Rectal Ulcers: Symptoms, Treatment, and When to Seek Help

Rectal ulcer 2

Dr.
Tsai: Thank you very much for your professional and prompt response; you are truly a passionate and excellent physician! I would like to ask you the following: 1.
Following my previous condition, the doctor believes that my rectal ulcer will heal on its own, so I continue to take Lamerac (Mesalazine) and am advised to take it as needed (along with one Esomeprazole tablet before bed).
However, I am unsure if I am being overly sensitive, as I still feel sharp and dull pains in my abdomen (lower left and right, around the navel), and I experience increased flatulence (waking up at night and after meals), but there is no blood in my stool.
The doctor suggested a follow-up colonoscopy in three months, but I am worried that my intestines may still be inflamed.
Should I go to a larger hospital for another examination? (I wonder if my cesarean section six months ago is related.) Or should I try to relax and not overthink it? 2.
Due to anxiety (I find it difficult to fall asleep after waking up at night), my gastric ulcer symptoms seem to have worsened (initially diagnosed with three early-stage ulcers during an endoscopy).
I have been taking Pantoprazole (40 mg) for about a month (one tablet before breakfast), but my initial hunger pangs have developed into mild pain before and after meals, and I experience intense hunger in the afternoon...
Should I ask the doctor to increase the dosage? The doctor advised me not to be too anxious, but because of the pain, it is hard to ignore it.
Please give me your advice, Dr.
Tsai.
Thank you very much! I appreciate your hard work! Thank you!

chelle, 30~39 year old female. Ask Date: 2012/11/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello,
(1) Rectitis is commonly associated with symptoms such as bloody stools or tenesmus (the constant feeling of needing to pass stools).
The sharp and dull pain in the lower left abdomen and around the navel does not seem directly related.
Given that there was a cesarean section six months ago, the possibility of adhesions between the uterine incision and the intestines should be considered.
The recommended solutions include increasing physical activity, reducing constipation, consuming more fruits and vegetables, and staying hydrated.
If severe pain occurs, medical evaluation is necessary.
Whether you need to go to a larger hospital for further examination depends on your symptoms; if they worsen, further investigation is advised.
If symptoms gradually improve, there is no need for excessive concern.
(2) Tamsulosin (40 mg) is a 24-hour long-acting medication, and increasing the dosage is not recommended.
If symptoms worsen before or after meals, a physician should evaluate and adjust other gastrointestinal medications accordingly.
Changhua Hospital is concerned about your health.

Dr.
Cai An-shun

Reply Date: 2012/11/06

More Info

Understanding rectal ulcers, their symptoms, treatment, and when to seek help is crucial for managing your health effectively. Rectal ulcers can be a source of discomfort and anxiety, especially when accompanied by symptoms such as pain, changes in bowel habits, and other gastrointestinal issues. Here’s a comprehensive overview based on your concerns.

Symptoms of Rectal Ulcers
Rectal ulcers can manifest in various ways, including:
- Pain: This is often localized in the lower abdomen or rectal area. You mentioned experiencing stabbing and dull pain, which can be indicative of inflammation or irritation in the rectal area.

- Changes in Bowel Movements: Increased gas and changes in stool consistency can occur. The absence of blood in your stool is a positive sign, but persistent discomfort should not be ignored.

- Bloating: This can be a result of dietary choices or stress, which can exacerbate gastrointestinal symptoms.

Treatment Options
1. Medications: Your doctor has prescribed medications like Laxative and possibly a stool softener to help manage your symptoms. These can aid in reducing pain during bowel movements and promote healing.

2. Dietary Adjustments: Incorporating a high-fiber diet can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

3. Hydration: Drinking plenty of water is essential to prevent constipation and promote overall digestive health.

4. Warm Sitz Baths: These can provide relief from pain and discomfort associated with rectal ulcers. Sitting in warm water can help soothe the area and promote healing.

When to Seek Help
Given your symptoms and concerns, it’s essential to monitor your condition closely. Here are some guidelines on when to seek further medical attention:
- Persistent or Worsening Symptoms: If your abdominal pain intensifies or if you start experiencing new symptoms such as blood in your stool, significant changes in bowel habits, or fever, you should consult your healthcare provider immediately.

- Anxiety and Stress Management: Since you mentioned that anxiety is affecting your sleep and possibly exacerbating your gastrointestinal symptoms, consider discussing this with your doctor. They may recommend stress management techniques or refer you to a mental health professional.

- Follow-Up Appointments: Your doctor suggested a follow-up colonoscopy in three months. If your symptoms do not improve or worsen before that time, it may be prudent to seek an earlier evaluation.

Connection to Previous Surgery
Your concern about the potential impact of your previous cesarean section on your current symptoms is valid. Surgical procedures can sometimes lead to adhesions or changes in bowel function, which may contribute to discomfort. If you suspect this is a factor, discussing it with your healthcare provider can help clarify the situation.

Conclusion
In summary, while rectal ulcers can be concerning, many cases can be managed effectively with appropriate treatment and lifestyle adjustments. It’s essential to maintain open communication with your healthcare provider, especially if your symptoms change or worsen. Remember, your mental well-being is just as important as your physical health, so addressing anxiety and stress is crucial in your overall treatment plan. Don’t hesitate to reach out to your doctor with any concerns; they are there to help you navigate your health journey.

Similar Q&A

Understanding Anal Ulcers: Causes, Treatment, and When to Seek Help

Hello Dr. Ko: I have a history of constipation, but recently, for about a month, I have been experiencing significant pain after bowel movements. There have been one or two instances where the pain was so severe that it kept me awake at night. During my recent visit to the doctor...

Dr. Ke Fangxu reply Surgery
Hello: In response to your question, we generally do not refer to anal ulcers when describing anal fissures. Anal fissures are typically caused by constipation or diarrhea, and their characteristics include severe pain and minor bleeding. The vast majority do not require surgical...

Understanding Rectal Bleeding: Causes, Symptoms, and When to Seek Help

Hello Dr. Hou: For the past six months, I have been experiencing bleeding and pain every time I have a bowel movement. The amount of blood is not much, about 4 to 5 drops, but I only feel pain during bowel movements. I also have some constipation issues. A few days ago, while usi...

Dr. Hou Yongji reply Surgery
Hello: Please overcome your psychological barriers and seek treatment from a colorectal surgeon as soon as possible. Based on your description, without cooperating with on-site diagnosis and treatment, it will not be possible to provide accurate diagnosis and treatment. Thank you...

Effective Treatments and Medications for Anal Fissures: A Guide

Hello, doctor. Recently, I have been experiencing bleeding during bowel movements, possibly due to increased stress. What treatment options are available, and what medications should I apply? Thank you for your guidance.

Dr. Hou Yongji reply Surgery
1. If there is rectal bleeding, it is essential to be examined by a specialist. Do not assume it is hemorrhoids or anal fissures and treat it casually. 2. In young individuals, rectal bleeding is often due to anal fissures, most of which will heal naturally. Treatment should foc...

Understanding Gastrointestinal Issues and Bowel Health Concerns

Hello Doctor: I have many symptoms and I'm not sure where to start. First, regarding my gastrointestinal condition, for the past three to four months, I have been experiencing burping regardless of whether I eat or not. In the morning, after taking a couple of sips of wate...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello, 1. It is recommended to undergo an upper gastrointestinal endoscopy based on your gastrointestinal condition, as the symptoms may indicate gastritis or peptic ulcer disease. 2. Currently, parasitic infections are quite rare in the country; your situation may be due to p...