Bowel Issues: Symptoms and Concerns About Colon Health

Bowel issues

Hello doctor, I have previously experienced several episodes of constipation where my stools were very large, causing blood in the toilet and significant pain in my rectum, but this has not occurred recently.
Currently, I have bowel movements every two days, but I still experience pain during defecation.
The stool is predominantly brown, but there is a streak of blood on it, and there is also blood on the toilet paper when I wipe.
My stools are generally quite large, and after bowel movements, I feel a swollen, painful sensation.
Sometimes I experience itching, but it subsides after a few hours.
Occasionally, I wake up at night due to a feeling of pressure and pain in my rectum, but it lasts only a few seconds to a few minutes.
This situation has persisted for quite some time, and I am very concerned about the possibility of colorectal cancer.

Miss Lin, 20~29 year old female. Ask Date: 2020/04/29

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
Warm sitz baths can help relieve pain, maintain cleanliness, and promote blood circulation.
You can also purchase over-the-counter hemorrhoid suppositories for use.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2020/04/29

More Info

Based on the symptoms you've described, it seems that you are experiencing a combination of bowel issues that could be related to several underlying conditions, including hemorrhoids, anal fissures, or possibly irritable bowel syndrome (IBS). The presence of blood in your stool and on toilet paper, along with pain during bowel movements, is concerning and warrants further investigation.

Understanding Your Symptoms
1. Blood in Stool: The presence of blood, especially if it appears as streaks on the stool or on toilet paper, can indicate several issues. Hemorrhoids are swollen blood vessels in the rectal area that can bleed during bowel movements, especially if the stool is hard or large. Anal fissures, which are small tears in the lining of the anus, can also cause pain and bleeding. Both conditions can be exacerbated by constipation or straining during bowel movements.

2. Pain During Bowel Movements: Experiencing pain during bowel movements can be a sign of several issues. If the stool is large and hard, it can stretch the anal canal, causing pain. This can lead to a cycle of avoidance, where the fear of pain leads to constipation, which in turn leads to larger stools and more pain.

3. Bowel Habits: You mentioned having bowel movements every two days, which is within the normal range for some people, but if you're experiencing pain and the sensation of incomplete evacuation, it may indicate an underlying issue. The feeling of needing to go but not being able to can be associated with IBS, which is characterized by a combination of constipation and diarrhea, along with abdominal pain.

4. Other Symptoms: The itching and swelling you experience after bowel movements could be related to irritation from wiping, hemorrhoids, or even a skin condition. The fact that you wake up with discomfort suggests that your symptoms may be affecting your sleep quality, which is another important aspect to consider.

Recommendations
Given your symptoms, it is crucial to consult a healthcare professional for a thorough evaluation. Here are some steps you can take in the meantime:
1. Dietary Changes: Increasing your fiber intake can help soften your stool and make it easier to pass. Foods high in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also essential, as it helps prevent constipation.

2. Avoid Straining: When you feel the urge to go, try to respond promptly. Avoid straining during bowel movements, as this can worsen hemorrhoids and lead to fissures.

3. Warm Baths: Taking warm baths can help soothe anal discomfort and reduce swelling if hemorrhoids are present.

4. Over-the-Counter Treatments: You may consider using over-the-counter topical treatments for hemorrhoids or stool softeners to ease your bowel movements. However, it’s best to consult with a healthcare provider before starting any new medication.

5. Monitor Symptoms: Keep a record of your bowel habits, including the frequency, consistency, and any associated symptoms like pain or bleeding. This information can be very helpful for your healthcare provider.

6. Seek Medical Attention: Given the presence of blood and ongoing pain, it is essential to see a healthcare provider. They may recommend a colonoscopy or other diagnostic tests to rule out more serious conditions, including colorectal cancer, especially considering your history of significant constipation and rectal bleeding.

Conclusion
While your symptoms may be indicative of common conditions such as hemorrhoids or IBS, the presence of blood and persistent pain should not be overlooked. Early diagnosis and treatment are key to managing your symptoms effectively and ensuring your overall colon health. Please make an appointment with a healthcare professional as soon as possible to discuss your symptoms in detail and receive appropriate care.

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