Symptoms of Suspected Intestinal Obstruction and Rectal Mass

Suspected intestinal obstruction, rectal mass?

On the morning of October 22, I experienced pain in the lower left abdomen.
After an evaluation, the doctor diagnosed it as intestinal spasms and prescribed medication for three days.
Following that, I began to have occasional mild abdominal pain, along with increased bowel sounds and more frequent flatulence, but I did not experience any bloating or vomiting, and I have been having a bowel movement once a day.
On the 29th, I visited Cheng Kung University Hospital, where the doctor, after listening to my description and performing a physical examination, concluded that there was nothing concerning and advised me to continue monitoring my symptoms.
Subsequently, the frequency of bowel sounds and flatulence decreased, and the sensation of passing gas changed to feel more like gas escaping.
I still have a daily bowel movement.
Today, I felt quite anxious, so while showering, I used my fingers to apply body wash and explored my rectum, where I felt something that seemed quite large.
Should I immediately go to a clinic or hospital for a digital rectal examination or other tests to determine if it is an internal hemorrhoid or a tumor? (I have had episodes of hard stools and have also experienced blood in my stool.)

Wei, 20~29 year old female. Ask Date: 2021/11/02

Dr. Ke Fangxu reply Surgery

The lumps that can be felt during a digital rectal examination are mostly hemorrhoids or prostate issues.
It is essential to consult a professional physician for an accurate diagnosis.
If necessary, a sigmoidoscopy or colonoscopy can be performed for confirmation.
If a tumor is indeed present, a biopsy will need to be conducted.

Reply Date: 2021/11/02

More Info

Based on your symptoms and the medical history you've provided, it is essential to take your concerns seriously, especially given the presence of a palpable mass in the rectal area and your family history of cancers.
Firstly, the symptoms you described, including left lower abdominal pain, increased bowel sounds, and changes in flatulence, can be indicative of various gastrointestinal issues. The fact that you have been experiencing these symptoms intermittently, along with the absence of severe symptoms like abdominal distension or vomiting, suggests that you may not be facing a complete intestinal obstruction. However, the presence of a mass that you can feel during self-examination raises the possibility of a rectal mass, which could be benign (like hemorrhoids) or malignant (like a tumor).

Given your family history of colorectal cancer, it is prudent to be proactive about your health. The presence of blood in your stool, even if it is not consistent, is another red flag that should not be ignored. Blood in the stool can arise from various sources, including hemorrhoids, diverticular disease, or more serious conditions such as colorectal cancer.
You mentioned that your doctor previously assessed your condition and suggested observation. While this is a common approach when symptoms are mild and non-specific, the discovery of a mass during self-examination warrants further investigation. It is advisable to schedule an appointment with your healthcare provider as soon as possible for a thorough evaluation. This may include a digital rectal examination, and possibly a colonoscopy, which is the gold standard for visualizing the colon and rectum to identify any abnormalities, including polyps or tumors.

In terms of your symptoms, the increased bowel sounds and flatulence could be related to changes in your diet, stress, or gastrointestinal motility issues. However, the fact that you have also experienced changes in your bowel habits and the sensation of a mass cannot be overlooked.
In conclusion, I strongly recommend that you seek medical attention promptly. Do not hesitate to express your concerns about the mass you felt and your family history of cancer. Early detection is crucial in managing any potential issues effectively. Your healthcare provider may suggest imaging studies or a referral to a gastroenterologist for further evaluation. Remember, it is always better to err on the side of caution when it comes to your health.

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