Sometimes a miserable bout of diarrhoea is caused by nothing more than nerves or a 24-hour stomach bug. Lingering gas and bloating can be set off by a recent long-haul flight.
But similar symptoms could also represent something far more serious. It can be tricky to tell with the gastrointestinal tract, the long tube that runs from the mouth to the end of the large intestine. We asked gut health experts to share some of the warning signs they’d never want their patients to ignore.
1. BLOOD IN THE TOILET
When people see blood in or on their stool, they often ignore it because they assume it’s from hemorrhoids, said Dr Cathy Eng, a professor of medicine at the Vanderbilt-Ingram Cancer Center.
When hemorrhoids, which are swollen, inflamed veins, are irritated or pressure is applied, they can cause bright red blood to appear on toilet paper, or as drops in the toilet bowl or on the surface of your stool. But it’s often not possible to tell by appearance whether the blood is from haemorrhoids or something more serious, Dr Eng said.
Health issues including colorectal cancer, Crohn’s disease, diverticulitis and even certain stomach bugs can also cause blood to appear in or on the stool, said Dr Baha Moshiree, a gastroenterologist and professor of medicine at Wake Forest University School of Medicine in North Carolina.
Stool that appears black, tarry or dark maroon can be a sign of bleeding in the stomach or upper digestive tract from a stomach ulcer, a cancer in the stomach or oesophagus or other conditions, Dr Moshiree said.
Any blood in or around the stool is worth mentioning to a doctor, Eng said.
2. AN UNUSUAL CHANGE IN BOWEL MOVEMENTS
It’s a good idea to tell a doctor about unexpected changes to the shape, frequency or consistency of your bowel movements, such as newly appearing constipation, diarrhoea or thin stools, said Dr Andrew Chan, a gastroenterologist at Mass General Brigham in Boston.
When such changes occur without a clear reason, such as shifts in diet, medications, stress levels or work schedule, it could signal that something is off, Dr Chan said. A growing tumour in the colon, for instance, can cause constipation or thin stools, Dr Eng said. And intestinal inflammation can cause both constipation and diarrhoea, often with pain, gas and bloating.
3. DIARRHOEA THAT WON'T GO AWAY
If your bowel movements have been loose or watery for more than five to seven days, especially if you also have abdominal pain, cramping or changes in your appetite, it’s worth looping in a health professional, Dr Eng said.
Intestinal infections caused by certain viruses, such as the parasites cyclospora or giardia or the bacterium Clostridioides difficile, can cause diarrhoea, cramping, pain or appetite changes that may benefit from antibiotics or other treatments, Dr Moshiree said.
Inflammatory bowel diseases such as Crohn’s or ulcerative colitis can also cause chronic diarrhea, pain, cramping, gas and bloating, as can celiac disease, an autoimmune condition in which eating gluten causes the immune system to attack the small intestine. In some cases, colorectal cancer can also cause persistent diarrhea, Dr Eng said.
4. DIFFICULTY SWALLOWING
Any recurring pain, discomfort or trouble with swallowing can be worrisome, Dr Moshiree said. This includes feeling like you can’t move food from your mouth to your throat or a sensation that food is getting stuck in your throat.
If you’re noticing any of these symptoms frequently – even if they only last for a moment – see a doctor, Dr Moshiree said. Nerve or muscle conditions, such as Parkinson’s disease or multiple sclerosis, can cause discomfort or trouble swallowing, she said. And conditions that cause a blockage near the throat, such as throat or esophageal cancers, can make it difficult for food to pass through.
In severe cases, food that becomes stuck can lead to choking, but “it doesn’t have to be that extreme” to be worth mentioning to a doctor, Dr Chan said.
5. SYMPTOMS THAT WAKE YOU IN THE MIDDLE OF THE NIGHT
Diarrhoea, abdominal pain, cramping, nausea or other gut symptoms that wake you up should raise an alarm, Dr Moshiree said. Serious conditions including Crohn’s disease or colorectal cancer can cause these unpleasant nighttime awakenings. Stomach viruses or food poisoning can also jolt you awake, she said.
Less urgent gut conditions, such as irritable bowel syndrome or run-of-the-mill indigestion, are less likely to disrupt your sleep, Dr Moshiree said, since their symptoms are more likely to occur when you’re awake.
Also be sure to tell a doctor if you’re frequently having night sweats that aren’t menopause-related, Dr Eng said. Night sweats can be a symptom of many types of cancer, including those related to the gastrointestinal tract, such as colorectal cancer and pancreatic cancers.
As a general rule, an unexplained loss of more than 10 per cent of your body weight, across any time frame, is worth telling a doctor about, Dr Moshiree said. Worrisome conditions that can cause unexpected weight loss include gastrointestinal cancers, inflammatory bowel diseases, intestinal blockages and gastroparesis, a disorder that causes your stomach to empty too slowly.
THE BOTTOM LINE
If you’re unsure whether a digestive symptom is worrisome, especially if it doesn’t resolve within a few days to a few weeks, it’s a good idea to run it by a doctor, the experts said.
A primary care doctor at a local clinic, or even a gynecologist, can be a good first stop, Dr Eng said. That doctor can then refer you to a specialist, like a gastroenterologist, if you need one.
By Caroline Hopkins Legaspi © The New York Times Company
The article originally appeared in The New York Times.
Source: New York Times/mm