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What is meant by the term Bowel Problems?

Bowel problems and complaints are very common and may be caused by a wide spectrum of conditions. People mean different things when using the term bowel problems. Not infrequently, people complain or more than one symptom. There is a lot of overlap between bowel symptoms and different bowel conditions. It is therefore important not to ignore symptoms because even specialist doctors cannot say with certainty what is the problem without performing an examination. It may also be necessary to perform more specific tests such as a colonoscopy in order to exclude more sinister problems such as bowel cancer.

The most commonly occurring bowel symptoms are

• Blood in stool (rectal bleeding)  or bleeding from anus (bleeding from back passage) is an important complaint as it may be a symptom of bowel cancer. Blood may be seen on tissue paper, mixed in with the stool or it may be passed as “pure blood” or clots on its own (i.e. without actually passing a bowel motion). Any new symptoms of blood in stool should be reported to your doctor, and usually requires further investigation (e.g. colonoscopy or flexible sigmoidoscopy), depending on age and duration of the bleeding.  
• Abdominal bloating and pain. In younger patients, may be related to irritable bowel syndrome (IBS).  
• Diarrhoea (diarrhea). Change in bowel function to looser or more frequent stool. Any persistent change  lasting more than 6 weeks is of concern and should generally be investigated. Colonoscopy is usually the best investigation although the final decision will be based on patient preference, ability to take laxatives and general fitness.
• Constipation. A change in bowel habit to harder,  more constipated or less frequent bowel motions.  A very common problem that causes much distress for patients. A little less worrying compared to a change towards looser stool. However, as with any new and persistent bowel symptom, it should be reported to your doctor in the first instance
• Anal pain, soreness or discomfort. May be related to relatively simple bowel problems such as piles (haemorrhoids), anal fissure or perianal abscess.
• Anal itch (itchy bottom) or irritation. Often referred to as pruritus ani
• Faecal incontinence (bowel incontinence) This may be just staining of underwear or loss of the complete bowel motion. Can cause great distress and is much more common than people realise. However, because it can be embarrassing, people sometimes do not report it to their doctors.

Although most conditions are benign and may be successfully treated with simple measures, some patients may delay seeking medical advice because of embarrassment or fear of cancer. It is important to remember that more serious conditions such as inflammatory bowel disease and bowel cancer may also present with bowel  problems which should not therefore be ignored.

What are the most common bowel problems?

The most common bowel problems are listed below

• Irritable Bowel Syndrome (IBS)
• Anal fissure
• Excessive Gas
• Haemorrhoids - Piles
• Pruritus ani (“itchy bottom”)
• Anal abscess or anal fistula
• Constipation
• Diverticular disease
• Faecal incontinence
• Bowel cancer
• Colon polyps
• Anal cancer
• Ulcerative colitis
• Crohn’s disease

What should I do if I have any new bowel symptoms?

Any new anorectal or bowel symptoms including any change in bowel function should be reported to your GP who may decide to refer you for specialist investigation. Some symptoms are a cause particular concern and warrant urgent referral for investigation. These include the following guidelines from NICE (National Institute for Clinical Excellence)

NICE Guidelines on referral of patients with suspected lower gastrointestinal cancer (bowel cancer)

If you have any questions about the issues discussed on this page or other colorectal issues, your own GP is often the best first port of call.

If appropriate, they will be able to arrange a referral to a colorectal specialist centre such as the Glasgow Colorectal Centre.

Bowel problems are very common in both the young and the old. Typical symptoms include diarrhea (diarrhoea), constipation, IBS symptoms, blood in stool (rectal bleeding), bleeding from anus, anal itch, irritation & anal pain. Bowel problems such as these are a common cause for patients seeking medical advice.  

Not infrequently, piles or hemorrhoids are incorrectly blamed for many of these symptoms. Most problems are due to benign, easily treated conditions. However, it is important not to ignore symptoms and early assessment is important as both serious and simple benign conditions may present with similar symptoms.

Bowel problems

Diarrhoea, constipation, blood in the stool &IBS symptoms