Anal and Bowel Issues: Symptoms and Solutions

Anal and bowel issues?

Hello, doctor.
Recently, I've been experiencing difficulty with bowel movements.
Three days ago, I felt like I injured my anus during a bowel movement.
At that time, my stool was normal, but towards the end, it became thin and intermittent, making it hard to pass.
Since then, I've been passing gas more frequently, but I only have a bowel movement every three days.
I drink plenty of water, but my stool has become thinner than usual, and I find it hard to clean myself properly afterward.
The stool tends to stick to the toilet bowl, and when I wipe with toilet paper, the skin on one side of my anus feels sticky, although there isn't much discharge.
I experience pain when straining during bowel movements, but it feels more like a minor abrasion rather than severe pain.
After a bowel movement, it feels like my anus isn't completely closed, and I have the sensation of not fully evacuating, which makes it difficult to clean myself.
I often feel like there's stool that hasn't been fully expelled near the anal opening.
I sometimes go three to four days without a bowel movement, and when I do, the stool is hard, and occasionally I notice a little blood from the anus.
There is a slight discharge when I wipe, but it resolves after a while, and I don't usually have that sticky sensation on the skin around the anus.
In recent years, I have experienced occasional minor fecal incontinence, but it's very infrequent.
I once had a fall on my coccyx, but the examination showed only a slight misalignment, and I occasionally feel minor pain in that area, especially when pressure is applied.
I'm concerned that this situation might indicate rectal cancer.
Could you please provide me with some advice? Thank you.

Bu Bu, 20~29 year old female. Ask Date: 2017/06/24

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your concerns, it is recommended that you visit a colorectal surgeon for further evaluation.
Maintaining a regular routine and healthy eating habits is still an important reminder.
Please note that online consultations are not equivalent to in-person medical visits and cannot provide accurate diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2017/06/24

More Info

It sounds like you are experiencing a range of bowel and anal issues that are causing you significant discomfort and concern. Based on your description, several factors could be contributing to your symptoms, including constipation, potential anal fissures, and possibly even issues related to your previous tailbone injury. Let's break down your symptoms and explore potential solutions.

Symptoms Overview
1. Bowel Movement Difficulties: You mentioned that your bowel movements have become infrequent (every three to four days) and that they are often hard and difficult to pass. This can lead to straining during bowel movements, which may cause pain and discomfort.

2. Anal Pain and Discomfort: The pain you feel during bowel movements, especially towards the end, could indicate the presence of an anal fissure. An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools. This can lead to sharp pain during and after bowel movements.

3. Feeling of Incomplete Evacuation: The sensation that you have not completely emptied your bowels can be frustrating and may contribute to the feeling of needing to go again shortly after a bowel movement.

4. Occasional Bleeding: The presence of blood during bowel movements, especially if it is bright red, can be alarming. While it can be associated with hemorrhoids or fissures, it is essential to monitor this symptom closely.

5. Tailbone Injury: Your history of a tailbone injury could potentially contribute to your current symptoms, particularly if there is any lingering pain or discomfort in that area.

Potential Causes
Given your symptoms, the most likely causes include:
- Constipation: This is often the primary issue leading to straining and the development of fissures.

- Anal Fissures: These can develop from passing hard stools and can cause significant pain.

- Hemorrhoids: Swollen blood vessels in the rectal area can also lead to pain and bleeding.

- Functional Disorders: Conditions like irritable bowel syndrome (IBS) can cause alternating patterns of constipation and diarrhea, leading to discomfort.

Recommendations
1. Dietary Changes: Increasing your fiber intake can help soften your stools and promote regular bowel movements. Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Additionally, consider drinking more water to stay hydrated.

2. Over-the-Counter Remedies: You might benefit from using a stool softener or a mild laxative to help ease your bowel movements. However, these should be used sparingly and not as a long-term solution.

3. Warm Baths: Taking warm baths can help soothe anal discomfort and promote relaxation, which may make bowel movements easier.

4. Avoid Straining: When you feel the urge to go, try to respond promptly rather than holding it in. Straining can exacerbate fissures and lead to further complications.

5. Consult a Healthcare Provider: Given your concerns about rectal bleeding and the possibility of more serious conditions like rectal cancer, it is crucial to consult a healthcare provider. They can perform a thorough examination, possibly including a digital rectal exam or colonoscopy, to rule out any serious issues.

6. Pelvic Floor Exercises: If you have lingering issues related to your tailbone injury, pelvic floor exercises may help strengthen the muscles in that area and improve bowel function.

Conclusion
While your symptoms may be concerning, many of them can be managed with lifestyle changes and medical intervention. It is essential to seek professional advice to ensure that there are no underlying serious conditions. Regular follow-ups with a gastroenterologist can help you manage your symptoms effectively and improve your quality of life. Remember, early intervention is key to preventing complications and ensuring optimal digestive health.

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