For quite a while now, I have been unable to open my bowels properly. I am either constipated with terrible tummy pains or I have diarrhoea. I have tried looking into it on the internet but there is so much information, I have diagnosed myself with all sorts! I have made an appointment to see my GP but I have to say, I am embarrassed but also scared that there could be something seriously wrong. Do you think I will be referred to a specialist and if so, what will happen then?
Mr David Jayne, Consultant General Surgeon
Any change in normal bowel habit that lasts for more than a few days should be taken seriously. Although the possible causes of an altered bowel habit, with either constipation or loose motions, are numerous and many are self-limiting and not serious, it is important that an underlying problem is ruled out. Initially, you should seek the advice of your GP who will be able to interpret your symptoms and decide whether there is any need for further investigation. Alteration in bowel habit is a common complaint that GPs deal with and there is no need to feel embarrassed. Referral for a specialist opinion does not necessarily mean there is a problem.
If you are referred for further investigation, this will probably be to either a colorectal surgeon or a gastroenterologist. The specialist will undertake a consultation enquiring about your symptoms and perform a basic examination. On the basis of this, the specialist may recommend further investigation, which usually involves some form of imaging of your bowel.
Most commonly this involves a colonoscopy, which is the passage of a flexible camera around the large bowel. This is a commonly performed investigation, which is undertaken as a day case procedure, and provides information about the whole of the bowel. Alternatively, an x-ray test of the bowel (Barium enema) or CT scan of the abdomen may be recommended. Any of these tests will be able to help determine if there is a serious problem causing the change in bowel habit. If the test is negative, this is often reassuring and no further treatment is required.