Bowel Changes Should Be Investigated
Dear Dr. Roach: I have a question regarding my stool. It is not normal, but is in pieces, which are small and sometimes elongated. I am in no pain or discomfort. I have not lost weight or changed my eating habits. It started about a year ago. I had a colonoscopy six months ago. Everything was OK. I am a female, 64 years old. I have been eating a lot of whole wheat and lots of vegetables and fruits.
My doctor does not appear to be concerned, but I am. Could I be allergic to certain foods? I am not sure what to do. — E.R.
Answer: Changes in bowel movements mean that either there’s been a change in the diet or a change in the bowel. Thin, elongated stool is very worrisome for a partial blockage in the large bowel, especially due to colon cancer, so a colonoscopy was exactly the right test to do.
Given that the colonoscopy was OK, I would be concerned about a change in diet. Your diet did not change, but for others, if a dietary change was made about the same time as bowel movements did, it would be pretty clearly the cause. However, conditions like irritable bowel syndrome often cause changes in bowel habits — sometimes causing constipation or loose bowel movements; sometimes both, alternating.
Food allergies usually bring on abdominal discomfort, nausea or vomiting. Celiac disease can cause variable bowel changes, especially diarrhea.
If you were experiencing weight loss, abdominal pain or other significant symptoms, your concern might be justified. Since you are otherwise well, try keeping a food diary to see if you can identify which foods worsen your symptoms.
Dear Dr. Roach: My friend got colon cancer at 43. I asked why she did not get a colonoscopy earlier. She said that she had no symptoms and that insurance pays at 50 years old or over. How many people get colon cancer before age 50? — S.M.
Answer: Only about 10 percent of colon cancer occurs before age 50. A family history of a first-degree relative getting colon cancer should prompt a colonoscopy at least 10 years younger that the family member was when diagnosed — so if your father was diagnosed at age 51, you should have a colonoscopy at age 41. Unfortunately, not everybody who will get colon cancer has a family history. Any bleeding from the rectum or in the stool should prompt a visit and at least a discussion of whether a colonoscopy is necessary — at any age. Most cases of bleeding aren’t cancer, but I’ve seen many cases of polyps and inflammatory bowel disease show up with bleeding.
Dear Dr. Roach: Recently I’ve read several references as to how kudzu has been successfully used to treat alcoholism. But it’s not being sold anywhere. Two questions: Why isn’t it available to the public; and why is it being actively killed off with herbicides rather than being harvested? — S.M.
Answer: A pilot study did show that a kudzu extract reduced the amount of alcohol that people drank (ordinary volunteers, not necessarily people with problems with alcohol). However, it’s a difficult process to prove that the extract is safe and effective in the long term. You can buy kudzu extract at some health-food stores or on the Internet, but the researchers found that none of the preparations they tried was effective. The kudzu concentration in the commercial versions was less than 1 percent, and the study used 30 percent to 40 percent concentration. I don’t recommend using existing kudzu preparations.
In the meantime, I am assured that there is plenty of kudzu to go around.
Dr. Roach regrets that he is unable to answer indiv idual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orland o, FL 32853-6475.