Change in Bowel Habit

What tests do I need to undergo?

Changes in bowel habit that are due to dietary or lifestyle changes generally do not require further testing. However, in patients with associated ‘alarm signs’, we will perform further investigations. These are patients with:

• associated rectal bleeding or mucoid stools
• abdominal pain or swelling
• loss of weight and/or appetite
• family history of colorectal cancer or polyps

These patients should undergo evaluation of the colon in the form of an optical colonoscopy, CT colonography or barium enema. Individuals above the age of 50 years are also advised to undergo a colonoscopy for screening for colorectal cancer. In addition, patients with diarrhoea from suspected infection or antibiotic use may also benefit from special tests on their stools.

When colonic evaluation is normal and yet patients remain symptomatic, further tests for suspected functional bowel disorders may be performed. These tests include:

• anorectal manometry: to assess anal muscle tone
• transit marker studies: time taken for stools to empty
• defecography: to assess completeness of stool emptying