I am a colorectal surgeon and I tell patients to look at their poop before they flush

During a 12-hour anorectal screening drive in Pune, I screened 352 people and saw just how easily bowel symptoms are normalised. What stayed with me was not the Guinness World Record, but how many people had been quietly living with symptoms for months or even years.

In Short

• A 12-hour screening drive in Pune examined 352 people for anorectal issues
• Nearly 80% had constipation, while about 60% reported bloating or discomfort
• Many participants had lived with symptoms for months or even years

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People dismiss bowel and rectal symptoms more often than almost anything else I encounter in my practice. There is often hesitation before someone talks about bleeding, constipation, changes in bowel habits or discomfort. Sometimes people laugh it off. Sometimes they simply say they have been dealing with it for a long time and assume it was normal.

I saw this hesitation clearly during a recent 12-hour anorectal screening drive in Pune, where my team and I screened 352 people, an achievement that set a Guinness World Record. But the record was not what stayed with me. It was the number of people quietly living with symptoms.

Nearly 80% of those screened had constipation, while around 60% reported bloating or abdominal discomfort. Most people would consider these ordinary complaints. After all, constipation happens, gas happens, and bloating happens. But there is an important difference between something that happens occasionally and a symptom that has quietly become part of your everyday life.

Many people have been living with these complaints for months, sometimes years, without mentioning them to anyone. That is what concerns me.

WE TALK OURSELVES OUT OF WHAT OUR BODIES ARE SAYING

Bowel and anorectal problems still carry a strange sense of embarrassment. People are comfortable discussing headaches, blood pressure, diabetes or joint pain. But when the conversation moves towards bowel movements, rectal bleeding or what happens in the toilet, many suddenly become uncomfortable.

I see people trying to explain symptoms away before they have even spoken to a doctor. Bleeding is dismissed as piles. A change in bowel habits is blamed on “something I ate.” Constipation is accepted as a normal part of getting older. Bloating is blamed on stress or a particular food.

Sometimes those explanations are correct. But sometimes they are not.

I’m not asking anyone to panic over one bad day. Everyone can experience constipation, loose stools, gas or abdominal discomfort from time to time. What I am asking you to notice is a change.

If something is new, keeps coming back, persists longer than it should or no longer matches your usual pattern, it deserves attention. One of the biggest mistakes I see is people waiting for a symptom to become severe before they decide it is worth discussing.

Your body does not always give you a dramatic warning. Sometimes it gives you a small change that keeps repeating.

BEFORE YOU FLUSH, CHECK FOR THESE SIGNS

1. BLOOD IN THE STOOL

Whether it is bright red or dark, do not automatically dismiss blood in your stool. Haemorrhoids are a common cause of rectal bleeding, and many episodes of bleeding may have a benign explanation. But “common” does not mean “certain”.

If bleeding is unexplained, keeps returning or is accompanied by other changes, it needs to be examined. I would much rather see someone come to me and discover that the bleeding was caused by something easily treatable than see someone wait because they assumed it was only piles.

2. A CHANGE IN BOWEL HABITS

Pay attention when your usual bowel pattern changes. New constipation, diarrhoea or stools that look noticeably different from what is normal for you should not simply be ignored, especially when the change persists.

Your bowel habits can change for many reasons, including diet, medication, infections and lifestyle changes. But a persistent unexplained change deserves a conversation with a doctor.

3. FEELING THAT YOU HAVEN’T COMPLETELY EMPTIED YOUR BOWELS

This is another symptom people often overlook. If you regularly leave the toilet feeling that there is still more to pass, tell your doctor.

It may seem like a minor inconvenience, but it is a genuine symptom and should be interpreted in the context of your other symptoms and medical history. You do not need to feel embarrassed explaining this. For a doctor, it is information.

4. BLOATING OR ABDOMINAL DISCOMFORT THAT WON’T GO AWAY

Occasional gas and bloating are normal. But when bloating becomes frequent or abdominal discomfort starts appearing day after day, I would not simply tell someone to ignore it.

Again, there can be many explanations. Food intolerance, constipation, digestive problems and several other conditions can cause these symptoms. The important question is not whether bloating is common. The question is whether it is new, persistent or different from what you normally experience.

5. UNEXPLAINED WEIGHT LOSS OR LOSS OF ENERGY

Losing weight without trying is something I would never recommend brushing aside. Persistent tiredness can also have many causes, including poor sleep, nutritional deficiencies, stress and other medical conditions. But when unexplained weight loss or persistent fatigue occurs alongside bowel symptoms, it is worth getting checked.

I am not saying that these symptoms mean cancer. They often do not. But they are signals that deserve a proper medical assessment rather than an assumption.

WHY I DON’T WANT YOU TO ASSUME IT IS JUST PILES

Colorectal cancer is not rare enough for us to ignore changes in bowel health. In India, it is the fourth most common cancer among men and the fifth most common among women.

That does not mean every person with constipation, bleeding, or bloating has cancer. Far from it. Most of these symptoms will not turn out to be cancer. Many anorectal conditions are entirely treatable once they are properly examined.

The problem is that we cannot determine the cause simply by guessing. That is where a doctor comes in.

I’m not asking you to diagnose yourself. I’m asking you to notice a change and bring it to someone qualified to interpret it.

DON’T WAIT FOR THE SYMPTOM TO BECOME UNBEARABLE

One thing my experience during the screening drive reinforced for me is how much people can normalise discomfort. Someone can live with constipation for months. Someone can see blood while passing stool and repeatedly tell themselves it is piles. Someone can experience bloating every day and simply change their diet without ever discussing it.

And because the symptoms are not severe enough to stop them from working, eating or going about their daily lives, they convince themselves that they are not important.

But health problems do not always announce themselves loudly. Sometimes, the earliest sign is simply that something has changed.

Screening those 352 people taught me something simple: most people are willing to discuss their symptoms once they get past the first uncomfortable sentence.

That first sentence may be difficult. It may be, “I have been bleeding when I pass stool.” Or, “I have been constipated for months.” Or, “My bowel habits have changed.” Or even, “I feel like I am not completely emptying my bowel.”

Say it. Your doctor has heard it before.

YOUR BOWEL's HEALTH IS NOTHING TO BE EMBARRASSED ABOUT

I want people to stop treating bowel and anorectal health as something that should not be discussed. Nothing is embarrassing about talking your body.

There is also no price for waiting until a symptom becomes unbearable before seeking help.

I’m not asking you to become anxious about every change in your digestion. I’m asking you to become more aware of your own normal. Know what your usual bowel habits are. Notice when something changes. Notice when a symptom persists. And most importantly, do not let embarrassment decide for you.

The record from that screening drive was significant, but what stayed with me was much more personal. Hundreds of people walked in with symptoms they had quietly accepted as part of life. Once they started talking, those symptoms became something that could be assessed.

That is the part I want people to remember.

Your bowel health is nothing to be embarrassed about. It is also not something you should flush away and hope will resolve on its own.

Sometimes, taking a second look is the first step.

(Dr Ashwin Porwal, Founder and Colorectal Surgeon, Healing Hands Clinic)

- Ends