Rectal Discomfort: Causes of Mucus and Blood in Stool

Q: Rectal Discomfort: Causes of Mucus and Blood in Stool

Hello, Miss： Your colonoscopy and CT scan have confirmed that there are no structural abnormalities, so it is likely that your bowel movement difficulties are due to dysmotility. <br>You may use prokinetic or stool softener medications, and ensure that your menstrual cycle (endoc

There is a sensation of a foreign body in the anus, with mucus and blood streaks in the stool?

Hello Doctor: I have been suffering from constipation for many years, typically having a bowel movement only 1 to 2 times a week.
I often feel that my bowels are not completely empty, and I experience a sensation of something being stuck in my anus.
Earlier this year, during a check-up, my doctor found traces of blood, so I underwent a colonoscopy.
The results were normal, but since then, I feel that my bowel movements have only been normal for less than a month before I started having difficulties again.
Not only can I not have a bowel movement, but the sensation of a foreign object in my anus makes it hard for me to sit still.
I started using a rectal suppository, but this year, it only allowed me to pass a small amount.
Two months ago, I went to another gastroenterologist, and the X-ray report indicated fecal impaction on both sides.
The medication prescribed did not help, and after taking castor oil, I only passed a little.
The doctor then ordered a CT scan, and I took Dulcolax before bed.
If I take it, I experience severe abdominal pain and diarrhea the next morning.
The CT report indicated that there was a lot of stool but no other significant issues.
The doctor prescribed me medication for two weeks.
Initially, taking the medication at bedtime helped, but for the past two days, I have not felt any effect.
I have not been able to have a bowel movement for a week, and when I tried using a suppository, nothing came out.
(In the past, when I couldn't pass stool, I would manually stimulate my anus.) However, I have been passing gas, and I feel like the rectal wall is protruding, completely blocking the rectal opening, preventing me from passing stool.
I had to use my fingers to dig, resulting in only three small pieces, each covered in mucus and blood (the mucus feels similar to phlegm).
That night, I took Dulcolax, but I still had no pain or urge to use the bathroom.
My abdomen has become very distended, and I have gained a kilogram this month, despite exercising and drinking plenty of water and eating vegetables.
My lower left abdomen feels hard, but I still cannot pass stool.
Doctor, what could be causing the blockage at my rectal opening? (Could it be hemorrhoids? In the past, I have had internal hemorrhoids that would protrude and require manual reinsertion, but that hasn't happened this month because I can't pass stool at all.) Do I need to undergo any further examinations? Thank you for your patience in reading this.
I appreciate it.

JOY, 30~39 year old female. Ask Date: 2015/11/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss: Your colonoscopy and CT scan have confirmed that there are no structural abnormalities, so it is likely that your bowel movement difficulties are due to dysmotility.
You may use prokinetic or stool softener medications, and ensure that your menstrual cycle (endocrine function) is normal.
If necessary, you can also use enema medications to alleviate discomfort.
Changhua Hospital cares about your health.
Chen Shih-Dian

Reply Date: 2015/11/14

More Info

Understanding rectal discomfort, especially when accompanied by mucus and blood in the stool, can be quite distressing. Your symptoms suggest a complex interplay of constipation, possible rectal obstruction, and inflammation, which may be causing the mucus and blood you are experiencing.
Firstly, chronic constipation, as you described, can lead to a variety of complications. When stool remains in the colon for extended periods, it can become hard and difficult to pass, leading to fecal impaction. This condition can cause significant discomfort and may result in the rectal wall becoming stretched or inflamed, which could explain the sensation of a foreign body in the rectum. The presence of mucus and blood can indicate irritation or damage to the rectal lining, possibly due to straining or the passage of hard stool.

The fact that you have experienced blood in your stool, even if it was noted during a colonoscopy that everything appeared normal, is concerning. While the colonoscopy may have ruled out significant pathologies such as polyps or malignancies, it does not completely eliminate the possibility of other conditions such as hemorrhoids, anal fissures, or inflammatory bowel disease (IBD) that could cause similar symptoms.
Your description of using manual stimulation to facilitate bowel movements suggests that you may be experiencing a form of rectal prolapse or rectocele, where the rectal wall bulges into the vagina (in females) or the rectum itself may be protruding. This can create a sensation of obstruction and may require further evaluation.
Given your ongoing symptoms, including the inability to pass stool despite using laxatives and the presence of mucus and blood, it is crucial to seek further medical evaluation. You may need to consider the following steps:
1. Consult a Gastroenterologist: A specialist can provide a more thorough evaluation of your gastrointestinal tract. They may recommend additional imaging studies, such as a defecography, to assess how well your rectum and pelvic floor are functioning during bowel movements.

2. Consider Dietary Adjustments: While you mentioned consuming water and vegetables, it may be beneficial to work with a nutritionist to ensure you are getting adequate fiber and hydration tailored to your specific needs.

3. Pelvic Floor Therapy: If there is a concern about pelvic floor dysfunction, physical therapy focusing on the pelvic floor may help improve your ability to have bowel movements.

4. Medication Review: Discuss with your doctor the medications you are currently taking, including Dulcolax and any other laxatives. Sometimes, a combination of treatments or a different approach may be necessary.

5. Monitor Symptoms: Keep a detailed record of your bowel habits, dietary intake, and any other symptoms you experience. This information can be invaluable for your healthcare provider in determining the best course of action.

In summary, your symptoms of rectal discomfort, mucus, and blood in the stool warrant further investigation. It is essential to address these issues promptly to prevent complications and improve your quality of life. Please do not hesitate to reach out to your healthcare provider for further assistance and to discuss the next steps in your care.

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