Bowel Issues: Symptoms, Causes, and Solutions

Bowel issues

Hello, Doctor.
I usually have normal bowel movements, once every morning.
However, about a week ago, I suddenly felt a burning and swollen sensation around my anus in the middle of the night.
The next day, after having a bowel movement, I started to feel a constant urge to defecate, going three times a day.
The stools are loose and unformed, but the color appears normal, and there is no blood upon wiping.
However, I constantly feel a dull ache and pressure in my buttocks, and there is a sensation of something being stuck at the anal opening, especially when sitting.
This situation has made me anxious and irritable, affecting my work and causing me to feel paranoid, leading to restless sleep.
I seem to have lost about 1 kilogram in weight this week.
I have had itching around the anal area for some time, and sometimes scratching leads to minor skin tears and bleeding.
I have bought over-the-counter ointments that help, but the issue recurs after a while.
During a company health check last November, my stool occult blood test was normal.
In the last couple of days, I feel that the condition of my buttocks and anus has improved significantly; the frequency of bowel movements has decreased, and while the stools are still somewhat soft, they have returned to a more formed shape, similar in size to what I usually have.
However, after defecation, I still occasionally feel a slight urge to go, and there is some itching around the anus.
When I touch it, it feels like there is a small lump (I have not had issues with hemorrhoids before).
Could you please tell me what condition this might be? How can I improve it? I would greatly appreciate your response.

Lin Xiansheng, 40~49 year old female. Ask Date: 2019/03/21

Dr. Ke Fangxu reply Surgery

Anal itching is a common issue during seasonal changes.
In addition to medication and topical treatments, there are three important considerations: 1.
Do not scratch to avoid causing an infection in the wounds.
2.
Temporarily avoid spicy foods to prevent capsaicin from irritating the skin.
3.
Avoid using soap or body wash to clean the anal area to prevent excessive removal of the skin's natural oils.
If these measures are followed, improvement can generally be seen within about a week.
If there is no improvement, it is advisable to consult a physician for evaluation and possible medication.
If necessary, a colonoscopy may also be performed.

Reply Date: 2019/03/21

More Info

Understanding bowel issues can be quite complex, as they often involve a range of symptoms and underlying causes. Based on your description, it seems you are experiencing a combination of symptoms that may suggest several possible conditions, including hemorrhoids, irritable bowel syndrome (IBS), or even anal fissures. Let's break down your symptoms and explore potential causes and solutions.

Symptoms Overview
1. Increased Frequency of Bowel Movements: You mentioned that your bowel movements increased to three times a day, with loose, unformed stools. This can indicate a change in your gastrointestinal function, possibly linked to stress, dietary changes, or an underlying gastrointestinal disorder.

2. Discomfort and Burning Sensation: The burning and swelling sensation around the anus, along with a feeling of incomplete evacuation, can be indicative of hemorrhoids or anal fissures. These conditions can cause discomfort, especially when sitting, and may lead to a cycle of itching and scratching, further aggravating the area.

3. Anxiety and Stress: Your anxiety about these symptoms can exacerbate gastrointestinal issues. Stress is known to affect gut motility and can lead to symptoms like diarrhea or constipation.

4. Weight Loss: A slight weight loss of about 1 kg over a week can be concerning, especially if it is unintentional. It may be a result of changes in appetite due to discomfort or anxiety.

Possible Causes
1. Hemorrhoids: Swollen veins in the rectal area can cause itching, burning, and discomfort. They can also lead to changes in bowel habits, especially if there is straining during bowel movements.

2. Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder is characterized by a combination of symptoms, including abdominal pain, bloating, and altered bowel habits (diarrhea or constipation). Stress and dietary factors often play a significant role in IBS.

3. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to pain and bleeding during bowel movements and may cause a cycle of discomfort and anxiety.

4. Dietary Factors: Changes in diet, such as increased fiber intake or consumption of irritants (spicy foods, caffeine, etc.), can also lead to changes in bowel habits and discomfort.

Solutions and Recommendations
1. Dietary Adjustments: Focus on a balanced diet rich in fiber, which can help regulate bowel movements. Foods like fruits, vegetables, whole grains, and legumes are beneficial. Stay hydrated by drinking plenty of water.

2. Stress Management: Since anxiety can exacerbate gastrointestinal symptoms, consider incorporating stress-reducing techniques such as mindfulness, yoga, or regular physical activity into your routine.

3. Avoid Irritants: Identify and avoid foods that may trigger your symptoms. Common irritants include caffeine, alcohol, and spicy foods.

4. Over-the-Counter Treatments: For hemorrhoids, topical treatments such as hydrocortisone creams or witch hazel pads can provide relief. If you suspect anal fissures, a stool softener may help ease bowel movements.

5. Consult a Healthcare Provider: Given your symptoms, especially the changes in bowel habits and the presence of discomfort, it would be wise to consult a gastroenterologist. They may recommend further evaluation, such as a colonoscopy, to rule out any serious conditions.

6. Monitor Symptoms: Keep a diary of your symptoms, dietary intake, and stress levels. This can help you and your healthcare provider identify patterns and triggers.

In conclusion, while your symptoms may suggest several potential conditions, a thorough evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate treatment plan. Taking proactive steps in managing your diet, stress, and symptoms can lead to significant improvements in your overall gastrointestinal health.

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