OpenHealth Q&A

Concerns About Possible Rectal Prolapse

**Concerns Regarding Rectal Prolapse** **Medical Background:** - **Health Conditions:** Type 1 diabetes, gastroparesis, elevated cholesterol, GAD, GERD, minor hiatal hernia, uterine fibroids, ovarian cysts, mild adenomyosis (currently monitored by GYN with expectations of resolution post-menopause), and ADHD. - **Medications:** - **Daily:** - Insulin - Rosuvastatin (10 mg) - Zoloft (150 mg) - Buspar (10 mg) - Adderall (5 mg) - **Bi-Weekly:** - Dexilant (60 mg) - **As Needed:** - Zofran (4 mg) - Hyoscyamine (0.125 mg) - **Supplements:** - Magnesium citrate (300 mg) - Vitamin D3 (2000 IU) - Coenzyme Q10 **Duration of Symptoms:** Approximately 10 days. Recently, I've experienced a peculiar sensation during bowel movements where it feels as though something is being drawn back up as I complete the act. Initially, I thought I might not be fully evacuating my bowels, but this occurrence has become consistent, and it's unfamiliar and concerning. Could this indicate the onset of a rectal prolapse? If so, should I consult with my gastroenterologist, primary care physician, or another specialist? It is not causing me any acute pain, and I do not believe it warrants an emergency room visit. **Previous Medical History:** About a month ago, I was prescribed progesterone for perimenopause. Shortly thereafter, I developed an infection following a mole excision and was treated with doxycycline. This coincided with a particularly stressful period in my life. During this time, I experienced intense colon spasms (which necessitated the use of hyoscyamine, something I hadn’t needed in a long while). I suffered significant pain in my lower left and central abdominal areas. Everything returned to normal post-bowel movement, but the experience was excruciating, often accompanied by sudden urges to defecate without warning, leading to a mix of cramping, discomfort, constipation, and diarrhea along with noticeable bloating and gas. Hemorrhoidal bleeding was also an issue, which made matters even worse. Upon halting the progesterone and finishing the full course of doxycycline, my infection resolved, and my stress levels diminished. Subsequently, my bowel movements normalized to daily or every-other-day occurrences, and with a diet supported by magnesium, the consistency has been softer. However, I am now grappling with this unusual pulling sensation. It's a very strange feeling, akin to an awareness of something in my anal area, although I want to stress that I've never engaged in any practices that would introduce anything into that space, nor do I have any interest in doing so. There is no pain, and visually, everything appears normal. Any insights on what this might be? Could it be a prolapse—or something else entirely? Should I seek medical attention now, or is it advisable to observe for a bit longer? Thank you for your assistance!

Answers (1)

6/29/2025, 7:20:47 PM

OpenHealth AI

It sounds like you’re experiencing some discomfort and concern regarding the unusual sensations during bowel movements. This could potentially be related to several factors, including muscular function, pelvic floor issues, or, as you mentioned, rectal prolapse. However, it’s important to note that not all sensations of pulling or pressure indicate a prolapse, especially since you mention there is no pain or visible abnormality.

Understanding Rectal Prolapse:

• Rectal prolapse occurs when the rectum protrudes through the anus, typically associated with discomfort or visible changes. The sensation you describe doesn’t clearly match classic symptoms, which often include visible bulging or discomfort while sitting or during bowel movements.

Possible Causes of Your Symptoms:

1. Muscle Tension or Spasms: They may contribute to the pulling sensation, especially if you’ve had previous colon spasms.
2. Changes in Bowel Habits: Given your previous issues with bowel irregularity, it’s possible that your body is adjusting after those stressors.
3. Pelvic Floor Dysfunction: This could lead to unusual sensations during bowel movements and may not directly relate to prolapse.

Next Steps:

1. Self-Monitoring: Keep track of your symptoms over the next week. Note any changes, including the frequency, intensity, or nature of the pulling sensation, as well as any changes in bowel habits.
2. Hydration and Diet: Continue to ensure you're well-hydrated and favor foods high in fiber to maintain regularity. Your magnesium supplement is good for this, but consider also fruits, vegetables, and whole grains.
3. Physical Activity: If possible, engage in light exercise to promote bowel regularity and overall pelvic health.
4. Avoid Straining: Make sure you aren’t straining during bowel movements, as this can lead to or exacerbate pelvic floor issues.
5. Relaxation Techniques: Stress can often exacerbate gastrointestinal symptoms, so practices such as mindfulness or gentle yoga may help.

When to Seek Medical Attention:

If you notice any of the following, it may be time to consult a healthcare professional:

• The pulling sensation worsens significantly or becomes painful.
• Develop any bleeding or noticeable changes in stool.
• Sudden changes in bowel habits (persistent diarrhea or constipation).
• Any new symptoms, like urinary incontinence or fecal incontinence.

Given your complex health history, you might consider discussing these symptoms with your primary care physician, as they can provide insight into whether an evaluation by a gastroenterologist or a urogynecologist is warranted.

Please remember, you're not alone in navigating this, and it’s good that you’re reaching out for information and support. If you have further symptoms or concerns, feel free to ask.