Rectal Sensations: When to Seek Gastroenterology Advice

I would like to request a medical evaluation?

Hello Doctor, I previously inquired about the sensation of a foreign body in the anus.
From last Saturday, the 6th, to today, the 14th, I have seen two doctors, and I still feel a sensation of a foreign body in the anus.
Is this normal? When I use a bullet-shaped suppository, the sensation seems to lessen.
At that time, the doctor performed a digital rectal examination and said there was no issue.
Initially, I thought it was due to the use of an anoscope, but during the second visit, another doctor informed me that they do not have an anoscope, so there was no digital examination performed then.
Additionally, I have been feeling the urge to defecate frequently, but when I do, there is only a small amount of stool.
I would like to know if my situation requires a colonoscopy.
I have observed that my stool does not contain blood, and there is no diarrhea.
Could it be that anxiety is causing the sensation of a foreign body in the anus, or is it truly a symptom caused by hemorrhoids? Thank you, Doctor.

Lin, 30~39 year old female. Ask Date: 2023/05/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be a personal sensation of abnormality or anxiety; if necessary, one can seek treatment from a psychiatry department or undergo anal rectal pressure measurement tests at a medical center's colorectal surgery department.

Reply Date: 2023/05/14

More Info

When it comes to rectal sensations, particularly the feeling of a foreign body in the anal area, it is essential to understand the potential causes and when to seek further medical advice. Based on your description, it seems you have been experiencing this sensation for over a week, which can understandably be concerning.
Firstly, it is important to note that the sensation of a foreign body in the rectum can arise from various conditions. Common causes include hemorrhoids, anal fissures, or even muscle spasms in the pelvic floor. Hemorrhoids, which are swollen veins in the lower rectum and anus, can often lead to discomfort and a sensation of fullness or pressure. They may not always present with visible blood in the stool, especially if they are internal.
You mentioned that you have been using a bullet-shaped suppository, which may temporarily relieve the sensation. This is likely due to the lubrication and the physical presence of the suppository, which can help alleviate discomfort caused by hemorrhoids or anal spasms. However, the fact that the sensation persists after discontinuing the suppository suggests that there may be an underlying issue that needs to be addressed.

Regarding your visits to the doctor, it is reassuring that the initial examination did not reveal any immediate concerns. However, the absence of a rectal examination during your second visit may leave some questions unanswered. A thorough examination, including a digital rectal exam, is crucial in assessing any abnormalities in the anal canal or rectum.

You also expressed concern about the need for a colonoscopy. While your stools have not shown any blood and you are not experiencing diarrhea, the persistent sensation of a foreign body, especially if accompanied by changes in bowel habits or discomfort, warrants further investigation. A colonoscopy can help rule out any significant issues such as polyps, tumors, or inflammatory bowel disease, especially if symptoms persist or worsen.

Anxiety can indeed exacerbate physical sensations, including the feeling of a foreign body in the rectum. Stress and anxiety can lead to increased muscle tension and heightened awareness of bodily sensations, which may contribute to your discomfort. It is essential to consider this aspect and explore relaxation techniques or stress management strategies to help alleviate some of the anxiety you are experiencing.

In summary, while your symptoms may be related to common conditions such as hemorrhoids or anxiety, it is advisable to follow up with a gastroenterologist for a comprehensive evaluation. This may include a colonoscopy if deemed necessary, to ensure that there are no underlying issues that require treatment. Additionally, discussing your anxiety with a healthcare provider may provide you with strategies to manage your symptoms better. Remember, it is always better to err on the side of caution when it comes to your health, so seeking further medical advice is a prudent step.

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