Rectal Symptoms: Is It Hemorrhoids or Something Else?

Anus

Hello, I have been experiencing irregular bowel movements for quite some time.
Sometimes I have normal bowel movements once a day or multiple times, while other times I only go once a week.
I occasionally feel abdominal pain, but the stool is normal.
I initially thought it was constipation, but the stool is not hard; it sometimes feels like it's in pieces.
There have been instances where I felt the urge to have a bowel movement, but when I go to the bathroom, I only pass gas, and after that, the urge to defecate disappears.
However, I have to strain a lot to pass the stool, which is either normal or in pieces.

Previously, when I had an upper gastrointestinal endoscopy, I was diagnosed with gastroesophageal reflux disease (GERD), and I mentioned these symptoms to the doctor.
The diagnosis was likely irritable bowel syndrome (IBS), which made me feel more at ease.
However, the symptoms fluctuate; sometimes I have a bowel movement daily, and other times only once or twice a week.
A few days ago, after using the restroom, the stool was also in pieces (and required some straining to pass).

Later, I noticed something unusual; upon touching, I found a protrusion near the anus that felt swollen, soft, and similar to normal tissue.
It is not painful or itchy, and I only noticed it because it felt strange.
The area around the anus also felt slightly swollen, but again, it is not painful or itchy.
Previously, I experienced itching around the anus, but that has since resolved.
There were times when I felt sharp nerve pain in that area, especially before my menstrual period, but now, aside from occasional cramps during menstruation, I no longer experience that.
The next day upon waking, I noticed that the small protrusion was gone, and the swelling around the anus had also disappeared.
Could this be external hemorrhoids? Do I need medication or surgery, or can this condition be improved through lifestyle changes? This is the first time I have experienced these symptoms; I have never had this before!

LAN LAN, 20~29 year old female. Ask Date: 2008/12/03

Dr. Hou Yongji reply Surgery

Based on your description, a precise diagnosis cannot be made.
Typically, conditions related to the rectum and anus cannot be diagnosed remotely; the evaluation must include a thorough medical history, visual examination, digital rectal examination, and possibly endoscopy or X-ray imaging.
It is recommended that you seek consultation with a colorectal specialist as soon as possible (attached is a list of colorectal specialists).
Thank you.

Reply Date: 2008/12/03

More Info

Understanding rectal symptoms can be quite challenging, especially when they present with a variety of signs and sensations. Based on your description, it seems you are experiencing a combination of bowel irregularities and a possible external anal condition, which could be related to hemorrhoids or other issues.

Firstly, let's address the bowel symptoms. You mentioned experiencing irregular bowel movements, sometimes having normal stools, and at other times feeling constipated, with stools that are not hard but may come out in pieces. This pattern can be indicative of a condition known as Irritable Bowel Syndrome (IBS), which is characterized by a mix of constipation and diarrhea, along with abdominal discomfort. The fact that you have been diagnosed with gastroesophageal reflux disease (GERD) suggests that you are already aware of gastrointestinal issues, which can sometimes coexist.

The sensation of needing to strain during bowel movements, along with the feeling of incomplete evacuation, can be frustrating and may contribute to the development of external hemorrhoids. Hemorrhoids are swollen veins in the lower rectum and anus, and they can be either internal or external. External hemorrhoids can cause a lump near the anus, which may feel soft and non-painful, as you described. The fact that you noticed a protrusion near the anus that later disappeared could indeed suggest a transient external hemorrhoid or a thrombosed hemorrhoid, which can resolve on its own.

The absence of pain, itching, or significant discomfort is a positive sign, as these symptoms are often associated with more severe conditions. However, the presence of a lump or swelling around the anus, even if it is painless, warrants attention. It is essential to monitor any changes in this area, as well as any recurring symptoms.

In terms of management, there are several lifestyle modifications and home remedies that can help alleviate symptoms associated with hemorrhoids and bowel irregularities:
1. Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help regulate bowel movements and prevent constipation. Staying well-hydrated is also crucial.

2. Regular Exercise: Engaging in regular physical activity can promote healthy bowel function and reduce the risk of developing hemorrhoids.

3. Proper Bathroom Habits: Avoid straining during bowel movements, and try to establish a regular bathroom routine. Responding to the urge to have a bowel movement promptly can help prevent constipation.

4. Over-the-Counter Treatments: There are various topical treatments available for hemorrhoids, such as creams or ointments that can provide relief from discomfort and inflammation.

5. Warm Baths: Soaking in a warm bath can help soothe the area and reduce swelling.

If your symptoms persist, worsen, or if you notice any new symptoms such as bleeding, significant pain, or changes in bowel habits, it is essential to consult a healthcare professional. They may recommend further evaluation, such as a physical examination or imaging studies, to rule out other conditions.

In summary, while your symptoms may suggest external hemorrhoids, it is crucial to maintain awareness of any changes and to consider lifestyle modifications to improve your bowel health. If you have concerns or if symptoms persist, seeking medical advice is always a prudent step.

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