Rectal Pressure and Foreign Body Sensation: Causes and Treatments

Feeling of anal heaviness, sensation of anal foreign body?

Hello doctor, recently whenever I stand for 1-2 hours or exercise, such as cycling for an hour or running for an hour, I feel a sensation of something protruding from my anus or experience pain when I contract.
After applying some medication, the discomfort improves, but I do not experience this issue when sitting for long periods.
What could these symptoms indicate? Do I need surgical treatment?

konfyoos, 20~29 year old female. Ask Date: 2022/04/27

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoids.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Spicy and irritating foods should be temporarily avoided, and increasing dietary fiber intake can be beneficial.
Warm sitz baths should help alleviate symptoms, and over-the-counter hemorrhoid suppositories can be used.
Laxatives should not be taken casually.
If symptoms persist, it is best to consult a physician.
Surgical treatment is likely not necessary at this time.

Reply Date: 2022/04/27

More Info

Understanding rectal pressure and the sensation of a foreign body can be quite distressing, and it is essential to explore the potential causes and treatments for these symptoms. Based on your description, it seems that you experience a sensation of something protruding from the rectum or discomfort during activities such as standing for prolonged periods or exercising. This sensation can be associated with several conditions, and understanding these can help in determining the appropriate course of action.

One common cause of the sensation of rectal pressure or a feeling of something "falling out" is rectal prolapse. This occurs when the rectum descends through the anal opening, which can happen due to weakened pelvic floor muscles, often exacerbated by prolonged standing, heavy lifting, or straining during bowel movements. Symptoms may include a visible bulge, discomfort, and pain during bowel movements.
Another possibility is hemorrhoids, which are swollen blood vessels in the rectal area. They can cause discomfort, pain, and a sensation of fullness or pressure, especially during activities that increase abdominal pressure, such as standing or exercising. Hemorrhoids can be internal or external, and while they may not always require surgical intervention, they can be managed with lifestyle changes, topical treatments, and, in some cases, surgical procedures.

Additionally, anal fissures, which are small tears in the lining of the anus, can lead to pain during bowel movements and a sensation of discomfort. These can be exacerbated by hard stools or straining. Treatment typically involves dietary changes to ensure softer stools, topical anesthetics, and sometimes medications to promote healing.

Given that you mentioned some improvement with topical treatments after bowel movements, it suggests that your symptoms may be related to one of these conditions. However, the fact that you do not experience these symptoms while sitting could indicate that your pelvic floor muscles are being strained during standing or certain activities, leading to discomfort.

In terms of treatment, it is crucial to first consult with a healthcare professional, preferably a gastroenterologist or a colorectal surgeon, who can perform a thorough examination and possibly recommend diagnostic tests such as a colonoscopy or imaging studies to rule out any serious underlying conditions.
Conservative management strategies may include:
1. Dietary Modifications: Increasing fiber intake to promote regular bowel movements and prevent straining.

2. Hydration: Ensuring adequate fluid intake to help soften stools.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises like Kegels can help support the rectum and alleviate symptoms.

4. Topical Treatments: Over-the-counter creams or ointments can provide relief from pain and discomfort associated with hemorrhoids or fissures.

If conservative measures do not provide relief, or if there is significant prolapse or persistent symptoms, surgical options may be considered. Surgical interventions can range from minimally invasive procedures to more extensive surgeries, depending on the severity of the condition.

In conclusion, while your symptoms may be indicative of conditions like rectal prolapse, hemorrhoids, or anal fissures, a thorough evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate treatment plan. Early intervention can help alleviate discomfort and prevent potential complications.

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