Morning Abdominal Discomfort and Rectal Pressure: Causes and Solutions

Q: Morning Abdominal Discomfort and Rectal Pressure: Causes and Solutions

Hello： The symptoms you described may indicate a feeling of incomplete evacuation (the urge to defecate but unable to do so). <br>You should pay attention to whether there is any fecal impaction. <br>Hemorrhoids can sometimes cause anal pain or a sensation of a foreign body. <br>

Abdominal discomfort upon waking up accompanied by a sensation of a foreign body in the anus?

Hello, Dr.
Tsai.
I previously underwent gastroscopy and colonoscopy, and my attending physician indicated that aside from mild internal hemorrhoids and mild gastroesophageal reflux, there were no abnormalities in my gastrointestinal tract.
However, for over a month now, I have been experiencing discomfort in my abdomen upon waking up, and I have difficulty having a bowel movement; it often takes 1 to 3 hours before I can successfully pass stool, and sometimes it takes most of the day to pass a small amount.
I also have a sensation of having something unpleasant in my abdomen.
Could you please advise what might be causing this? Additionally, during this period, I have frequently experienced a feeling of heaviness and a foreign body sensation in my anal area.
Is this a normal symptom of internal hemorrhoids? How can I improve my condition regarding internal hemorrhoids?

Li Tongxue, 20~29 year old female. Ask Date: 2016/07/10

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: The symptoms you described may indicate a feeling of incomplete evacuation (the urge to defecate but unable to do so).
You should pay attention to whether there is any fecal impaction.
Hemorrhoids can sometimes cause anal pain or a sensation of a foreign body.
In both cases, it is important to stay well-hydrated, consume plenty of fruits and vegetables, avoid prolonged sitting or standing, and establish a habit of daily bowel movements.
If you still have questions, you can return for a consultation with your physician or visit a colorectal specialist.
Changhua Hospital cares about your health.
Dr.
Cai Anshun.

Reply Date: 2016/07/10

More Info

Morning abdominal discomfort and rectal pressure can be quite distressing, especially when they disrupt your daily routine. Based on your description, it seems you have undergone both gastroscopy and colonoscopy, which have ruled out significant gastrointestinal abnormalities aside from mild internal hemorrhoids and gastroesophageal reflux disease (GERD). However, the persistent discomfort and altered bowel habits you are experiencing warrant further exploration.

Possible Causes of Morning Abdominal Discomfort
1. Irritable Bowel Syndrome (IBS): Given your symptoms of abdominal discomfort, difficulty in bowel movements, and the sensation of incomplete evacuation, IBS could be a potential diagnosis. IBS is a functional gastrointestinal disorder characterized by a combination of symptoms including abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or alternating between both). Stress and dietary factors often exacerbate IBS symptoms.

2. Constipation: The sensation of wanting to defecate but being unable to do so can indicate constipation. This can be caused by a low-fiber diet, inadequate fluid intake, or a sedentary lifestyle. The feeling of having "dirty" contents in your abdomen may also be related to stool buildup in the colon.

3. Hemorrhoids: Since you mentioned having mild internal hemorrhoids, these can contribute to discomfort, especially if there is straining during bowel movements. Hemorrhoids can cause sensations of pressure or fullness in the rectal area, which might explain the feeling of rectal heaviness or "foreign body" sensation.

4. Gastroesophageal Reflux Disease (GERD): Although primarily a condition affecting the esophagus, GERD can lead to discomfort that may be felt in the upper abdomen, especially after meals. The reflux of stomach acid can also contribute to feelings of nausea or discomfort.

Recommendations for Management
1. Dietary Modifications: Increasing fiber intake through fruits, vegetables, and whole grains can help alleviate constipation. Additionally, staying well-hydrated is crucial. Avoiding trigger foods that may exacerbate GERD, such as spicy foods, caffeine, and alcohol, can also be beneficial.

2. Regular Exercise: Engaging in regular physical activity can stimulate bowel function and help reduce symptoms of IBS and constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Bowel Habits: Establishing a regular bowel routine can help. Try to set aside time each day to use the bathroom, especially after meals when the gastrocolic reflex is strongest. This may help train your body to have more regular bowel movements.

4. Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating relaxation techniques such as mindfulness, yoga, or meditation into your daily routine.

5. Medical Follow-Up: Given your ongoing symptoms, it may be beneficial to follow up with your healthcare provider. They may consider additional tests or treatments, such as medications for IBS or hemorrhoid management, to help alleviate your symptoms.

Conclusion
Your symptoms of morning abdominal discomfort and rectal pressure could be multifactorial, involving aspects of IBS, constipation, and possibly exacerbated by your mild internal hemorrhoids. A comprehensive approach that includes dietary changes, regular exercise, and stress management, along with medical follow-up, can help improve your quality of life. If symptoms persist or worsen, further evaluation by a gastroenterologist may be warranted to explore other potential underlying conditions.

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