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Suggest Treatment For IBS And Inflammation In The Rectal Area

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Posted on Fri, 23 Jun 2017
Question: Yes, several years ago before I realized my gall bladder was not functioning (the HIDA scan eventually showed in the negatives and I had it removed) I began having a lot of discomfort when having a bm. Burning, itching, and what felt like inflammation in the rectal area. No hemeroids...Could this be a symptom of bile acid diarhea? I have IBS symptoms but the burning persists.
doctor
Answered by Dr. Bhagyesh V. Patel (28 minutes later)
Brief Answer:
bile acid diarrhea or proctitis

Detailed Answer:
Hello Dear
I evaluated your query thoroughly
* Differential diagnosis include bile acid diarrhea or proctitis
* Would require following queries to be answered for the same
1. How long after cholecystectomy these symptoms started
2. current bowel movements as consistency ( soft / hard ) ,diarrhea, frequency ,
abdominal pain ;burning , itching only after passing stools or 24 hrs
any relation of burning with particular foods
3. bleeding in stools
4. details of current IBS symptoms
5. any evaluation done as colonoscopy or others for current problem if yes
which with scanned reports if available
6. current medicines
7. other systemic illness if any
8. vomiting , pain upper abdomen after meals , appetite , weight alterations
fever if any noticeable finding
9. smoking / alcohol if any
10.anal sex activities if any
11.any other information you would like to share for the same
Thanks for using Healthcaremagic.com & giving me an opportunity to assist .
Awaiting for your details
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Bhagyesh V. Patel (1 hour later)
1.How long after cholecystectomy these symptoms started
Symptoms began just about a year prior to removal of gall bladder and have continued intermitantly.

2. current bowel movements as consistency ( soft / hard ) ,diarrhea, frequency ,
abdominal pain ;burning , itching only after passing stools or 24 hrs
any relation of burning with particular foods
Bowel movements most often soft, but I occasionally have bouts of constipation. Itching and burning after bm's. There are times when I have to flush out the rectal area with water due to the intense burning and/or irritation when there is any fecal matter in that area. A small particle of fecal material can feel like a rock. Spicy foods make it worse.

3. bleeding in stools
No bleeding in stools.
4. details of current IBS symptoms
Tend to swing from loose stools to constipation. Bloating in lower abdomen, but have had some success when avoiding all grains. Some discomfort in the upper stomach area - acid stomach when under stress.

5. any evaluation done as colonoscopy or others for current problem if yes
which with scanned reports if available
Yes have had a colonoscopy every couple of years. At one time physician noted "red spots" throughout my disgestion, but that went away. Last colonoscopy 'clean." Don't have scans, sorry.

6. current medicines
prozac 90 mg weekly

7. other systemic illness if any
hypothyroid - taking T3, T4

8. vomiting , pain upper abdomen after meals , appetite , weight alterations
fever if any noticeable finding
No vomiting, occasional upper abdomen pain but usually at night, not right after meals. No weight alterations or fever.

9. smoking / alcohol if any
No smoking or alcohol.

10.anal sex activities if any
No anal sex activities.

11.any other information you would like to share for the same
Hmmm...I do have fever blisters on my mouth occasionally, but have never been diagnosed with genital herpes.
doctor
Answered by Dr. Bhagyesh V. Patel (31 minutes later)
Brief Answer:
Anal fissure +/- proctitis,require per rectal,proctosope examination .

Detailed Answer:
Hello Dear
Thanks for the very deeply concerned reply .
* This narration makes the possibility of anal fissure with or without proctitis ;
bile acid diarrhea very less likely .
* Strongly recommend to get a per rectal and proctoscope examination by a
Consultant Surgeon with appointment .
* Till then follow certain guidelines to get better recovery :
- drink plenty of liquids as possible to support digestion
- consume diet in that manner so that you have soft bowel evacuations on
regular basis with high fiber , green leafy vegetables , fresh curd , ant i
oxidants , vitamins , minerals , trace elements
- honey , amla , turmeric are best herbal supporters in your case
- chew your food properly
- keep your BP , blood sugar , cholesterol , thyroid hormones , weight level
under control
- avoid all oily , spicy , non vegetarian stuffs , junk foods till possible
- Sitz bath ( sitting in a tub filled with lukewarm water 10 minutes morning ,
evening & specially after passing stool ) help a lot .
- OTC product Lidocaine gel (2%) for local application after sitz bath & after
passing stool give soothing
- in our clinic we recommend ispaghula husk for regular smooth evacuations
- keep the anal part clean , dry
- avoid sitting for long periods over hard surface , long drives till possible
- avoid all terricotton / sily under wears
- need of systemic antibiotics , anti inflammatory , prophylactic anti worms
pro biotics , anti histaminics are subject to physical examination findings .
- avoid stress / anxiety -- your major enemies
- have regular sound sleep of 7-8 hrs
- remain ambulatory with regular walking , exercises , YOGA
- avoid any of the pain killers till possible specially non steroidal ant
inflammatory ones
Hope this will help you definitely .
Welcome for any further assistance .
Wishing you fine recovery from the same .
Regards dear take care .
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Bhagyesh V. Patel

General Surgeon

Practicing since :1999

Answered : 20405 Questions

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Suggest Treatment For IBS And Inflammation In The Rectal Area

Brief Answer: bile acid diarrhea or proctitis Detailed Answer: Hello Dear I evaluated your query thoroughly * Differential diagnosis include bile acid diarrhea or proctitis * Would require following queries to be answered for the same 1. How long after cholecystectomy these symptoms started 2. current bowel movements as consistency ( soft / hard ) ,diarrhea, frequency , abdominal pain ;burning , itching only after passing stools or 24 hrs any relation of burning with particular foods 3. bleeding in stools 4. details of current IBS symptoms 5. any evaluation done as colonoscopy or others for current problem if yes which with scanned reports if available 6. current medicines 7. other systemic illness if any 8. vomiting , pain upper abdomen after meals , appetite , weight alterations fever if any noticeable finding 9. smoking / alcohol if any 10.anal sex activities if any 11.any other information you would like to share for the same Thanks for using Healthcaremagic.com & giving me an opportunity to assist . Awaiting for your details Regards