Anal Heaviness: Causes, Symptoms, and Treatment Options

Anal heaviness sensation

Hello, Doctor.
I previously visited a colorectal clinic due to a lump and a feeling of heaviness in my anus.
After an examination, the doctor indicated that it was hemorrhoids and advised me not to worry.
The feeling of heaviness was attributed to mild hemorrhoid symptoms, but since I have not experienced any bleeding during bowel movements, there is no cause for concern.
I was advised to focus on conservative treatment.
I would like to ask the doctor: 1.
I have seen some doctors suggest that the lump might be a thrombosed hemorrhoid.
How can it be resolved? 2.
I understand that the feeling of heaviness is referred to as "tenesmus." What recommendations do you have for treating or alleviating this symptom, or are there any precautions I should take? Thank you for your guidance, and I appreciate your hard work.

A Hong, 30~39 year old female. Ask Date: 2023/05/01

Dr. Ke Fangxu reply Surgery

1.
It will absorb on its own.
2.
Ointments or suppositories can help alleviate symptoms, and some anti-inflammatory medications may also be beneficial.
The key point is to avoid prolonged straining during bowel movements to prevent poor blood circulation, which can lead to hemorrhoid swelling.

Reply Date: 2023/05/01

More Info

Understanding anal heaviness, particularly in the context of hemorrhoids, involves recognizing the symptoms, causes, and treatment options available. Based on your description, it appears that you have been diagnosed with hemorrhoids, which can indeed lead to feelings of heaviness or pressure in the anal area. Let’s delve deeper into your concerns.

Causes of Anal Heaviness
Anal heaviness or a feeling of fullness can be attributed to several factors, primarily related to hemorrhoids. Hemorrhoids are swollen veins in the lower rectum and anus, and they can be classified into two main types: internal and external. Internal hemorrhoids are located inside the rectum, while external hemorrhoids are under the skin around the anus.
The sensation of heaviness or pressure can arise from:
1. Swelling of Hemorrhoids: When the veins in the anal region become engorged with blood, they can create a feeling of fullness or heaviness.

2. Blood Clots: In some cases, external hemorrhoids can develop blood clots (thrombosed hemorrhoids), leading to significant pain and a hard lump near the anus.

3. Constipation: Straining during bowel movements can exacerbate hemorrhoids and contribute to feelings of heaviness.

4. Pelvic Floor Dysfunction: Weakness or dysfunction in the pelvic floor muscles can also lead to a sensation of heaviness.

Symptoms
The symptoms associated with hemorrhoids can include:
- Pain or discomfort in the anal area
- Swelling or a lump near the anus
- Itching or irritation
- A feeling of fullness or heaviness
- Mucus discharge
- Bleeding during bowel movements (though you mentioned this has not occurred in your case)

Treatment Options
1. Conservative Management: Since your doctor has recommended conservative treatment, this typically includes lifestyle modifications such as:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining.

- Hydration: Drinking plenty of fluids can also aid in preventing constipation.

- Regular Exercise: Engaging in regular physical activity can promote healthy bowel function.

2. Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone or witch hazel can help relieve itching and discomfort.

3. Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help reduce swelling and relieve discomfort.

4. Medications: If pain or discomfort is significant, your doctor may recommend oral pain relievers such as acetaminophen or ibuprofen.

5. Thrombosed Hemorrhoids: If the hard lump you mentioned is indeed a thrombosed hemorrhoid, treatment options may include:
- Incision and Drainage: If the thrombosed hemorrhoid is painful, a healthcare provider may perform a minor procedure to remove the clot.

- Surgical Options: In cases where hemorrhoids are recurrent or severe, surgical procedures such as hemorrhoidectomy or rubber band ligation may be considered.

Addressing the Sensation of Heaviness
For the sensation of "裡急後重" (urgency with a feeling of heaviness), consider the following:
- Pelvic Floor Exercises: Strengthening the pelvic floor muscles through Kegel exercises can help improve symptoms.

- Avoiding Straining: Make sure to avoid prolonged sitting on the toilet and straining during bowel movements.

- Regular Bowel Habits: Establishing a regular schedule for bowel movements can help reduce urgency and discomfort.

When to Seek Further Help
If your symptoms persist or worsen despite conservative treatment, or if you experience new symptoms such as significant bleeding, severe pain, or changes in bowel habits, it is important to follow up with your healthcare provider. They may recommend further evaluation or more advanced treatment options.

In summary, while hemorrhoids can cause discomfort and a sensation of heaviness, there are effective management strategies available. By making lifestyle changes and following your doctor's recommendations, you can alleviate symptoms and improve your quality of life. Always feel free to reach out to your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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