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Tummy Troubles: Infrequently Asked Questions

Sometimes I really have to strain to have a bowel movement. How do I make "it" come out easily?

Straining to have a bowel movement can be caused by firm stool. If your stool looks like rabbit pellets, a stool softener, such as ducosate, may help. Another problem may be a weak pelvic floor. A specialized nurse or physical therapist can often help you fix this issue with some muscle training exercises.

Sometimes I have accidents in my underwear. This is particularly problematic when I am at a restaurant. Is this normal?

No, this is not normal, but it is much more common than you think. This can result as a complication from childbirth, but men also have this problem, so obviously childbirth isn't the only cause (maybe children are!). The cause of this symptom usually can be diagnosed during a routine physical exam. See your primary care physician who can often provide simple solutions.

Sometimes when I pass gas, there is a little more than air that comes out. Why?

This is often because your muscle forgot how to tell the difference between air and liquid. Sounds like a simple task, but it is really quite complicated. Your physical therapist and physician can help retrain your muscles to know the difference.

I have blood in my stool that I know is hemorrhoids. Do I need to worry about this?

Make sure it is only hemorrhoids by having your physician perform a colon exam and making sure that it is nothing else. After all, there could be two separate issues. 

March is colon cancer awareness month. Colon cancer is almost always preventable – one simple test: a colonoscopy – can save lives.

My mom had colon cancer, but she was old. Do I need to worry? I feel fine and don't have any pain or bleeding. Do I really need to go through a colonoscopy?

Yes. There are no symptoms from a polyp. Symptoms from colon cancer come once it is advanced. You need to get your colonoscopy screening before you have symptoms so you can avoid cancer. If you are 50 or older, you need a colonoscopy. If you are African-American, you need to start getting a colonoscopy at age 45. If anyone in your family has had colon or uterine cancer, you need to get your first colonoscopy when you are 40 or when you are 10 years younger than your relative was when they had cancer. If a relative had uterine cancer at age 45, you need to get a colonoscopy at age 35. Obesity and smoking each double your risks of colon cancer. 

Michele Woodley, MD is board-certified in gastroenterology and on staff at Missouri Baptist Medical Center. She received her medical degree from SUNY Stony Brook in New York, and completed her residency and fellowship at Washington University School of Medicine in St. Louis. She also is a clinical assistant professor at Washington University.

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