Bowel Problems

[PNarasim]

Hi,
I am a 31 year old male. Since Sep 2003 (13 months) I have been having bowel problems. The problem is that I have a bowel movement in the morning after waking up. I feel like I have not completely evacuated the bowels. Then when I get to the office I feel like having a bowel movement again and I do have a bowel movement. Once again after lunch I have a bowel movement if the lunch is slightly heavy.

I had a sigmoidoscopy in Feb that was unremarkable. I had elevated liver enzymes, which were followed up by Ultrasound of the upper abdomen with attention to Liver. The U/S suggested that there could be hyperechoic masses within the liver. So there was a followup CT with IV contrast. The CT report said:

There are no focal masses in Liver, Spleen, Kidneys etc.
There is mild diffuse hypodensity to the Liver. Otherwise the test is unremarkable.

Impression:
No focal masses. Probable mild infiltration of fat

My concern is with the fact that most of the times, my stools are thin. They are large in size only when they are hard, which is not often since I keep moving bowels frequently. They are invariably thin in one direction if they are soft.

All the doctors I have been to have said it is nothing serious. None of the doctors think Colonoscopy is necessary. The doctor that did the sigmoidoscopy thought I had IBS, I do not know if it is because he saw something in the colon to that effect.\

My questions are:

1. Could it something serious since I have had this for more than a year? I have to admit that my symptoms were almost absent for the entire month of June and they returned back in July.

2. I do have an anal abscess. Can this cause stools to be become thin in one direction, since it is protruding?

Thanks

[Kevin Pho, MD]

To answer your questions:
1) IBS can certainly cause your symptoms, and it is reassuring that the the sigmoidoscopy was normal.  Treatment options for this can include antispasmodic agents as well as increasing the fiber in the diet.  To be 100% certain that nothing is wrong, you could insist on the colonoscopy.

2) If the abscess is large enough to partially obscure the colon, then it may be possible that the shape of the stool may change.

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.
Medical Weblog:
kevinmd_b

[Billard]

I have loose bowels every morning, starting at about 3:00 a.m. and going until 6:00 or 7:00 a.m.  No pain there but always a "dire rear" as I've coined it.
Have taken Metamusil 'till I'm blue in the face but it does no good.  
Any body out there with some help?  Getting desperate.  Am well up in years, too.

[gabbyv]

I have had blood in my stool for a while now. It usually happens after a bowl movement. But it takes a while to stop bleeding. It is a bright red and the other day it was a little clotty. The docter gave me supostitorys because she thought it was a lection from using the rest room because I some times have to strain to go. But it still bleeds and I have use the medicen. So know what should I do?