Change in bowel habits

We are often warned to be on the lookout for a ‘change in bowel habit’ as this may indicate disease and should be reported to a physician.  But what does this actually mean, and are such changes really important?  Elsewhere on this website there is a discussion of changes in stool shape such as thinner, longer, grooved stools, etc.  These changes are not usually meaningful.  But other changes are.

Meaningful changes in bowel habit would include the following:

  • The recent development of constipation that seems persistent and progressively worse
  • Diarrhea, new and persistent
  • Abdominal cramps, including those that precede a bowel movement and are lessened by having a bowel movement
  • New abdominal distention or bloating in association with any changing bowel pattern
  • Any of the above changes with associated pain in the rectum
  • The presence of an unusual amount of mucus or slime or pus in the bowel movements
  • The urge to have a bowel movement (often small) more frequently, often with a sense of incomplete emptying
  • Getting up at night to have bowel movements when this was previously rarely necessary
  • The presence of blood or strawberry jam-like material passed on its own or with stool.

Any of the above changes should be reported to a physician.  Most warrant careful assessment that will almost certainly include some sort of scoping of the bowel, and often an ultrasound examination of the abdomen.  In a recent review of close to 200 patients with colorectal cancer diagnosed at the Pezim Clinic, the two most common problems that these patients presented with were rectal bleeding and a change in bowel habit.

© Pezim Clinic, Vancouver, British Columbia, Canada