Patient: Disease: Suspected of IBS
Anorectal sensation: 1. Slight swelling, frequent irritation. The swelling is more than that of falling, and this swelling feeling is like gas trapped in the rectum. The symptoms are reduced or disappeared when standing, walking and lying down, and feeling relaxed or disappearing for a long time after defecation. The symptoms are obvious or worse after sitting, the symptoms are obvious when carrying heavy objects, and the symptoms are worse after strenuous exercise.
2. There is occasional pain in the anus on the rectum side. This pain is close to throbbing pain and occurs on the left side of the anus. This sensation is at most 3 times a day, and there is no continuous. Defecation conditions: 1. Frequent and frequent bowel movements When going to the toilet, sometimes you can go out, sometimes just for defecation; or after going to the toilet, it is only for exhaustion. Now there are 4 times in a day that can actually be discharged. Among these 4 times, the amount of one in the morning is relatively large. The other times decrease in chronological order. Regardless of the amount, you will feel relaxed after the discharge. 2. Stool cannot be exhausted at one time. For example, when you wake up in the morning to defecate, you feel that you are exhausted. But after 15-20 minutes, you will feel relaxed again. . After rowing, it can still be discharged, but the amount is less than the previous time. 3. The bowel movement is more difficult than before. After squatting, you need to wait 30 seconds to 1 minute before you start to discharge, and sometimes you need to hold your breath in the middle. 4. Stool characteristics change , The stool is soft at the beginning of the onset, such as a thin strip, currently soft and flat. When the amount is very small, the stool is thin and thin like a blade. Once there is an internal groove. 5. No diarrhea, no blood in the stool, no Mucus, etc. The color is normal. There are no other symptoms of discomfort throughout the body. Other symptoms: The mental stress is high, and the symptoms for more than a month make the body feel blurred, unable to distinguish between bowel movements and exhaust, and exhaust is more difficult than before. Sometimes it is just exhaust. I went to WC in order to intentionally. In addition, when sitting in a chair, I will unconsciously change the body's center of gravity to avoid squeezing the buttocks and causing discomfort. However, all discomforts are limited to the anus and rectum. There are no other symptoms of discomfort throughout the body, and the appetite is good. Causes of illness: October 22, 2009, urinary tract inflammation, complicated by urgency in the anus, frequent feeling of bowel movements, no stool discharge after WC. But after squatting for a while, it can be slightly relaxed. After 3 days of infusion of antibiotics and rectal microwave treatment, Both urinary system and anal discomfort symptoms disappeared. Continue to take antibiotics for two weeks, and there are no symptoms of discomfort within these two weeks. However, on the last day of these two weeks, the anal discomfort recurs (no recurrence of urinary system discomfort), and the symptoms are as described above. After recurrence, I went to the Social Health Center on November 10 for diagnosis and treatment of recurrence of prostatitis, infused with antibiotics azithromycin for a week, and at the same time oral clarithromycin, and warm water bath. It was ineffective. From November 17 onwards, Chinese medicine was taken orally for one week. Improved, the disease has not been significantly improved, but because of the improvement in spirit, I feel a little better. On November 28, the city doctor also visited anorectal surgery, diagnosed with internal hemorrhoids, prescribed "Polymediol 4000, Ma Yinglong hemorrhoid suppository, and Puji hemorrhoids" Suppository, Maizhiling Tablets”, the symptoms became easier on the second day of medication and obviously improved on the third day, but the signs of improvement did not last. Continue the medication on the fourth and fifth days. . . No improvement, symptoms returned to the state before the medication. . On December 4, it was found that the stool began to become thin and flat. On December 5, Shenzhen Futian People’s Hospital diagnosed internal hemorrhoids plus minor proctitis. On December 7, the colonoscopy result was completely normal. Urological tests found mild inflammation of the prostate, but it was believed that this mild inflammation would not affect the anorectal. The anorectal and urologist consulted and thought that overuse of antibiotics would cause flora imbalance. It is recommended to take live bacteria capsules. Prescribe live bifidobacteria. After taking Peifeikang now, there has been no significant improvement. On December 9th, I used Pien Tze Huang Hemorrhoid Ointment, and the next day I felt smooth stool. However, the continued medication did not improve, and the symptoms returned before the improvement. During this period, I insisted on a warm water sitz bath every day. During the sitz bath and for a period of time afterwards, I felt relaxed, and the others did not feel any significant improvement.
1. I want to know what kind of disease I am. Why does the stool become soft, thin and flat? There was even an internal groove once? But the colonoscopy reported no problem.
2. The doctor at Futian Hospital overturned the previous diagnosis of "internal hemorrhoids, mild proctitis" by digital examination and analoscopy because the report of the electronic colonoscopy was normal. Is it scientific?
3. Does stool deformation necessarily mean that there is compression in the cavity? Does frequent feces mean that the cavity becomes narrower and smaller, resulting in a small amount of stool that can cause greater pressure and trigger the nervous system defecation reflex? No abnormality in microscopic examination , Is it because the microscopic examination can only see the inner wall, and there may be other lesions outside the rectum, causing this symptom? Pelvic floor syndrome? Prolapse of the rectal mucosa?
The last hospital visited: Shenzhen Futian People's Medical
Xiao Zhang: Hello!
First of all, you don't need to be too nervous! Because, from fecal occult blood to colonoscopy, no colorectal tumors were found.
If your current symptoms are to be explained by monism, the most likely cause is the intussusception of the rectal mucosa. Only this disease can explain all your symptoms. If you can come to Maoming, I will give you a digital rectal examination and the diagnosis will be basically confirmed.
Patient: Director Li, thank you! Thank you for reviewing my long medical history in your busy schedule and enthusiastically making a preliminary diagnosis for me! I may not be able to come to Maoming for the time being due to work, so I will definitely visit you if I have the opportunity! I am currently taking compound glutamine enteric-coated capsules with hemorrhoid ointment and rectal medication. It seems to be getting better. I will observe for a while and ask you if you have any questions! Thanks again, I wish you good health and success in your work!