Persistent Urge to Defecate After Bowel Movement: Causes and Solutions

After having a bowel movement, there is a persistent urge to defecate but unable to do so?

Hello Doctor, I am currently 29 years old.
In January, I underwent a rectal examination and discovered I had an anal fistula and hemorrhoids.
I later had surgery to remove them, and my wound just healed in early March.
However, in early April, I frequently experienced a strong urge to defecate after having bowel movements (I have bowel movements daily, and they are somewhat soft and paste-like).
Yet, when I return to the bathroom, I can only pass a small amount or just gas.
It feels like I have already emptied my intestines, but there is still a sensation of something being stuck in my anus that I cannot expel.
Additionally, I have noticed fresh red blood during bowel movements.
Could you please help me understand what symptoms I am experiencing? I have daily bowel movements, but after I finish, it feels like there is still something in my anus that I cannot get out, and I am even experiencing bleeding.

Mr. Li, 20~29 year old female. Ask Date: 2016/04/11

Dr. Ke Fangxu reply Surgery

This situation is likely indicative of a higher possibility of hemorrhoidal bleeding.
After anal fistula surgery, it is also possible to experience temporary sensory abnormalities.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoidal suppositories can be used, but it is best not to take stool softeners indiscriminately.
At this age, increasing dietary fiber and fluid intake should be sufficient.
If bleeding persists, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/04/11

More Info

The symptoms you are experiencing, particularly the persistent urge to defecate after having a bowel movement, can be quite distressing and may indicate several underlying issues. Given your medical history of rectal surgery and hemorrhoids, it's essential to consider how these factors might be contributing to your current symptoms.

Firstly, the sensation of incomplete evacuation after a bowel movement can be associated with several conditions. One common cause is rectal tenesmus, which is the feeling of needing to pass stools even when the bowels are empty. This can occur due to inflammation, irritation, or structural changes in the rectum or anal canal, which may have been exacerbated by your previous surgery or the presence of hemorrhoids.

Another potential cause could be irritable bowel syndrome (IBS), which can lead to altered bowel habits and sensations of urgency. IBS can manifest as diarrhea, constipation, or a mix of both, and it often comes with abdominal discomfort. The fact that your stools are described as "muddy" could suggest a form of diarrhea, which is common in IBS.

Additionally, the presence of fresh red blood in your stool is concerning and should not be overlooked. This could indicate several issues, including:
1. Hemorrhoids: Even after surgery, hemorrhoids can recur, leading to bleeding and discomfort.

2. Anal fissures: These are small tears in the lining of the anus that can occur due to passing hard stools and can cause pain and bleeding.

3. Inflammatory bowel disease (IBD): Conditions like ulcerative colitis or Crohn's disease can cause similar symptoms, including bleeding.

Given these possibilities, it is crucial to seek further evaluation from a healthcare provider. They may recommend a physical examination, possibly including a digital rectal exam, and may suggest imaging studies or endoscopy to assess the rectum and colon more thoroughly.

In terms of management, here are some general recommendations:
- Dietary changes: Increasing fiber intake can help regulate bowel movements and reduce straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. However, if you are experiencing diarrhea, you may need to balance fiber intake with soluble fibers that can help firm up stools.

- Hydration: Ensure you are drinking plenty of fluids, as dehydration can worsen constipation and lead to harder stools.

- Medications: Over-the-counter stool softeners or fiber supplements may be beneficial. However, consult your doctor before starting any new medication.

- Pelvic floor therapy: If there are issues with muscle coordination in the pelvic area, physical therapy focusing on the pelvic floor may help improve symptoms.

- Follow-up care: Regular follow-ups with your healthcare provider are essential, especially if you notice any changes in your symptoms or if the bleeding persists.

In conclusion, while your symptoms may stem from a variety of causes, it is essential to address them promptly to prevent complications and improve your quality of life. Please consult with a healthcare professional who can provide a comprehensive evaluation and tailored treatment plan based on your specific situation.

Similar Q&A

Persistent Urge to Defecate: Understanding Gastrointestinal Concerns

Hello, Doctor: I am a 26-year-old male, 172 cm tall and weighing 93 kg. My occupation primarily involves mental activities, and I have a sedentary lifestyle, especially in front of the computer, with very little physical exercise and frequent late nights. I do not smoke, drink al...

Dr. Yuan Hongdao reply Gastroenterology and Hepatology
Hello, if you have the urge to defecate but cannot, it may be necessary to consider rectal inflammation, foreign bodies in the rectum, external pressure on the rectum, or sensitivity of the nerves. I recommend moderate exercise, drinking plenty of water, and increasing your intak...

Persistent Urge to Defecate: Understanding Your Gastrointestinal Concerns

I have a persistent feeling of needing to have a bowel movement, even though I have undergone a colonoscopy that showed normal results, and there are no hemorrhoids. I have also consulted with gynecologists, and every doctor has said everything is normal. However, the sensation o...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Recommendations: 1. Adjust your diet: Limit greasy, spicy foods, and dairy products. 2. Warm sitz baths: Perform once daily after bowel movements, for 20 minutes each time. Wishing you safety and health. Department of Gastroenterology, Taoyuan General Hospital, Dr. Chen Ch...

Understanding Frequent Bowel Urges: Is It Psychological?

A few days ago, I was experiencing diarrhea, but today my stool has returned to a more normal state. However, after having a bowel movement, I still feel the urge to go but cannot. Could this be caused by psychological factors?

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Gastroenteritis has not fully resolved yet.

Persistent Urgency to Defecate: Possible Causes and Concerns

Hello doctor, I have been experiencing persistent urges to have a bowel movement since the day before yesterday. Yesterday, I had yellow watery stools for the first time, and the second time there was only a small amount of yellow watery stool, with no blood present. After that, ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Increased colonic peristalsis leads to the urge to defecate; it is important to maintain a light and easily digestible diet.