Rectal Issues: Symptoms, Diagnosis, and Treatment Options

Rectal issues

Hello Doctor: In April of this year, I started consuming a lot of spicy foods and sitting for long periods, which led to sudden difficulties with bowel movements.
I experienced frequent urges to defecate, but each time the stool volume was very small or nonexistent.
Sometimes, there was a small amount of white mucus on the surface of the stool.
Every afternoon, I felt bloated in my rectal area, which worsened by the evening, and I also experienced a dull pain in the coccyx region.
In June, I underwent a colonoscopy and fecal occult blood test at the hospital, which revealed rectal inflammation and rectal mucosal prolapse.
The mucosal prolapse required surgery.
After the surgery, the rectal inflammation was not addressed, and as of September, the aforementioned symptoms persist.
Drinking magnesium citrate helps with bowel movements somewhat.
Should I continue treatment? I am concerned that delaying further treatment may worsen my condition...

Mr. Zhang, 30~39 year old female. Ask Date: 2020/08/15

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello Mr.
Zhang, if your colon examination was normal, it is possible that you may have Irritable Bowel Syndrome (IBS) given your age.
You can improve your lifestyle by reducing the intake of irritants and spicy foods, increasing your consumption of fruits and vegetables, drinking more water, and exercising regularly.
Additionally, taking probiotics can also be beneficial.
Lastly, please discuss your condition with your primary care physician.
Thank you for your question.

Reply Date: 2020/08/15

More Info

Understanding rectal issues, particularly in the context of your symptoms and diagnosis, is crucial for effective management and treatment. Based on your description, it seems you are experiencing a combination of rectal inflammation and mucosal prolapse, which can lead to significant discomfort and complications if not addressed properly.

Symptoms
The symptoms you are experiencing, such as difficulty in bowel movements, frequent urges with little output, and the presence of mucus, are indicative of rectal issues. The sensation of fullness and pain in the coccyx area can also be associated with rectal inflammation or other underlying conditions. The presence of mucus can suggest irritation or inflammation in the rectal area, which aligns with your diagnosis of rectal inflammation.

Diagnosis
Your diagnosis of rectal inflammation and mucosal prolapse was confirmed through a colonoscopy and stool occult blood tests. Rectal inflammation (proctitis) can be caused by various factors, including infections, inflammatory bowel disease (IBD), or as a result of dietary habits, such as consuming a lot of spicy foods. Mucosal prolapse, on the other hand, often requires surgical intervention, as you have already undergone.

Treatment Options
1. Medication: Since your rectal inflammation has not been specifically treated, it is essential to discuss medication options with your healthcare provider. Anti-inflammatory medications, topical treatments, or even antibiotics may be necessary depending on the underlying cause of the inflammation.

2. Dietary Changes: You mentioned that consuming certain foods exacerbates your symptoms. It may be beneficial to adopt a diet low in irritants (like spicy foods) and high in fiber to promote regular bowel movements. Staying hydrated is also crucial.

3. Sitz Baths: Warm sitz baths can help alleviate discomfort and promote healing in the rectal area. This can be particularly soothing if you are experiencing pain or irritation.

4. Follow-Up Care: Since your symptoms persist even after surgery, it is vital to have ongoing follow-up appointments with your gastroenterologist or colorectal surgeon. They may recommend further diagnostic tests, such as imaging studies or additional scopes, to assess the condition of your rectum and rule out other potential issues.

5. Physical Therapy: In some cases, pelvic floor physical therapy can be beneficial, especially if there are issues with bowel function or pelvic floor muscle coordination.

Concerns About Progression
You expressed concern about the potential for your condition to worsen if left untreated. This is a valid concern, as untreated rectal inflammation can lead to chronic pain, further complications, or even more severe conditions like abscesses or fistulas. Therefore, it is imperative to continue seeking treatment and not to ignore ongoing symptoms.

Conclusion
In summary, it is essential to continue your treatment for rectal inflammation, especially since your symptoms have not resolved post-surgery. Engage in open communication with your healthcare provider about your ongoing symptoms and treatment options. Early intervention can prevent complications and improve your quality of life. If you feel that your current treatment plan is not effective, do not hesitate to seek a second opinion or ask for a referral to a specialist in colorectal health.

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