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Q. I have changes in bowel movements after going for vacation. Why?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 06, 2021

Hi doctor,

I went for a vacation before five months. I came back and got sick. My bowel movements got changed from thick to smaller and thinner with less volume of total stool. A stool test was done and it was normal. I did a fit test before two years and it was normal. The ultrasound of abdomen was normal. I had this problem for a month and then got better. After that, I got the problem again suddenly. I also had burning and pain in the anus. I also had bleeding from the anus. It got better slowly within a week. I do not have any blood in my stools. I asked my doctor for a colonoscopy and he told me that it is unnecessary.

#

Hi,

Welcome to icliniq.com.

Please say whether you have abdominal pain, do you strain to pass stools, have a problem of anal fissure, or feeling pain after passing stools during constipation. It can be a simple anal fissure. Please say whether your physician did a digital rectal examination or inserted his finger into the anal canal for diagnosing pain and blood.

Thank you doctor,

I do not have abdominal pain and I do not strain while passing stools. I felt a fissure like pain. I have not done a rectal examination and I did only phone consultation. I did a stool tests before the appearance of these symptoms a couple of months ago. I am worried about my bowel movements and why do I have a change? It becomes better within a week and comes back again. What to do?

#

Hi,

Welcome back to icliniq.com.

You can have a rectal infection (infectious proctitis) and this can cause a recurrent rapid bowel movement. This is the cause for you to have bleeding and can cause the formation of anal fissure. Please do stool tests for ova parasites, calprotectin, complete blood count, blood IHA (indirect hemagglutination) titer for E. histolytica (entamoeba histolytica). I consider giving you antibiotics after seeing the results. For now, conservative treatment can be done. You can take Isabgol husk two tablespoons daily and apply Diltiazem gel in the anal canal through the nozzle. Get the above tests to understand the reason behind the altered bowel movements.

Thank you doctor,

I did a stool test for parasites along with another stool test for blood. The results were negative. When I had bleeding and pain, I had a strong smell, not as a stool smell but a few years ago I had a fungal infection in other areas. Now, the bleeding is less but still, I have blood and the strange smell is gone. But the stool is not normal like before and saw something red on the piece of the stool.

#

Hi,

Welcome back to icliniq.com.

Fungus infection of the bowels is extremely uncommon and it can occur only in immunocompromised patients like the one with HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome). You do not have symptoms such as significant weight loss, fever, uncontrolled diarrhea to suggest HIV. Please mention about the vacation, do you swimmed in freshwater or any other person along with you had similar symptoms. The parasite entamoeba histolytica is the only possibility. But it usually responds to Metronidazole and it is taken for seven days. Other parasitic infections such as trematodes infections and roundworm infections are the other possibilities.

Thank you doctor,

I did not go swimming and I went to the beach. I went on a small boat. I tested for STD and all the results were negative.

#

Hi,

Welcome back to icliniq.com.

A single test sample is not enough for detection. At least three samples should be taken on three different days or a 24-hour stool collection for stool ova and parasites can be done. There is no slip or electronic requisition that I can make for you. You need to approach laboratories in your area and show them the list of testing that I suggested to you.

Thank you doctor,

Do I need colonoscopy?

#

Hi,

Welcome back to icliniq.com.

According to your age, the chances of having a serious disease of the colon and rectum is very low and none of your findings suggest a serious illness. Your symptoms got started after a vacation and these symptoms suggest a mild parasitic infection. It is of benign cause and resolves with antibiotics.

Thank you doctor,

Which tests do I need to do?

#

Hi,

Welcome back to icliniq.com.

Did you receive it or not?

Thank you doctor,

No, I did not receive it. When I started to have this problem, my anus area had a lot of sweating and my underwear will have spots or streaks sometimes. Recently, it has got stopped.

#

Hi,

Welcome back to icliniq.com.

This is not abnormal. The anal area has hair follicles and sweat glands. It is natural to have some moisture over there. You need to do a complete blood count, blood for IHA titer for E..Histolytica, and stool for ova and parasites. Do it with three samples on three consecutive days and stool for calprotectin should be done.

Thank you doctor,

I get all these tests done.

#

Hi,

Welcome back to icliniq.com.

You are welcome.

Thank you doctor,

In the summer, when I started to have this, I did a blood test which showed a liver enzyme with raised levels. My ultrasound of the abdomen was normal. Does it cause a problem?

#

Hi,

Welcome back to icliniq.com.

Yes, you do a complete liver function test and consult me back.


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