Rectal Discomfort After Bowel Movements: Causes and Solutions

Feeling of foreign body sensation after using the restroom?

Hello Doctor: I have suffered from constipation since childhood.
Recently, I often do not have the urge to have a bowel movement and do not go every day, but when I do feel the urge, the bowel movement is smooth.
I haven't gone to the bathroom for about two or three days.
Yesterday, although I was able to have a bowel movement, I felt that the stool was quite hard, and I had to strain to pass it.
After using the restroom, for about twenty-four hours until today, I have felt a sensation of something foreign in my anus, with slight pain (very mild) when sitting or walking.
Sometimes, I even have to contract my anus to feel the foreign sensation.
I also noticed something that feels like a lump.
I have experienced this sensation after constipation before, but it wasn't as pronounced, and I didn't confirm whether there was a lump.
I would like to ask the doctor if surgery is necessary in this situation.
If not, what can I do to improve it, and how long will it take to return to normal? Thank you, doctor, for taking the time to respond.
I am really anxious about this situation and don't dare to talk to my family about it.

Nìmíng, 10~19 year old female. Ask Date: 2020/05/21

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 alleviate pain, maintain cleanliness, and promote blood circulation.
You can also purchase hemorrhoid suppositories at the pharmacy for use, which may lead to recovery in about 1-2 weeks.
Surgical treatment should not be necessary; however, if symptoms persist without improvement, it is advisable to consult a physician for evaluation.

Reply Date: 2020/05/21

More Info

Experiencing discomfort after bowel movements can be distressing, and it's important to understand the potential causes and solutions. Based on your description, it seems you have been dealing with constipation, which can lead to hard stools and straining during bowel movements. This can result in a variety of symptoms, including the sensation of an obstruction or discomfort in the rectal area.

Possible Causes of Rectal Discomfort
1. Constipation: As you've noted, infrequent bowel movements and hard stools can lead to discomfort. When stool is hard, it can cause strain during defecation, leading to pain and a feeling of incomplete evacuation.

2. Hemorrhoids: Straining can cause or exacerbate hemorrhoids, which are swollen veins in the rectal area. Symptoms can include pain, itching, and the sensation of a lump or mass.

3. Anal Fissures: If the stool is particularly hard, it can cause small tears in the lining of the anus, known as anal fissures. These can be quite painful, especially during and after bowel movements.

4. Rectal Prolapse: In some cases, straining can lead to a condition where part of the rectum protrudes through the anus, which may feel like a lump or mass.

5. Other Conditions: Less commonly, other conditions such as infections, abscesses, or even tumors can cause similar symptoms. However, these are less likely given your description.

Recommendations for Management
1. Dietary Changes: Increasing your intake of dietary fiber can help soften stools and promote regular bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Aim for at least 25-30 grams of fiber per day.

2. Hydration: Drinking plenty of water is crucial. Adequate hydration helps to soften stool and makes it easier to pass.

3. Regular Exercise: Physical activity can help stimulate bowel function. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Over-the-Counter Remedies: You might consider using stool softeners or mild laxatives to help ease the passage of stool. However, these should be used sparingly and not as a long-term solution.

5. Warm Sitz Baths: Taking warm baths can help relieve discomfort and promote relaxation in the anal area.

6. Avoid Straining: When you feel the urge to have a bowel movement, try to go to the bathroom promptly. Avoid straining, as this can worsen symptoms.

When to Seek Medical Attention
If your symptoms persist or worsen, or if you notice significant changes in your bowel habits, it is important to consult a healthcare provider. They may recommend a physical examination to check for hemorrhoids, fissures, or other abnormalities. In some cases, imaging studies or a colonoscopy may be necessary to rule out more serious conditions.

Surgical Considerations
Surgery is typically not the first line of treatment for the symptoms you've described. Most cases of rectal discomfort related to constipation, hemorrhoids, or fissures can be managed conservatively with lifestyle changes and medications. Surgical intervention is usually reserved for severe cases or when conservative measures fail.

Conclusion
In summary, your symptoms are likely related to constipation and the resulting strain during bowel movements. By making dietary and lifestyle changes, you can often alleviate these symptoms. However, if you continue to experience discomfort or have concerns about a possible lump, it is advisable to seek a medical evaluation. Remember, it’s important to address these issues openly with a healthcare provider to ensure proper diagnosis and treatment.

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