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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4057
Experience:  BSN, MSN, CNS
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I have a concern about tailbone pain and bowel movements.

Customer Question

I have a concern about tailbone pain and bowel movements. About 2 months ago, I began to have pain on the left side of my tailbone. I am sleeping on a 30 yr. mattress and thought that might be the problem. Then I started having problems using the bathroom...straining to only have narrow or loose stool. I went to a surgeon who examined the rectal area and i have 4 internal hemorrhoids that protrude from anus when I have a bowel movement. I constantly feel like something is inside me. The Dr. put me on anusol which helps me tremendously to remove my biles. Sometimes my stool appears normal and others it is narrow and flat. The anusol is not shrinking the hemorrhoids but acting like a lubricant to help me remove biles. I still have some tailbone pain but is relieved with IB profen.   Should I pursue this anymore. I am 32 with no family history of colon cancer. Can the hemmorhoids be causing me to have narrow stool and a feeling like something is inside? Do you think the tailbone pain is related to the pressure in my rectum? Dr. would like to tie off hemorrhoids. What do you think? In need of another opinion.
Submitted: 3 years ago.
Category: Health
Expert:  Susan Ivy replied 3 years ago.
Hello and welcome back to JustAnswer Health.

Yes, there are procedures that can be done to relieve you hemmoroids - a rubber band procedure and surgical methods are frequently done, often times right in the doctor's office.

And yes, the 'feeling of something inside of you' can be caused by the hemorrhoids as well as constipated stool.

It is conservative treatment, especially in a young person, to first try the things your doctor suggested, because in many cases the hemmoroids will shrink and not require further procedure.

But if you are still having much discomfort then the next step is for you have one of these procedures to remove the hemmoroids (which will depend exactly on the nature or type of your hemmoroids).

Either way, until the time you get them removed, and also to prevent future development of more hemmoroids, you will still need to work on (if you are not already) drinking 6 to 8 glasses of water per day; and since most people on a modern diet find it hard to get enough fiber (although you should try by eating foods such as fresh fruits and vegetables, & whole grains) you should take a fiber supplement. Psyllium (generic for metamucil) in capsule form or mixed with water is one type; Citrucel (available over the counter as well) is another form that can be taken daily along with a full glass of water and these products will achieve a 'bulking up' of the stools up and prevent the straining and development of hemmoroids. Additional things to help with regular bowel function including taking an omega or 'good fat' oil supplement such as flax seed oil; fish oil, Evening Primrose Oil (helps with lubrication, as well as other physical functions), and working to set up a regular bowel program (such as sitting on the toilet at the same time daily after a hot meal or fluid like coffee - to begin to train your system to go daily at the same time). You may also want to take an acidophilus supplement or probiotic. These can be found in every grocery and drug store, although some of the better brands are found in the refrigerated section of a health food store. These products help to give you an adequate 'good' bacterial balance in your intestine - which helps you digest your food better, and also have softer stools. Sometimes people lack this due to having been on antibiotics at some point, or just from not eating the right types of foods that contain these organisms.

As far as the tail bone pain, it could very well be referred pain from either the hemmoroids or the lower colon. Your lower colon may be irritated from the constipation as well. Especially if there is no broken skin on the tail bone, and you have not injured it. If you had injured your tail bone you could always request an X-ray - but there is not much treatment for an fractured tail bone anyway in most cases.

I hope this helps you. If you have additional questions or need clarification please reply to this post so that I may further assist you. (please note I will be away from the computer until later this evening, but I will look to see if you needed anything further when I return).

Also, if you would like to read about the procedures to remove hemorroids, this is a good reference:

http://www.mayoclinic.com/health/hemorrhoids/DS00096




Edited by Susan Ivy on 11/8/2010 at 9:09 PM EST
Customer: replied 3 years ago.
I have a concern about tailbone pain and bowel movements. About 2 months ago, I began to have pain on the left side of my tailbone. I am sleeping on a 30 yr. mattress and thought that might be the problem. Then I started having problems using the bathroom...straining to only have narrow or loose stool. I went to a surgeon who examined the rectal area and i have 4 internal hemorrhoids that protrude from anus when I have a bowel movement. I constantly feel like something is inside me. The Dr. put me on anusol which helps me tremendously to remove my biles. Sometimes my stool appears normal and others it is narrow and flat. The anusol is not shrinking the hemorrhoids but acting like a lubricant to help me remove biles. I still have some tailbone pain but is relieved with IB profen.   Should I pursue this anymore. I am 32 with no family history of colon cancer. Can the hemmorhoids be causing me to have narrow stool and a feeling like something is inside? Do you think the tailbone pain is related to the pressure in my rectum? Dr. would like to tie off hemorrhoids. What do you think? In need of another opinion.
Based on my symptoms of narrow stool, tail bone pain, difficulty defecating....do you think I need a colonoscopy to make sure that it is nothing more serious or do you think the diagnosis of the internal hemorrhoids and rectal prolapse is enough to warrant the symptoms I am having?
Expert:  Susan Ivy replied 3 years ago.
Thank you for providing your follow up question.

Again, with the symptoms you describe, the most likely cause of the narrow stool, tail bone pain, difficulty defecating is related to the constipation and hemmoroids. This is frequently seen in people.

But with a rectal prolapse that you mention now, you do fit a criteria for colonoscopy. Of course, different insurance companies and different doctors will have slightly different criteria, and will base the decision on whether to perform any procedure on the whole picture of the patient.

I will outline for you below typical criteria for colonoscopy:

1) Rectal bleeding (frank or occult) (you do not mention having this)

2) Iron deficiency anemia (in non-menstruating women - in menstruating women this criteria would also depend on whether evidence of GI pathology is present) (you do not mention having this)

3) Diarrhea, constipation, or irritable bowel syndrome when any ONE of the following is
present:
- Persistent (at least 4 weeks) symptoms (e.g. constipation, diarrhea, tenesmus) in
patient older than 40 years, after negative stool cultures
- Change in chronic symptoms
- Unexplained weight loss greater than 5% of body weight
- Rectal prolapse
(you report constipation and rectal prolapse )

4) Melena with negative EGD (this means dark tarry stools which may come from upper GI bleeding, but negative EGD means no upper GI bleeding is found, so colonoscopy is needed to find cause of upper GI bleeding) You do not mention this symptom.

5) History of polyps or prior abnormal colonoscopy. You don't mention this symptom.

6)
Prior endometrial or ovarian cancer diagnosed at age <50 (every 5 years) (no mention of this symptom)

7)
Post-cancer resection, clear colon: 1 year, then 3 year, then q 5 years (you don't mention this history)

8)
Crohn’s or Ulcerative Colitis surveillance after 8 years of disease (q 1-3 years) (You do not have this situation)

9) Positive family history. (you report no history of colon cancer in your family)


Although it seems that overall you are at a low risk to have colon cancer, according to one guideline, you meet the criteria for colonoscopy.

I would also recommend that you do the above things mentioned in the first reply to help with your bowel function (that is if you are not already doing them) as these are preventative actions for further hemmoroids, worsening prolapse, development of diverticuli, and development of polyps (which evolve into cancer and must be monitored once they develop) - in other words engaging in these health habits will help to prevent you from developing colon cancer in the first place.

Reference: http://www.sfhp.org/files/PDF/providers/guidelines/Colonoscopy_Criteria_2009-4-7.pdf





Edited by Susan Ivy on 11/9/2010 at 1:35 AM EST
Customer: replied 3 years ago.
The dr said the rectal prolapse could be from having three children in four years with my youngest being one is that true?
Expert:  Susan Ivy replied 3 years ago.
Yes, that is true. The history of the pushing can definately cause these types of changes in the soft tissues, and also may have contributed to the hemmoroid development.
Customer: replied 3 years ago.

I'm sorry to ask again but now that I gave you more info about me is there still a|need for a colonoscopy? Thank you for your expertise!
Expert:  Susan Ivy replied 3 years ago.
Well, it makes it less likely that the prolapse is due to anything dangerous like cancer, knowing that you have had 3 children in recent years.. I can't tell you though, no, you should not have the colonoscopy though, because there is always some rare minuscule chance that you could have some issue.

But I can say, that if I was you, I personally would not get one (that is unless there is something like bleeding or unexpected weight loss that you have not told me about). I would first try to regulate things with the diet, psyllium, water, acidophilis, etc. If the pain, hemmoroids and prolapse did not improve though, I would continue to search for causes, which could mean colonoscopy. Also I am not sure what the doctor has recommended to you to do for the prolapse. The fiber, etc. will help the prolapse too, but depending on how bad it is, you may need surgery for it at some point, as well as surgery or a procedure for the hemmoroids. I don't think you should go on uncomfortable with this, if a procedure can be done to help you.
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4057
Experience: BSN, MSN, CNS
Susan Ivy and 6 other Health Specialists are ready to help you
Customer: replied 3 years ago.
Thank you so much...you have eased my mind and answered my concerns thoroughly!!!
Expert:  Susan Ivy replied 3 years ago.
You are very welcome. Had a good night.

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