Rectal Discomfort and Bowel Health: Common Concerns

Bowel issues?

Hello Doctor:
1.
My diet is normal, and I have a bowel movement once a day.
However, recently I often feel a sensation of something foreign near the anus, as if it is not completely clean.
When I check during my shower, I cannot feel anything (I am sure I have touched the area where I feel the foreign sensation), and my stools have not changed in size; they are still quite bulky.
Is this something that can happen? (Aside from this, I have no other health issues.)
2.
When my stools suddenly become too hard, I experience significant pain near the anus, almost like being cut.
In more severe cases, there is some bleeding, but it is not a lot, and there is no blood on the toilet paper.
Is it normal for there to be no blood on the toilet paper? I remember that with anal fissures, there tends to be a lot of bleeding.
3.
I used to have a severe constipation habit, although it has improved significantly now (I force myself to have regular bowel movements every day).
I would like to ask if my previous constipation habits could have any long-term effects on my current condition.

Xiǎng huó xiàlái de rén, 10~19 year old female. Ask Date: 2021/04/26

Dr. Ke Fangxu reply Surgery

1.
It is possible that prolonged bowel movements may lead to the swelling of hemorrhoids.

2.
The typical symptoms of anal fissures include pain during bowel movements accompanied by slight bleeding, often caused by constipation or diarrhea.
The fundamental treatment involves addressing bowel movement issues, along with warm sitz baths, which can help alleviate pain, maintain cleanliness, and promote blood circulation.
Over-the-counter hemorrhoid suppositories can also be purchased for relief.
If symptoms persist without improvement, it is advisable to consult a physician.

3.
Habitual constipation may lead to swollen hemorrhoids or chronic anal fissures; however, it typically does not result in any serious complications.

Reply Date: 2021/04/26

More Info

Understanding rectal discomfort and bowel health is a common concern that many individuals face, and it can often lead to anxiety and confusion regarding one's health. Based on your description, let's address your concerns systematically.

1. Feeling of a Foreign Body and Incomplete Evacuation: The sensation of having a foreign body or feeling that the bowel is not completely evacuated can be quite distressing. This sensation may stem from various factors, including muscle tension in the pelvic floor, hemorrhoids, or even anal fissures that may not be immediately apparent upon self-examination. It is also possible that you are experiencing a form of rectal hypersensitivity, where the nerves in the rectal area are more sensitive than usual. This can occur even if there is no physical obstruction or abnormality present. If this sensation persists or worsens, it would be advisable to consult a gastroenterologist for a thorough evaluation.

2. Hard Stools and Pain: Experiencing pain during bowel movements, especially with hard stools, is a common issue. Hard stools can cause significant discomfort and may lead to anal fissures, which are small tears in the lining of the anus. While it is true that fissures can cause bleeding, the amount of blood can vary greatly. Some individuals may experience only minor bleeding or none at all, especially if the fissure is not severe. The absence of blood on toilet paper does not necessarily indicate that there is no issue; it may simply mean that the fissure is not actively bleeding at that moment. It is essential to maintain adequate hydration and dietary fiber intake to help soften stools and prevent this discomfort.

3. History of Constipation and Long-term Effects: Chronic constipation can lead to several complications, including the development of hemorrhoids, anal fissures, and even rectal prolapse in severe cases. While you have mentioned that your bowel habits have improved, it is important to recognize that the effects of long-term constipation can linger. The rectal and anal tissues may have undergone changes due to previous strain, and you might still experience some residual sensitivity or discomfort. Regular bowel habits, as you are practicing now, are crucial in maintaining bowel health and preventing recurrence of constipation-related issues.

In summary, while your symptoms may not indicate a severe underlying condition, they do warrant attention. It is advisable to maintain a high-fiber diet, stay well-hydrated, and consider the use of stool softeners if necessary. Additionally, if your symptoms persist or worsen, seeking medical advice from a gastroenterologist would be beneficial. They can provide a comprehensive evaluation and recommend appropriate treatments or lifestyle modifications tailored to your specific needs. Remember, proactive management of bowel health is key to preventing future complications and ensuring overall well-being.

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