Abnormal Bowel Movements and Rectal Discomfort Symptoms

Q: Abnormal Bowel Movements and Rectal Discomfort Symptoms

Hello： Whether further examination is needed can be determined by a clinical physician. <br>If the clinical physician assesses that it is not necessary, but you still wish to understand your condition better, you may consider participating in a private advanced health check-up. <

There is often a sensation of foreign objects after bowel movements, and the stool varies in thickness from thick to thin?

Hello Doctor: Since January of last year, I have frequently experienced a feeling of heaviness and a foreign body sensation in my anus.
Initially, I did not pay much attention to it, and the symptoms fluctuated.
However, I have noticed that the situation has been occurring more often and has become increasingly severe.
Recently, my stools have varied in thickness; the thicker ones can be about the size of three fingers, while the thinner ones are about the size of half a finger.
Sometimes, the thinner stools are difficult to pass and require significant effort to expel.
I usually have a bowel movement around 9 AM; sometimes, immediately after using the restroom, I can feel that my bowels are not completely empty, but I cannot fully evacuate.
By noon or in the afternoon, I typically feel the urge to go again, and that is when I can finally pass the stool.
(Previously, my bowel movement frequency was consistently once a day; recently, it has been two to three times a day on some occasions.) Sometimes, using a bidet with warm water to stimulate the anal area helps me empty my bowels completely; however, when I do not use it, I often feel that my bowels are not fully evacuated, which leads to needing to go to the bathroom twice a day.
The feelings of heaviness and foreign body sensation are persistent and quite bothersome in my daily life.
I have never had issues with constipation before, and my bowel movements were always smooth without any sensation of heaviness or foreign body in the anus.
I have done some online research, and the conditions mentioned mostly relate to hemorrhoids, polyps, or even colorectal cancer.
I tend to be more anxious and sensitive, and I am unsure if these symptoms or non-specific symptoms warrant further examination with an upper endoscopy, colonoscopy, and digital rectal examination for a more definitive diagnosis and to rule out any issues.
(I had an upper endoscopy at 20 years old and was diagnosed with a gastric ulcer (not caused by Helicobacter pylori), and I have a naturally sensitive gastrointestinal system.) Thank you for your assistance!

Newbie Worker A, 20~29 year old female. Ask Date: 2022/02/11

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Whether further examination is needed can be determined by a clinical physician.
If the clinical physician assesses that it is not necessary, but you still wish to understand your condition better, you may consider participating in a private advanced health check-up.
Additionally, you should review your dietary habits to ensure you are consuming enough fruits and vegetables and maintaining a balanced diet.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2022/02/11

More Info

The symptoms you are experiencing, including rectal fullness, abnormal bowel movements, and the sensation of incomplete evacuation, can be concerning and warrant further evaluation. Given your history of gastrointestinal issues, including a previous diagnosis of a gastric ulcer and a tendency towards gastrointestinal sensitivity, it is important to approach this situation with a comprehensive understanding of potential causes.

Firstly, the sensation of rectal fullness and the feeling of an obstruction can be associated with several conditions. Hemorrhoids, which you mentioned, can cause discomfort and a sensation of fullness, especially if they are internal. They can also lead to changes in bowel habits, such as straining during bowel movements, which may explain the variability in the size of your stools. Larger stools can be more difficult to pass, leading to the sensation of incomplete evacuation.

Additionally, the presence of mucus in your stool and the variability in stool size could indicate an underlying inflammatory condition, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). IBS is characterized by changes in bowel habits and abdominal discomfort, often exacerbated by stress or dietary factors. On the other hand, IBD, which includes conditions like Crohn's disease and ulcerative colitis, can lead to more severe symptoms, including rectal bleeding, weight loss, and persistent abdominal pain.

Given your age and the nature of your symptoms, it is also prudent to consider the possibility of colorectal polyps or even colorectal cancer, although the latter is less common in younger individuals. Symptoms such as changes in bowel habits, rectal bleeding, and persistent abdominal pain should not be ignored, especially if they are new or worsening.

In your case, the fact that you have experienced a change in bowel habits, including the need to strain for bowel movements and the sensation of incomplete evacuation, suggests that further investigation is warranted. A colonoscopy would be a valuable diagnostic tool to visualize the colon and rectum, allowing for the identification of any abnormalities such as polyps, inflammation, or other lesions. Given your previous gastrointestinal history and the current symptoms, a colonoscopy could help rule out serious conditions and provide peace of mind.

Additionally, it may be beneficial to discuss your symptoms with a gastroenterologist, who can provide a tailored approach to your situation. They may recommend dietary modifications, stress management techniques, and possibly medications to help manage your symptoms. If you are experiencing significant anxiety regarding your symptoms, addressing this aspect with a healthcare professional can also be beneficial.

In summary, while your symptoms may be related to benign conditions such as hemorrhoids or IBS, the presence of significant changes in bowel habits and the sensation of rectal fullness warrant further evaluation. A colonoscopy, along with a thorough discussion of your symptoms and medical history, will provide clarity and help guide appropriate management. It is essential to prioritize your health and seek the necessary evaluations to ensure any potential issues are addressed promptly.

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