Rectal Pressure: Causes and Solutions for Discomfort

There is a feeling of fullness in the rectum?

I used to experience some constipation and had internal hemorrhoids, typically having a bowel movement every two days.
However, recently I started eating breakfast and developed a habit of drinking water in the morning, which has led me to use the toilet more frequently.
I feel bloated and often pass gas, and sometimes I go to the bathroom up to twice a day (which I never did before).
Sometimes my stools are of normal shape, while other times they are a bit soft.
Strangely, despite the increased frequency, I still need to exert some abdominal pressure to pass stools, regardless of whether they are hard or soft.
It’s not that I have to squat for a long time, but it’s not as effortless as it used to be.
Additionally, sometimes when I sit down, I feel a bloated sensation in my rectum; it’s not painful, but it’s uncomfortable, and I find myself wanting to contract my anal sphincter.
This symptom has been bothering me for about 3 to 4 months.
I have seen four doctors, undergone four digital rectal examinations, and had one flexible sigmoidoscopy, all of which indicated no significant issues.
I also had stool tests (for occult blood and parasites) that came back normal.
Recently, I even paid out of pocket for a full colonoscopy, which also showed no problems.
The doctors only mentioned that my gastrointestinal function is not very good and that I tend to be anxious, advising me to exercise more.
So, where are these symptoms coming from? My mother thinks I am complaining without cause, and I have spent quite a bit on tests...
The most troubling symptom for me is the feeling of heaviness in my rectum, and I find it very bothersome to constantly focus on my anal area!

Mike, 20~29 year old female. Ask Date: 2013/03/14

Dr. Ke Fangxu reply Surgery

At the age of 23, along with having undergone all necessary examinations, your colon should not have any issues.
The symptoms that are troubling you are generally classified as Irritable Bowel Syndrome (IBS), which is often related to psychosocial stress.
Most cases can be improved through lifestyle changes and dietary adjustments.
If these symptoms significantly affect your daily life, medication may be used to alleviate them.
In more severe cases, antidepressants may be prescribed in conjunction.
It is advisable to reduce the intake of fatty foods and increase fiber consumption, while minimizing the use of tobacco, alcohol, and spicy irritants.
These changes should help alleviate your symptoms.

Reply Date: 2013/03/14

More Info

Understanding rectal pressure and discomfort can be a complex issue, especially when it involves symptoms like constipation, hemorrhoids, and the sensation of fullness or pressure in the rectal area. Based on your description, it seems that you have been experiencing a range of gastrointestinal symptoms, including changes in bowel habits, discomfort during bowel movements, and a persistent feeling of rectal pressure.

Causes of Rectal Pressure and Discomfort
1. Constipation: Chronic constipation can lead to increased straining during bowel movements, which can cause discomfort and a feeling of pressure in the rectal area. Even if you are having more frequent bowel movements now, if they are not complete or if you are still straining, this can contribute to the sensation of rectal pressure.

2. Hemorrhoids: Internal or external hemorrhoids can cause discomfort and a feeling of fullness in the rectal area. They can also lead to symptoms like bleeding or itching, which can exacerbate the sensation of pressure.

3. Dietary Factors: Changes in diet can significantly impact bowel habits. While you mentioned that you are now eating breakfast and drinking water in the morning, it's essential to ensure that your diet is rich in fiber. Insufficient fiber intake can lead to softer stools that may not pass easily, causing discomfort.

4. Anxiety and Stress: Psychological factors can also play a significant role in gastrointestinal symptoms. Anxiety can lead to increased muscle tension, including in the pelvic floor, which can make bowel movements more difficult and contribute to a sensation of pressure.

5. Pelvic Floor Dysfunction: This condition occurs when the muscles of the pelvic floor do not function correctly, which can lead to difficulty in bowel movements and a feeling of rectal fullness. This dysfunction can be exacerbated by stress and anxiety.

6. Irritable Bowel Syndrome (IBS): IBS is a common gastrointestinal disorder that can cause symptoms like abdominal pain, bloating, and changes in bowel habits. Stress and anxiety are known triggers for IBS symptoms.

Solutions and Management Strategies
1. Dietary Adjustments: Focus on a high-fiber diet that includes fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stools and can ease constipation. Additionally, ensure you are drinking plenty of water throughout the day to help with digestion.

2. Regular Exercise: Physical activity can help stimulate bowel function and reduce stress. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Relaxation Techniques: Since stress and anxiety can exacerbate gastrointestinal symptoms, consider incorporating relaxation techniques such as deep breathing exercises, yoga, or meditation into your daily routine.

4. Pelvic Floor Exercises: If pelvic floor dysfunction is suspected, pelvic floor exercises (often referred to as Kegel exercises) can help strengthen the muscles and improve bowel function.

5. Consult a Specialist: If symptoms persist despite lifestyle changes, consider consulting a gastroenterologist or a pelvic floor specialist who can provide targeted treatment options.

6. Psychological Support: If anxiety is a significant factor in your symptoms, speaking with a mental health professional can be beneficial. Cognitive-behavioral therapy (CBT) has been shown to help individuals manage anxiety and its physical manifestations.

Conclusion
It’s understandable to feel frustrated when experiencing persistent symptoms, especially after undergoing multiple tests with no clear diagnosis. It’s essential to continue advocating for your health and seeking solutions that address both the physical and psychological aspects of your symptoms. Remember that gastrointestinal health is often interconnected with emotional well-being, and addressing both can lead to significant improvements in your overall quality of life. If you continue to experience discomfort, consider seeking a second opinion or exploring alternative therapies that may provide relief.

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