How long should symptoms go on before I see a doctor?

[Jewel529]

I am a 45 yr old white female in good health. I have eaten Fiber One every morning for breakfast for 10yrs and it has kept me very regular.I eat plenty of fruits and veggies also. I had a colonoscopy about 10yrs ago (I was experiencing back pain then)that was normal. My OB-GYN does the rectal screening at my yearly appt. My last one was in December. Several months ago I started noticing a lot of unusual bowel sounds, left lower abdominal pain, a lot of gas and constipation. It went away. And then, about 2 weeks ago I started having left lower abdominal pinching pain again and low back pain and now for about 3days I have had constipation again. When I do have a bowel movement it is in very small amounts, sometimes soft and other times very hard. Like a few pellets, that is it. I have added Citrucel to my diet, but it has not helped much. I am able to pass gas. My dad has had several polyps removed, non cancerous. My mother has had normal colonoscopys, although she was diagnosed with IBS when she was in her 40's. I have an uncle that had colon cancer at the age of 57 in 1987 and is a survivor. I have 2 older siblings that have had normal colonoscopys. I am very concerned about these latest symptoms. What do you think of all this? Also, how big should stools be? The diameter of my stool does change when I am having normal bowel movements. Sometimes they are large, about the size of a quarter and sometimes small, like a dime. Is this normal? I have heard the size of your stools can tell you a lot. This latest episode seemed to start when I decided to try one of the new low-carb diet plans and started eating a lot of nuts. That is when the left side pain started and then came the constipation. It has been downhill from there. I have been under a lot of stress for several months also. How long should a let the constipation go on before I see a doctor? Anxious to hear you thoughts on this. Thanks.

[Kevin Pho, MD]

I would suggest another colonoscopy.  It is possible that the changes in stool caliber may be due to irritable bowel disease, however before attributing it to that you want to ensure it isn't anything else (i.e. polyps or cancer).  

There is no normal size for stool, since they would differ from patient to patient.  The type of food that is eaten can also affect stool shape and size.  

Regarding the constipation, a colonoscopy would be the first test to evaluate this as well.  Other tests to consider would be colonic motility studies as well as a thyroid test.  

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

[L-Town]

The general rule of thumb is to have any changes in bowel habits checked out it persists longer than two weeks.

[Jewel529]

I know this has been going on for at least 2 weeks! I am beginning to get VERY worried. I have not been sleeping because I am so anxious. I am seeing a GI doc this week. I hope he scopes me and we find an answer for all of these weird symptoms.

[eveningstar]

You are doing the very best thing for yourself by seeing the GI doctor.  Insist on a colonoscopy.  Chances are you are just fine, but the only way to tell with certainty is to have the colonoscopy and put your mind at ease.  It can literally save your life and if anything is wrong, chances are it is being found early.  Keep us posted and good luck!