[28M] Experiencing constipation and rectal bleeding

Patient Description

A 28-year-old male reports experiencing constipation for about two months, with episodes of feeling the urge to defecate but being unable to pass stool. When bowel movements occur, they range from normal to small and rocky in appearance. The patient has noted blood on the toilet paper when wiping, occasionally accompanied by mucus, but not consistently with every bowel movement. Additionally, there was an instance of blood in the toilet without a bowel movement. The patient experiences intermittent itching in the anal area. There is no abdominal pain reported. The patient also experiences minor episodes of shortness of breath and rapid heart rate, which have been evaluated with an EKG and chest X-ray, revealing no acute issues but showing signs of 'smoker's lung.' The patient attributes these symptoms to stress-induced anxiety. The patient acknowledges a low fiber diet and has not yet tried any treatments or lifestyle changes to address the constipation.

Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Constipation: This is a common condition where you may have infrequent bowel movements or difficulty passing stool. It can lead to small, hard stools and the sensation of incomplete evacuation. Constipation can be caused by a low-fiber diet, dehydration, lack of physical activity, or stress.
Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause itching, discomfort, and bleeding, especially when wiping. The presence of blood on the toilet paper and occasional itching could be related to hemorrhoids.
Anal Fissures: Small tears in the lining of the anus can cause pain and bleeding during bowel movements. They can also lead to itching and discomfort.
Mucus in Stool: This can occur with constipation and is often not a cause for concern unless accompanied by other symptoms like severe pain or significant changes in bowel habits.

Typical treatments for these conditions include dietary changes, increased fluid intake, and over-the-counter remedies. However, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.

What you can do

Here are some steps you can take to help alleviate your symptoms:

Increase Fiber Intake: Gradually add more fiber to your diet through fruits, vegetables, whole grains, and legumes. This can help soften stools and promote regular bowel movements.
Stay Hydrated: Drink plenty of water throughout the day to help prevent constipation.
Exercise Regularly: Physical activity can help stimulate intestinal function and improve bowel regularity.
Over-the-Counter Remedies: Consider using stool softeners or fiber supplements to help with constipation. However, consult a healthcare provider before starting any new medication.
Use MDandMe: You can use the MDandMe app to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

Persistent or worsening symptoms
Significant changes in bowel habits
Large amounts of blood in your stool
Severe abdominal pain
Unexplained weight loss

Remember, while these suggestions may help, it's important to consult a healthcare professional for a formal diagnosis and personalized treatment plan.

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3 mo ago

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