Is my flat stool with stomach pain serious at age 33?

Question

Hello doctor,

I am a 33-year-old male. I am a non-smoker and drinker of alcohol, and I do not currently take any medication. I am obese but actively losing weight. I weighed 430 lbs at my heaviest and am now down to 366 lbs. Five years back, I underwent a colonoscopy and upper endoscopy, both with normal findings.

Today, I am writing to you because I am concerned about the shape of my stool. One piece looks flat, and it is worrying me. I have been getting quick, sharp pains in the right side of my abdomen that happen at random and are not constant. I have not noticed any blood: no fatigue, sickness, fever, night sweats, or unintentional weight loss. I can eat fine and do not feel full. I will attach a photo of the stool I am concerned with. I did have to strain a little bit to get the stool out.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Thank you for sharing these details. It is invaluable.

A single episode of a flat or oddly shaped stool, especially in the context of recent straining, is most often due to compression as the stool passes through the anal canal or rectum and is not necessarily a sign of something serious, particularly since your colonoscopy (a generally outpatient medical procedure that uses a thin, flexible tube with a camera) and endoscopy (a medical procedure using a thin, flexible tube with a camera and light (endoscope) to view, diagnose, or treat internal organs) five years back were regular.

Abdominal pain felt on the right side occasionally may be attributed to cramping of the intestines, gas accumulation, or constipation, and in the absence of certain risk factors such as bloody stools, changes in bowel movements, fever, and unexplained weight loss, is not considered indicative of any serious issue. In your case, the probable cause of the problem would be a change in function of the bowels due to constipation or stool consistency.

Possible treatment and ways to help:

Slowly increase your fiber consumption through fruits, vegetables, oats, and whole grain foods to make your stools soft.
Make sure that you drink plenty of water, at least 2.11 to 3.17 quarts per day.
Regular physical activity can improve bowel motility, and since you are already losing weight, this will help both digestion and overall health.
If constipation persists, consider a gentle stool softener such as Docusate sodium or an osmotic laxative such as Polyethylene glycol under medical supervision.
For sharp abdominal pains, peppermint tea or capsules may help ease bowel spasms.
Keep a stool diary, including shape, consistency, and frequency, to identify patterns and triggers.

If the change in stool shape becomes persistent, or if you notice blood, mucus, worsening abdominal pain, or ongoing narrowing of stool caliber, it is essential to follow up with your GP (general practitioner) for a repeat evaluation. Given your history, your current symptoms do not strongly suggest something serious, but monitoring and addressing constipation is the key first step.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.