Persistent digestive symtoms/issues - need advice
30M, 5ft11, ~14 stone 4lbs, active (around 8k steps daily + 30–45 mins exercise bike). Looking for advice before seeing my GP because I’ve had persistent digestive symptoms for months and I’m worried.
Timeline:
January: changed to a high-protein diet (mainly chicken and vegetables, probably not enough fibre at the time)
Around 1 month later: constipation started becoming noticeable
I changed back to my previous diet but symptoms have continued ever since
Around the same period, I gradually tapered off sertraline after taking 1 tablet daily for ~8 years (symptoms may overlap with stopping)
Current symptoms:
Persistent constipation for months
Before this started, bowel movements were around every 2 days and normal for me
Now bowel movements are usually every 2–3 days, occasionally up to 5 days
Frequent straining
Pebble-like stools at times
Occasional pencil-like stools in the past, but not for months
Often feel like stool is “higher up” and not moving rather than ready to come out
Constant feeling of incomplete emptying / unable to fully empty
Not much natural urge to go
Sitting on the toilet longer doesn’t really help
When I eventually go after laxatives, it can be a large amount and symptoms improve temporarily
Upper abdominal symptoms:
Constant fullness/pressure/discomfort in upper middle abdomen (below breastbone)
Not painful, more a persistent uncomfortable fullness
Significant burping
Worse 1–2 hours after eating or drinking
Worse lying down
Better in mornings, worse by evening
Fullness sometimes makes deep breaths uncomfortable because abdomen feels tight/full
Tummy has been rumbling and making unusual noises more lately
No visible bloating, but internally feels full
Stool concerns:
Occasionally noticed very dark brown streaks on the outside part within stool (not the whole stool being dark, rest look normal)
Stools are NOT black, tarry, or sticky
No obvious blood, although I may have seen a tiny bright red dot once or twice but not 100% sure.
No mucus
Stool otherwise seems fairly normal apart from constipation changes
Things tried:
Movicol/macrogol daily previously → worked after several days but constipation returned
Fibogel → temporary help only
Increased fibre gradually over time, including fibre gummies
Drinking ~3–4.5 litres water daily
Negative symptoms:
No weight loss (weight stable)
Appetite normal
No nausea or vomiting
No fevers or night sweats
No fatigue
No symptoms waking me at night
No lower abdominal pain/cramping
No chest pain, dizziness or palpitations
Can pass gas normally
No family history of bowel cancer or bowel disease
No abdominal surgeries
History:
Had constipation fairly often as a child
No known reflux, IBS, ulcers, or previous GI conditions
Questions:
Could this still be chronic constipation/slow transit/incomplete evacuation despite lasting months?
Could upper abdominal fullness and burping be secondary to constipation, or suggest another GI issue?
Could stopping long-term sertraline contribute?
Are occasional very dark brown streaks within stool concerning if stools aren’t black/tarry?
What investigations would usually be appropriate (blood tests, thyroid, coeliac screening, stool tests, etc.)?
I'm planning to see a GP regardless but wanted opinions while waiting. Quick edit 8:44 AM: saw bright red blood on toilet paper and feces, worried now, was straining alot if that helps diagnose too.