lower back pain. Very painful to the touch. They sent me for a CT Scan which came back normal. An pelvic ultrasound ... normal. Lab work was perfect. I was beginning to feel crazy. My PCP then sent me to a GI  that said I was right and put me on a very potent antibiotic and strict diet.  No nuts, corn, salads, popcorn anything that does not digest well. So we waited for 5 weeks, (because the bowel can rupture especially when irritated)  and I went for a colonoscopy and EGT yesterday. Guess what... I have diverticulitus throughout my colon. and a hyatal hernia.  If I were you I would change my diet and immediatly go to a GI. Your bowel can rupture and be a serious threat to your life. My brother had to have emergency surgery, about 5 years ago, because he waited to long and did not know how serious his situation was. He was in ICU and we almost lost him because of it.  I hope this information is helpful.

[Anne B]

Thanks for your comments, Stacy.  I have an appointment with a GI Doc in a couple weeks.  My biggest concern is the change in shape of my stool.  Did you have that symptom with your diverticulitis?  I understand that a low-roughage, high fiber diet is one of the recommended treatments for diverticulitis.  Metamucil and stool softeners are also often prescribed.  I don't think there's a known cure for diverticulitis at this time, but changes in diet can certainly help!  Thanks again, for your dietary suggestions, and good luck to you!

[Anne B]

My recent colonoscopy was "normal", which means nothing in my colon is causing the change in the shape of my stool.  I do have a couple uterine fibroids, and am now wondering if the enlarged uterus or my bladder could be pressing on the lower colon to cause the change in stool shape...