Persistent Discomfort After Bowel Movements: Seeking Solutions

Difficulty achieving cleanliness after bowel movements?

I apologize for the inconvenience.
I am the person who previously asked about seeing many doctors.
I have already undergone a colonoscopy, and aside from having two diverticula in my cecum, everything else seems fine.
However, my biggest concern is that almost every time I finish using the restroom, I wash myself and then pat dry with toilet paper.
The problem arises after I feel completely clean; within 30 minutes to an hour, I start to feel a sticky sensation, and when I go to the restroom again and wipe, I notice yellow residue that doesn't seem to come off completely.
This situation keeps recurring, as if something is continuously seeping out.
It seems to have started after I received sclerotherapy.
Later, I underwent a rubber band ligation procedure (I used an anal hook; I have been wondering if this is the tool used).
It was fine for a while, but now the issue keeps happening.
I have become very anxious and feel the need to check the restroom frequently to ensure nothing is leaking.
The doctors at the hospital have said I only have mild hemorrhoids and that topical medication is sufficient, but this issue keeps recurring.
I feel like I'm going crazy (should I see a psychiatrist?).
What should I do? My family is also very concerned about my condition.
Please help me, Dr.
Ke.

Feng, 30~39 year old female. Ask Date: 2015/10/18

Dr. Ke Fangxu reply Surgery

Anal discharge is generally not a significant issue and typically does not require special treatment.
If the discharge is substantial enough to stain clothing, using feminine pads to absorb the discharge can be helpful.
If the discharge is not that severe, placing cotton balls at the anal opening is also a viable option.
There is no need for excessive worry; however, if you are still feeling mentally unsettled, it may be a good idea to consult with a psychiatrist.

Reply Date: 2015/10/18

More Info

It sounds like you are experiencing a persistent and distressing issue following bowel movements, which is understandably causing you significant discomfort and anxiety. Based on your description, it seems that you have undergone a thorough evaluation, including a colonoscopy, which revealed diverticula in your appendix but no other significant findings. You mentioned that your symptoms began after receiving a sclerotherapy injection and later underwent rubber band ligation, which may have contributed to your current condition.

The symptoms you are describing—feeling sticky or having a yellowish discharge after bowel movements—could be related to several factors, including residual stool, irritation of the anal area, or even a mild infection. It's important to note that the anal region can be sensitive, and any surgical intervention, such as rubber band ligation, can lead to changes in sensation and function.

Here are some potential avenues to explore in addressing your concerns:
1. Hygiene Practices: While you are already practicing good hygiene by washing and using toilet paper, consider using gentle, unscented wipes or a bidet to ensure thorough cleaning without irritation. Sometimes, excessive wiping can lead to irritation, which may exacerbate your symptoms.

2. Dietary Adjustments: A diet high in fiber can help regulate bowel movements and reduce straining, which may alleviate some of your symptoms. Ensure you are drinking plenty of water and consuming fruits, vegetables, and whole grains. If you are experiencing diarrhea or loose stools, this could contribute to the sensation of needing to clean frequently.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bowel control and reduce the sensation of urgency. Consider consulting a physical therapist who specializes in pelvic health for guidance on appropriate exercises.

4. Anxiety Management: Given that you mentioned feeling anxious about your symptoms, it may be beneficial to address the psychological aspect of your discomfort. Anxiety can exacerbate physical symptoms, and seeking support from a mental health professional could provide you with coping strategies to manage your concerns.

5. Follow-Up with a Specialist: If your symptoms persist despite conservative measures, it may be worthwhile to seek a second opinion from a gastroenterologist or a colorectal surgeon. They can evaluate your condition more thoroughly and determine if there are any underlying issues that need to be addressed.

6. Consideration of Other Conditions: Conditions such as anal fissures, infections, or inflammatory bowel disease could also contribute to your symptoms. A thorough evaluation by a specialist can help rule out these possibilities.

7. Medication Review: If you are currently taking any medications, discuss them with your healthcare provider to ensure they are not contributing to your symptoms. Some medications can cause gastrointestinal side effects that may exacerbate your discomfort.

In summary, while it is understandable to feel overwhelmed by your symptoms, there are several strategies you can employ to help manage your discomfort. It is crucial to maintain open communication with your healthcare providers and advocate for your health. If your symptoms continue to affect your quality of life, do not hesitate to seek further evaluation and support. Remember, you are not alone in this, and there are resources available to help you navigate these challenges.

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