Constipation, Hemorrhoids, Rectal Prolapse, or Pelvic Floor Dysfunction?

[AceOfSpades83]

Here is the information about my condition:

Since I posted this I have been doing more research about what my condition could possibly be in the meantime while still mustering up the courage to make an appointment and see the doctor. Long story short I came upon some links that basically convinced me that I am either dealing with a pelvic floor problem or a rectal prolapse, either an internal prolapse or a partial prolapse (I tried to sort of self examine but I cant tell if when I push any is coming through or if I'm feeling something else).

Here are the signs of a pelvic floor problem:

Common signs that can indicate a pelvic floor problem include:

accidentally leaking urine when you exercise, laugh, cough or sneeze

needing to get to the toilet in a hurry or not making it there in time

constantly needing to go to the  toilet

finding it difficult to empty your bladder or bowel

accidentally losing control of your bladder or bowel

accidentally passing wind

a prolapse

.in women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping

.in men, this may be felt as a bulge in the rectum or a feeling of needing to use their bowels but not actually needing to go

pain in your pelvic area, or

painful sex.

I don't really have pain in the pelvic area and I have never experienced any pain during masterbation or anything like that. The symptoms that I have dealt with since this all started and still deal with are; leaking urine when exercising, laughing, coughing, or sneezing, needing to go to the toilet constantly, finding it difficult to empty the bladder or bowl, accidentally passing wind and the prolapse felt as bulge in the rectum and feeling of needing to use the bowels and often not needing to go. These and all of the other symptoms that I spoke of in the other post. The main concern as I said before is that bulge feeling which I can really feel when I move the penis and which also concerns me and causes me a lot of anxiety when it comes to sexual performance etc. Its as if there is something stuck that needs to be pushed out as well as the bulge feeling and it is tempting to push and sometimes I pass gas when doing so. That and the fact that masterbating seems to aggravate it and increase the need to pass gas especially when about to ejaculate.

Here is the bit from the prolapse article which first led me to believe that this might be what I'm dealing with;

“The symptoms of rectal prolapse tend to come on slowly. The first symptom you'll notice is the feeling that there is a bulge at your anus. It may seem as though you are sitting on a ball.

With a mirror, you may be able to see a reddish-colored bulge peeking through or actually extending out of your anus. Sometimes during a bowel movement, a small part of the rectum will emerge, but may retreat on its own or be easily pushed back into place.

Normal physical activity, such as walking, sitting, and exercising, may also cause part of the rectum to push through your anus. At first, it can be returned to its proper location by hand.

If rectal prolapse worsens, there could be bleeding from the inner lining of the rectum. In cases of partial or complete prolapse, you may have trouble controlling liquid or solid bowel movement and gas from your rectum.

Up to half of the people with rectal prolapse experience constipation, while others may have episodes of constipation and incontinence.”

The very first thing that I noticed back when all of this started was as I said before it felt as though something had dropped down from my stomach into the anus and the feeling that something was bulging out etc. Again there is no bleeding but everything else seems to line up with what I am dealing with. I tried looking with a mirror but I couldn’t tell anything.

Types

There are three types of rectal prolapse. The type is identified by the movement of the rectum:

Internal prolapse: The rectum starts to drop, but hasn’t yet pushed through the anus.

Partial prolapse: Only part of the rectum has moved through the anus.

Complete prolapse: The entire rectum extends out through the anus.

Based on this if a prolapse is what I’m dealing with it would either have to be an internal or partial prolapse. I searched images on Google and if it was a complete prolapse there would be no doubt whatsoever from what I have seen.

So my first question is would it be possible for a GP and a specialist urologist who both physically examined me with the glove to misdiagnose me and miss an internal prolapse? My next question is does it seem as though I am just simply dealing with constipation, or internal hemorrhoids, or pelvic floor issues or a prolapse? I realize that a prolapse is a symptom of pelvic floor problems but I’m wondering what the main issue is that’s causing me all of the problems. I also realize that internal prolapse and internal hemorrhoids can often be hard to distinguish, but how could either of those be mistaken for just constipation alone by two different doctors?

[GuitarRox]

IBS often has a mental health component associated with it.  So, yes, your anxiety may be affecting the IBS and then the IBS affects your anxiety/ social anxiety.  Have you sought any treatment for the anxiety?  Have you ever done counseling or CBT therapy?  Is that available in your location?  Psychologists can make great headway.  And medication often will help when added on.  So, that's something to consider to cover all your bases.  Social anxiety is difficult to live with.  Holds you back from enjoying life and that's unfortunate.  I always say "don't let anxiety win".  So, address it to push it out of controlling your life.  

Yes, by all means if you want to start online with someone to discuss IBS, do so.  Not sure if they prescribe without seeing you so you'll have to see.  

And having social anxiety and these issues combined is definitely going to make you very self conscious and compound each other.  Sorry it's going on.  Let me know when you reach out online to a doc.  

[AceOfSpades83]

Yeah, I had read the same thing and I think its more of the IBS affecting the social anxiety if I had to venture a guess. I have tried both counseling and medication in the past. I tried two different kinds of medication, both of which reacted terribly with me and I hated the way it made me feel and the counseling may have helped a little. I don't really have access to therapy at the moment but I am working on changing my situation and may consider it again in the future. Step one is getting over the IBS or whatever this is that is literally destroying my life and my self-confidence. Social anxiety is and has been very difficult to live with and I agree with you about not letting it win.

Yeah, I think it may be a good way to start and then possibly having them relay the information to the appropriate doctor that I could see in person would be helpful as well if it came to that. Actually, they do prescribe, I spoke to a doctor on that site in January of last year and he prescribed me six weeks worth of Lactulose.

Exactly. Thank you very much and I will let you know when I speak to someone, which should be within the next day or two. I just want to have all of my symptoms and everything prepared beforehand etc.

I greatly appreciate all of your advice and continued communication.

[GuitarRox]

Thanks for writing again.  Ya, I think if you have anxiety in general as I'm guessing you have, it makes a problem you are experiencing more anxiety provoking.  Sorry about that, what a pain!  I don't like to hear 'it's all in our head'.  You are experiencing 'something'.  And urinary incontinence is clearly not something anyone wants.  If you are thinking IBS, can you see a gastroenterologist?  They do make medication for IBS.

[AceOfSpades83]

Oh, by all means, thank you. You have no idea how much the support and continued communication means to me.  Yeah, exactly, the social anxiety is making all of this far more difficult than it should be. It really is a pain and thank you. Yeah, I don't like hearing that either. Something is wrong and I know it is. I may have exactly what it is or what I'm feeling slightly confused but to say it's all in my head is a bit insulting. The urinary incontinence, the bloating, the gas, the feeling as though something is stuck in there and the idea that is affecting my erections is the worst part of all of this and is quite literally putting most aspects of my life on hold. Well, I was thinking the first thing I could do is try talking to an online doctor as that is a service available here and describe everything to them and see if they could prescribe me something to start and then possibly have them refer me to someone or something. There aren't many doctors around where I am and the social anxiety makes it hard for me to go to the places where they are available. This really is a terrible ordeal. I feel trapped. And I feel as though if it is IBS that it may be making the social anxiety and everything that I already deal with much worse.

[GuitarRox]

Thanks for the thorough information and question.  It is always possible for a doctor to make a mistake.  In this case though, it would have to be two.  However, if one was reading the information of the other, that could influence their findings, you know how that goes. You could always find a third for confirmation.  Constipation can be a mother to deal with.  People wind up in the hospital due to constipation as their bowel will be blocked and it becomes like a 911 emergency of blocked bowel.  If you have a slow moving digestive tract, that can impact you in the way you describe.  Have you tried stool softeners, upping your water intake and drinking something like prune or grape juice?  Those help.  A probiotic will also help if this is indeed the problem. Worth a try.  A physical therapist that specializes in pelvic floor issues can also help you if that is the problem as there really are PT's that this is the area they work with.  Women probably visit them more often but men have this problem obviously as well.  An internal hemorrhoid would probably have more symptoms than you are having or 'different' ones. A prolapse is an interesting question but we need you to see a third doctor to determine if the other two missed it.  Hernia?  

[AceOfSpades83]

Thank you very much for your detailed response. Well, both doctors performed a physical examination with the glove so I have my doubts that they could both be mistaken under those circumstances now that I have thought more about it. I'm kind of a wreck over this mentally though and I keep re-thinking everything. Yes, I have tried drinking more water, stool softeners, probiotics, eating more fiber, Metamucil, magnesium, exercising more, prune juice, I have switched to whole grain cereal and breads, I have tried to eat as healthy as I can by cutting out processed foods as much possible, I have been trying to eat more fruits and veggies, I have been exercising more, you name it I have tried it. After having done more research I have sort of come to the conclusion that it's most likely IBS. I mean the part that is giving me the most distress is how this is affecting me sexually. It is ruining my self-confidence due to the urinary incontinence and the worry of passing gas or other symptoms occurring during sex and more than that I feel as though it is somehow affecting my erections and lowering my energy levels in some manner. It sort of feels like my erections are being pulled down into my body or something like that and I'm not getting fully erect as I did before. I also feel more drained after masturbation with a heart rate that seems to remain elevated longer than it used to and I feel as though all of this is related to what I'm now convinced is the IBS. Throw in having been a long time sufferer of social anxiety and agoraphobia that come in different spurts and one of the biggest triggers being having to go to the doctor and the fact that when I went to see the urologist before he told me most of this is "all in my head" after learning about my anxiety problems...I'm having a bit of a hard time coping at the moment.