Rectal Discomfort: Is It Hemorrhoids or Rectal Prolapse?

Foreign body around the anus?

I usually have normal bowel movements, at least once a day, and I don't experience any foreign body sensation or blood in my stool, nor do I see blood when wiping.
Recently, I thought that not having a bowel movement in a day would be bad, so I went to the bathroom to squat.
I squatted for over 5 minutes because I felt the urge to go, and I strained a lot, but nothing came out (it felt like constipation).
Afterward, I kept feeling something at the anal area, thinking it was stool, and I continued to strain.
As a result, something kept coming out, and when I touched it, it felt like soft tissue but was not painful.
Since I had never experienced this before, I pushed it back in with my hand (though it still felt soft and was partially outside).
Now, when I stand, I can still feel the small soft tissue outside.
The next morning, I had a normal bowel movement without pain, so I'm very worried.
Do I need a colonoscopy? Could this be hemorrhoids or rectal prolapse?

An An, 20~29 year old female. Ask Date: 2017/11/02

Dr. Ke Fangxu reply Surgery

This condition is more likely to resemble external hemorrhoids, which can generally be treated with topical ointments.
Although the probability of developing colon cancer at the age of 22 is not zero, it is extremely low in general.
It is recommended to maintain a light diet and good lifestyle habits, avoiding spicy, irritating, and greasy foods.
Increasing the intake of dietary fiber can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication.
There is likely no immediate need for a colonoscopy.

Reply Date: 2017/11/02

More Info

Understanding rectal discomfort can be quite challenging, especially when symptoms can overlap between conditions like hemorrhoids and rectal prolapse. Based on your description, it seems you are experiencing a sensation of a soft mass at the anal region after straining during bowel movements. Let's break down the potential causes and the need for further evaluation.

Hemorrhoids vs. Rectal Prolapse
Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, itching, and bleeding. They can be classified as either internal or external. Internal hemorrhoids are located inside the rectum and usually do not cause pain unless they prolapse, while external hemorrhoids are under the skin around the anus and can be painful, especially if a blood clot forms.

Rectal prolapse, on the other hand, occurs when part of the rectum protrudes through the anus. This can happen during straining, particularly during bowel movements, and may feel like a soft mass that can be pushed back in. Rectal prolapse can occur in varying degrees, from a partial prolapse that only occurs during straining to a complete prolapse that is always visible.

Symptoms and Evaluation
From your description, you mentioned that you have normal bowel movements and do not experience pain or bleeding, which are positive signs. However, the sensation of a soft mass that you can feel and push back in could indicate either condition. The fact that you felt this after straining for an extended period suggests that it may be related to the increased pressure in the anal region.

When to Seek Further Evaluation
While your symptoms may not seem severe, it is essential to consult a healthcare professional for a proper evaluation. A colonoscopy may not be immediately necessary unless there are additional concerning symptoms such as:
- Persistent pain
- Significant changes in bowel habits
- Blood in the stool
- Unexplained weight loss
A physical examination by a healthcare provider can help determine whether you are dealing with hemorrhoids or rectal prolapse. They may perform a digital rectal exam or an anoscopy to visualize the area better.

Recommendations
1. Avoid Straining: Try to avoid prolonged straining during bowel movements. This can exacerbate both hemorrhoids and rectal prolapse.

2. Dietary Adjustments: Ensure you are consuming a high-fiber diet and staying hydrated to promote regular bowel movements and prevent constipation.

3. Consult a Specialist: If the soft mass persists or if you develop new symptoms, it would be wise to see a gastroenterologist or a colorectal surgeon. They can provide a thorough examination and discuss potential treatment options.

Conclusion
In summary, while your symptoms may suggest either hemorrhoids or rectal prolapse, a definitive diagnosis can only be made through a clinical evaluation. Given your concerns and the changes you’ve experienced, it would be prudent to seek medical advice. Early intervention can help manage symptoms effectively and prevent potential complications. Remember, it’s always better to address these concerns sooner rather than later for peace of mind and health.

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