Persistent Bowel Issues: When to Seek Medical Advice

Just having a bowel movement doesn't feel complete?

Hello, I have a bowel movement every 2-3 days, and this frequency hasn't changed.
However, I can clearly see a protrusion near my anus, which I initially thought was an external hemorrhoid and didn't pay much attention to it or consult a doctor.
I am quite particular about cleanliness; after every bowel movement, I always wash my buttocks with body wash or soap.
In the past, I occasionally noticed that after a bowel movement, while cleaning myself, a little stool would come out, but I didn't think much of it.
Recently, during my last three bowel movements, I didn't experience abdominal pain or diarrhea.
After confirming that I had no more urge to defecate, while sitting and washing myself, I suddenly felt the urge again halfway through, and this kept happening.
Each time I felt the urge, I only passed a small amount, which meant I had to keep washing until my anus became sore.
Today was particularly absurd; after my bowel movement, I felt no urge to defecate, but while sitting and washing, I felt the urge again and passed stool multiple times.
Each time, I only passed a small amount of soft, yellow-brown stool, and I ended up spending 1 hour and 50 minutes in the bathroom before I was sure I had no more urge to wash myself.
I am very worried that I might have a tumor.
Can current medical imaging techniques detect tumors in the colon or rectum?

Xiao Zhuang, 30~39 year old female. Ask Date: 2021/01/07

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, can imaging studies help with the feeling of incomplete bowel evacuation? Currently, imaging studies such as abdominal X-rays, lower gastrointestinal tract imaging, and computed tomography (CT) scans can assist in diagnosing rectal and anal disorders.
For rectal and colonic lesions, the size of the lesion is generally important; if it is a small polyp or a flat lesion, certain early-stage cancers may require a colonoscopy for clearer visualization, and this procedure can also allow for biopsy and treatment.
For issues with bowel movements, it is recommended to increase dietary fiber intake and maintain adequate hydration.
It is advisable to consult a colorectal surgeon or a gastroenterologist to arrange appropriate examinations.
Wishing you safety and health.
Sincerely, Dr.
Lin Ming-Hui, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/01/07

More Info

When it comes to persistent bowel issues, especially those accompanied by unusual symptoms such as the ones you've described, it is crucial to seek medical advice promptly. Your situation, characterized by infrequent bowel movements, the presence of a protruding mass near the anus, and the repeated urge to defecate even after having just done so, warrants a thorough evaluation by a healthcare professional.

Firstly, the protruding mass you mentioned could be indicative of several conditions, including hemorrhoids, anal fissures, or even more serious issues such as rectal prolapse or tumors. Hemorrhoids, which are swollen veins in the lower rectum and anus, can cause discomfort and may lead to bleeding or protrusion during bowel movements. Anal fissures, on the other hand, are small tears in the lining of the anus that can be quite painful and may also lead to a cycle of pain and constipation.

The fact that you are experiencing repeated urges to defecate after you believe you have finished could suggest a condition known as "tenesmus," which is the feeling of incomplete evacuation. This can be associated with various gastrointestinal disorders, including inflammatory bowel disease (IBD), infections, or even tumors. Given your concern about the possibility of a tumor, it is essential to address this with a healthcare provider who can perform the necessary examinations.

Modern medical imaging techniques, such as colonoscopy, CT scans, and MRI, are indeed capable of detecting tumors in the colon or rectum. A colonoscopy, in particular, allows for direct visualization of the colon and rectum and can also facilitate biopsy of any suspicious lesions. If a tumor is suspected, these procedures are critical for diagnosis and subsequent management.

In addition to imaging studies, your healthcare provider may also recommend laboratory tests, such as blood tests to check for signs of infection or inflammation, and stool tests to rule out any infectious causes of your symptoms.
It's also worth noting that your hygiene practices, while well-intentioned, may be contributing to your discomfort. Over-washing the anal area can lead to irritation and exacerbate any existing conditions. Instead, gentle cleaning with water and avoiding harsh soaps may be more beneficial.

In summary, given your symptoms and concerns, it is imperative to consult with a healthcare professional as soon as possible. They will be able to perform a comprehensive evaluation, which may include a physical examination, imaging studies, and possibly a colonoscopy, to determine the underlying cause of your symptoms and recommend appropriate treatment. Early intervention is key in managing bowel issues effectively and ensuring your overall health and well-being.

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