MISDIAGNOSED???

by Mark
(La Porte, TX)

I am a 49 year old man, 171 lbs, 5'9", reasonably fit. I do smoke and drink. The only gastric problem in my history is my gall bladder, which was removed in 2005. Recently (6 months) I have been experiencing bowel problems such as constipation, diarrhea, small amounts of bright blood, urgency to have a movement, usually with no result and the feeling that my bowel did not empty. I have also noticed a small protrusion from the anus while straining.

My doctor diagnosed this as IBS, also prescribing Dicyclomine and an anal cream which has had little or no affect on my symptoms.

I have been investigating my symptoms wherein I came across "Rectal Prolapse" which from what I have studied exhibits the exact same symptoms as mine.

I hope you can advise me about this condition vs my condition and how to go forward to remedy the problem.

Rectal prolapse

Rectal prolapse is a fairly common condition, particularly in women due to pelvic floor weakness. Symptoms do include a feeling of a lump protruding through the anus as well as pruritis ani (anal itch), due to leakage of stool, soiling, sometimes constipation and diarrhea plus occasionally anal pain.

The lump from the anal area can also occur due to other conditions such as hemorrhoids, fibro epithelial polyps, other polyps and occasionally cancer of the anus or rectum.

Symptoms of constipation and diarrhea are usually related to the IBS or the irritable bowel syndrome in anyone under the age of 55 years unless there is a strong family history of bowel cancers such as HNPCC. Of course, constipation predominant IBS increases the risk of rectal prolapse and hemorrhoids due to straining.

Whilst investigations are likely to turn out normal, I would suggest asking your doctor about having a colonoscopy as this will confirm or refute the diagnosis and also provide some reassurance too.

If looking for rectal prolapse, a simple rectal examination will probably provide the answer. If not, more complex tests such as defecation proctogram (an x-ray test that is dynamic and involves passing barium dye into the rectum followed by x-ray exam whilst defecating). Other tests such as anal manometry can also be done.
Whatever the cause for the lump in the anal area, an examination of that area is vital and you should ask your doctor to do this.

Good luck!

My name is Dr Peter Thatcher MBBS, MRCPI and I am a consultant physician and gastroenterologist in the UK. I have an interest in internet based medicine and administer this site in my spare time. I hope you find this site useful and informative. If you have any suggestions, please Contact Me or if you would like to comment on my site, please do so by Click Here. If you like the site and would like to make a donation to support what I am doing please do so by Clicking Here. Thank you for visiting and please drop by again!