Irritable bowel/incontinence

[jmproberts]

I am a healthly 58 y.o. female (with a BRCAI mutation).I have had irritable bowel most of my adult life with chronic diareah from about the age of 18 to 45.  In the next ten years I had  chronic constipation.  Now I am experiencing bowel movements with every urination, many times a day.  I am not able to control the movement once I begin to urinate.  The fact that these movements are especially narrow in circumferance, (they are formed, not loose) makes me wonder if perhaps the contour of my colon has changed, perhaps because of some growth or  narrowing.  I had colonoscopy five years ago with no polyps.
Is this kind of change in shape and frequency usually significant?  I don't know which doctor is the appropriate one with which to discuss this.  I do not see an internist.  I do not want to go to a doctor if this doesn't sound like a significant sign of any real problem.  I have dealt with bowel problems most of my life and don't like to make something out of nothing.
I am sure that the constant straining I did for about ten years has compromised my pelvic floor muscles.  I have urinary urgency and frequency, but not more than I am able to manage.
I know the answer is to see my doctor.  I just want an opinion of what this might sound like to you and which kind of doctor I might see if I decide to do that.  Please give me your thoughts on these symptoms/problems/neuroses(?) Are you a real doctor? A specialist in this area? Thanks, Happy New Year

[Kevin Pho, MD]

Any persistant change in caliber of the stool should be evaluated for possible polyps or cancer.  Being 58 years old and last having a colonoscopy 5 years ago, you may want to consider repeating an endoscopy (either a colonoscopy or flexible sigmoidoscopy) - although the chances of a new growth in 5 years is unlikely.  

If negative, then irritable bowel syndrome can also cause a change in stool shape.  However, before attributing the symptoms to this, you want to rule out cancer and polyps first.  

A gastroenterologist would be the proper specialist to see.  

And yes, I am a real doctor.  More information about me can be found on my blog (kevinmd_b).

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

[yoshi]

If you are 58,hormonal change would cause constipation.
as for diarhea (diarrhea),try eating yogurt,good one from healthfood store,not that dannon or store brand ****.