Bowel Issues: From Hemorrhoids to IBS Symptoms

Bowel issues

Dear Doctor,
I had a colonoscopy two years ago due to rectal bleeding, and the doctor said there were no major issues, just some hemorrhoids.
After returning home, my bowel movements have mostly been soft stools, diarrhea, unformed, or accompanied by mucus.
After using the restroom, I often feel like I haven't completely emptied my bowels.
I went back for another consultation, and the doctor only asked about my symptoms, suggesting that I might be experiencing stress and irritable bowel syndrome.
He prescribed medications for diarrhea and gastroenteritis.
However, recently I have been experiencing sharp pain in the anal and perineal areas.
The next day, whenever I pass gas or have a bowel movement, I feel significant pain in the perineum and lower left abdomen.
I also visited a urologist for a digital exam and ultrasound, but nothing abnormal was found.
As of now, I have a vague feeling of swelling in the lower left abdomen, which is not painful when pressed, and my bowel movements have become less smooth, with the stools appearing flat and grooved.
Dr.
Ko, I apologize for bothering you, but could you please help me with this? Thank you.

Awei, 20~29 year old female. Ask Date: 2020/02/27

Dr. Ke Fangxu reply Surgery

At the age of 27, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to start with a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication.

Reply Date: 2020/02/27

More Info

Understanding bowel issues can be complex, especially when symptoms overlap with conditions like hemorrhoids and irritable bowel syndrome (IBS). Based on your description, it seems you are experiencing a combination of symptoms that may be indicative of IBS, exacerbated by stress, and possibly related to your previous diagnosis of hemorrhoids.

Symptoms Overview
You mentioned experiencing soft stools, diarrhea, and a sensation of incomplete evacuation after bowel movements. These symptoms align with IBS, which is characterized by abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or both). The presence of mucus in your stool can also be a common symptom of IBS. Additionally, the pain in your perineum and left lower abdomen, particularly during bowel movements or gas release, could be related to pelvic floor dysfunction or increased sensitivity in that area due to your ongoing bowel issues.

Hemorrhoids and Their Impact
Your history of hemorrhoids could contribute to some of the discomfort you are experiencing. Hemorrhoids can cause pain, especially during bowel movements, and may lead to a feeling of incomplete evacuation. The presence of blood in your stool, which you noted previously, can also be associated with hemorrhoids, but it is crucial to ensure that it is not indicative of other conditions, such as anal fissures or more serious gastrointestinal issues.

Stress and IBS
Stress is a significant factor in IBS. It can exacerbate symptoms and lead to changes in bowel habits. The connection between the brain and the gut is well-documented, and stress can lead to increased gut motility, resulting in diarrhea or loose stools. Managing stress through relaxation techniques, therapy, or lifestyle changes can be beneficial in alleviating IBS symptoms.

Diagnostic Considerations
Given your symptoms, it is essential to continue working with your healthcare provider to rule out other potential causes of your discomfort. While your previous colonoscopy showed no significant issues, ongoing symptoms warrant further evaluation. Conditions such as inflammatory bowel disease (IBD), infections, or even food intolerances (like lactose or gluten intolerance) should be considered, especially if your symptoms have changed or worsened.

Management Strategies
1. Dietary Adjustments: Consider keeping a food diary to identify any potential triggers for your symptoms. A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) may help reduce IBS symptoms for some individuals. Additionally, ensure you are consuming enough fiber, as this can help regulate bowel movements.

2. Hydration: Staying well-hydrated is crucial, especially if you experience diarrhea. Dehydration can exacerbate symptoms and lead to further complications.

3. Stress Management: Incorporate stress-reducing activities into your routine, such as yoga, meditation, or regular exercise. These can help improve your overall well-being and may alleviate some of your gastrointestinal symptoms.

4. Medication: If your symptoms persist, discuss with your physician the possibility of adjusting your medication. Antispasmodics, laxatives, or medications specifically for IBS may be appropriate depending on your symptoms.

5. Follow-Up: Regular follow-up with your healthcare provider is essential. If new symptoms arise, such as significant weight loss, persistent pain, or changes in your stool that concern you, seek medical attention promptly.

Conclusion
Your symptoms suggest a multifaceted issue involving IBS and possibly exacerbated by stress and hemorrhoids. A comprehensive approach that includes dietary changes, stress management, and regular medical follow-up will be essential in managing your condition. Always consult your healthcare provider for personalized advice and treatment options tailored to your specific situation.

Similar Q&A

Is It IBS or Hemorrhoids? Understanding Your Digestive Concerns

Hello, doctor. I have a hemorrhoid issue. Over two years ago, I had a severe hemorrhoid episode where I experienced bleeding during bowel movements, along with symptoms similar to irritable bowel syndrome, which made me go to the bathroom multiple times a day. At that time, I con...

Dr. Yang Zhichao reply Gastroenterology and Hepatology
After reviewing, I hope to schedule an appointment for an examination at the outpatient clinic.

Understanding Bowel Issues: IBS, Hemorrhoids, and Related Symptoms

Hello, doctor. I have previously been diagnosed with irritable bowel syndrome and hemorrhoids. For the past four days, I have been experiencing a sensation of urgency to have a bowel movement, which disappears after I use the restroom. About one or two hours later, I feel the urg...

Dr. Chen Shidian reply Gastroenterology and Hepatology
It is irritable bowel syndrome, which can be treated with medication along with dietary and lifestyle adjustments.

Understanding IBS and Its Connection to Hemorrhoids: What You Need to Know

Hello, Doctor: I sometimes experience a dull pain in my lower right abdomen. After dinner, I have abdominal pain, bloating, diarrhea, constipation, a feeling of incomplete evacuation, hard or watery stools, and sometimes mucus in my stool. Additionally, I've noticed blood in...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Crohn's disease or ulcerative colitis can be diagnosed through colonoscopy. Hemorrhoidal bleeding may fluctuate, so it is recommended to try warm sitz baths. Wishing you good health.

Understanding Irritable Bowel Syndrome: Symptoms and Management Tips

Hello Doctor, about two months ago, I started experiencing recurring discomfort in my abdomen, and then my bowel habits began to change, leading to diarrhea. Sometimes I feel better, but then it gets worse again. Shortly after, I started having pain around my anus. The doctor per...

Dr. Ke Fangxu reply Surgery
At the age of 17, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is extremely low. Based on your description, it seems more like irritable bowel syndrome. It is recommended to maintain a light diet and a good lifestyle routine, while avoidi...