Rectal Discomfort: Causes of Pressure and Spasms - Gastroenterology and Hepatology

Q: Rectal Discomfort: Causes of Pressure and Spasms

Hello： Please pay attention to whether there are irritants in your diet, such as caffeine, spicy foods, or foods that may cause loose stools. <br>In addition to the aforementioned conditions, rapid bowel movements can also be caused by certain foods. <br>If the problem persists,

Anal heaviness with occasional spasms?

Hello doctor, I have been experiencing a persistent feeling of heaviness in my rectum (the area near the anus) for the past few months.
At times, it feels like cramps and sharp pain, and in severe cases, the pain radiates to my abdomen, causing cramping there as well.
When I'm not experiencing cramps, I still feel a heaviness in my rectum, along with a constant urge to have a bowel movement.
Sometimes I can pass stool, and other times I cannot.
The stool appears to be brown and shaped like a log, but there are also white, mucus-like substances that resemble intestinal lining.

Last month, I visited a proctologist who performed a digital rectal exam but did not find any significant issues with my rectum.
The doctor mentioned some internal hemorrhoids that were not concerning and suspected I might have endometriosis.
I subsequently consulted a gynecologist who performed a transvaginal ultrasound and reported that my uterus appeared normal.
However, I was advised to undergo blood tests for endometriosis.
Recently, I reviewed the blood test results, which indicated that my CA-125 level was 12, within the normal range.
The doctor said this was normal but could not completely rule out the possibility of endometriosis, leaving me without a definitive answer.
In recent days, the heaviness in my rectum has returned.
I feel discomfort in my rectum whenever I sit down or stand up, and changing my sitting position makes it feel like my rectum is moving up and down, which is very uncomfortable! I also have a constant urge to have a bowel movement, but it does not always result in passing stool.
My abdomen feels slightly tender, but I do not have constipation or blood in my stool.
This condition has been fluctuating, and I have never experienced anything like this before; it only started in the past two months.

I would like to ask the doctor what possible conditions these symptoms could indicate?

Amy, 30~39 year old female. Ask Date: 2020/07/10

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Please pay attention to whether there are irritants in your diet, such as caffeine, spicy foods, or foods that may cause loose stools.
In addition to the aforementioned conditions, rapid bowel movements can also be caused by certain foods.
If the problem persists, you may want to consult a gastroenterologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2020/07/10

More Info

Understanding rectal discomfort, especially when it involves sensations of pressure, spasms, and pain, can be quite complex. Your symptoms, including the feeling of rectal heaviness, spasms, and associated abdominal pain, can stem from various causes, and it's important to consider both physiological and psychological factors.

Firstly, the sensation of rectal pressure and spasms can often be linked to conditions such as hemorrhoids, anal fissures, or even pelvic floor dysfunction. While you mentioned that a doctor diagnosed you with mild internal hemorrhoids, these can still contribute to discomfort, especially during bowel movements. Hemorrhoids can cause a feeling of fullness or pressure in the rectal area, and if they become inflamed or thrombosed, they can lead to significant pain and spasms.

Another possibility is pelvic floor dysfunction, which can manifest as difficulty in coordinating the muscles involved in bowel movements. This dysfunction can lead to a sensation of incomplete evacuation, where you feel the urge to defecate but are unable to do so effectively. This can also be accompanied by abdominal discomfort and a feeling of heaviness in the rectal area.

You mentioned that your stool appears formed and has a coffee-colored appearance, which is generally normal unless there are other concerning symptoms like blood or significant changes in bowel habits. The presence of white material resembling intestinal mucosa could be mucus, which can be a normal finding but may also indicate irritation or inflammation in the intestines.

In terms of the psychological aspect, stress and anxiety can significantly impact gastrointestinal function. The gut-brain axis is a well-documented phenomenon where emotional states can influence gut motility and sensation. Stress can lead to increased muscle tension in the pelvic region, exacerbating feelings of discomfort and spasms. This could explain why your symptoms have intensified during periods of stress or anxiety.

Given that your tests for endometriosis came back normal, it may be beneficial to explore other avenues. Conditions such as irritable bowel syndrome (IBS) could also be a consideration, especially if your symptoms fluctuate and are associated with stress. IBS can cause a range of symptoms, including abdominal pain, changes in bowel habits, and feelings of urgency or incomplete evacuation.

To address your discomfort, consider the following steps:
1. Dietary Adjustments: Ensure you are consuming a high-fiber diet to promote regular bowel movements. Staying hydrated is also crucial.

2. Pelvic Floor Therapy: Engaging in physical therapy focused on the pelvic floor can help improve muscle coordination and alleviate symptoms.

3. Stress Management: Techniques such as mindfulness, yoga, or cognitive-behavioral therapy can help manage stress levels, which may, in turn, alleviate gastrointestinal symptoms.

4. Follow-Up Care: Since your symptoms are persistent, it may be beneficial to follow up with a gastroenterologist who can conduct further evaluations, such as a colonoscopy, to rule out other conditions.

5. Medication: Depending on the diagnosis, medications such as antispasmodics or laxatives may be prescribed to help manage symptoms.

In conclusion, while your symptoms may not point to a single identifiable condition, they are likely the result of a combination of factors, including potential gastrointestinal issues and the impact of stress. A multidisciplinary approach involving dietary changes, stress management, and possibly physical therapy could provide relief. Always consult with your healthcare provider for personalized advice and treatment options.

Similar Q&A

Understanding Rectal Pain: Possible Causes and Specialist Consultations

The symptoms described indicate that after bowel movements or during the night, the patient experiences significant pain in the anal area, which seems to originate from within the rectum. The pain is described as cramping, and there is no presence of blood or foreign objects duri...

Dr. Hou Yongji reply Surgery
Hello: Please first visit the colorectal surgery outpatient clinic to consult with a colorectal surgeon. Wishing you good health!

Understanding Anal Spasms: When to Seek Medical Attention

The anus has been twitching intermittently for several days, without pain or blood in the stool. Should I undergo further examination? Thank you.

Dr. Lin Minghui reply Gastroenterology and Hepatology
Anal twitching is mostly caused by spasms of the pelvic floor muscles or the muscles surrounding the anus. It may be triggered by inflammation of the pelvis or anus, or it could simply be due to emotional stress. Even in healthy individuals, emotional stress can lead to pelvic sp...

Understanding Deep Anal Pain: Causes and Concerns

Hello Doctor: For the past three days, while working, I suddenly experienced spasms deep in the anal area, which were very painful and lasted about 2 to 3 seconds. Afterward, I felt the urge to have a bowel movement. This occurs about once a day. Currently, my bowel habits are no...

Dr. Yang Zhichao reply Gastroenterology and Hepatology
Hello Mr. A, based on your description, both intestinal spasms and diverticulitis are possible. If symptoms persist, please consult a colorectal surgeon or a gastroenterologist for further evaluation. Thank you for your inquiry.

Unexplained Itching: Understanding Deep Discomfort in the Abdomen and Groin

Hello Doctor, in the past few days, I have been experiencing a sudden and frequent sensation of unexplained swelling or itching deep in my intestines, rectum, or pelvic area. It feels like there is a spasm, and I constantly feel the urge to tighten my anus to alleviate this disco...

Dr. Zhang Shuhao reply Surgery
This sensation may originate from the gastrointestinal tract, pelvic floor muscles, or gynecological issues. It is advisable to consult a colorectal specialist and a gynecologist for a physical examination and ultrasound to rule out any organ-related problems. If the organs are f...