Bowel Issues: Causes and Solutions for Discomfort - Gastroenterology and Hepatology

Q: Bowel Issues: Causes and Solutions for Discomfort

Hello： Your symptoms generally seem to be more consistent with internal hemorrhoids. <br>If you are concerned, you can consult a gastroenterologist or a colorectal specialist for a digital rectal examination or a sigmoidoscopy to better understand your condition. <br>Changhua Hos

Constipation

Hello Doctor: Thank you for your previous response.
It has been about a week since I experienced rectal bleeding, and I currently feel a constant acidic and itchy sensation inside the anus (which I believe is related to the intestines), accompanied by a slight pain, though it is not very pronounced.
I often feel the urge to have a bowel movement, and sometimes I feel relief after tightening my pelvic muscles, moving around, or passing gas.
There is a soreness between my coccyx and anus, especially noticeable when sitting or when pressure is applied to the buttocks and anus.
Soaking in warm water provides significant relief.

Previously, I would have a bowel movement once a day, typically in the morning, expelling the remnants from the previous day before noon.
My stools were mostly long and thick, resembling bananas.
Now, I feel the urge to defecate but do not experience the sensation of fullness in the anus; I have to exert effort to pass the stool, which is mostly about the thickness of an adult thumb, with segments around 10 centimeters long.
The consistency varies, and I often have to go multiple times to achieve the same total volume as before.
This has been occurring for the past two to three days.
The frequency and volume of gas have also decreased; it often feels like a quick release without the previous smoothness.

I have not noticed any further bleeding, and the color of my stool seems normal.
My weight has slightly decreased, likely due to changes in my mood affecting my appetite.
To facilitate bowel movements, I have been drinking plenty of water and eating fruits, as well as applying warm compresses to my abdomen and massaging in a clockwise direction.
I have even tried consuming blue-green algae, but there has been no improvement.
I am very concerned that my intestines may be obstructed.

Since I mentioned having a colonoscopy last June, is there a possibility that there could have been a negative development leading to an obstruction in the intestines during this time? Could it be due to polyps or other conditions? I have never experienced anything like this before, and I am quite anxious, so I am reaching out for your advice.
Thank you.

Mr. Zhang, 40~49 year old female. Ask Date: 2015/12/25

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Your symptoms generally seem to be more consistent with internal hemorrhoids.
If you are concerned, you can consult a gastroenterologist or a colorectal specialist for a digital rectal examination or a sigmoidoscopy to better understand your condition.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2015/12/25

More Info

Understanding bowel issues can be quite complex, especially when they are accompanied by discomfort, anxiety, and changes in bowel habits. Based on your description, it seems you are experiencing a combination of symptoms that may suggest a functional gastrointestinal disorder, possibly related to stress or anxiety, as well as potential physical issues such as hemorrhoids or anal fissures.

Causes of Bowel Discomfort
1. Functional Gastrointestinal Disorders: Conditions like Irritable Bowel Syndrome (IBS) are characterized by abdominal pain and altered bowel habits without any identifiable organic cause. Stress and anxiety can exacerbate these symptoms, leading to changes in bowel frequency and consistency.

2. Physical Issues: The symptoms you describe, such as the acidic and itchy feeling in the anal area, could indicate the presence of hemorrhoids or anal fissures. These conditions can cause discomfort during bowel movements and may lead to a fear of straining, which can further complicate bowel habits.

3. Dietary Factors: Changes in diet, hydration, and fiber intake can significantly affect bowel movements. Insufficient fiber can lead to harder stools, making them difficult to pass, while excessive fiber without adequate hydration can also cause discomfort.

4. Psychological Factors: Anxiety and stress can lead to a heightened awareness of bodily sensations, which may make normal bowel function feel uncomfortable or abnormal. This can create a cycle where anxiety about bowel movements leads to further difficulties.

Solutions for Bowel Discomfort
1. Dietary Adjustments: Increasing dietary fiber gradually can help improve stool consistency. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. However, it’s essential to increase fiber intake slowly and drink plenty of water to prevent bloating and gas.

2. Hydration: Drinking adequate amounts of water is crucial for maintaining healthy bowel function. Aim for at least 8-10 glasses of water a day, adjusting based on your activity level and climate.

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

4. Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating stress-reducing techniques such as mindfulness, yoga, or meditation into your routine. Cognitive Behavioral Therapy (CBT) may also be beneficial for managing anxiety related to bowel habits.

5. Medical Evaluation: Given your history of rectal bleeding and changes in bowel habits, it’s crucial to consult a healthcare professional. A gastroenterologist can perform necessary evaluations, such as a colonoscopy, to rule out any serious conditions like polyps or inflammatory bowel disease.

6. Symptomatic Relief: Over-the-counter medications, such as stool softeners or mild laxatives, may provide temporary relief. However, these should be used cautiously and not as a long-term solution to avoid dependency.

7. Warm Baths: Soaking in a warm bath can provide relief from anal discomfort and may help relax the pelvic muscles, making bowel movements easier.

Conclusion
Your symptoms warrant a thorough evaluation by a healthcare professional to rule out any underlying conditions. It’s essential to address both the physical and psychological aspects of your bowel issues. By making dietary changes, managing stress, and seeking appropriate medical care, you can work towards improving your bowel health and overall well-being. Remember, open communication with your healthcare provider is key to finding the right solutions for your specific situation.

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