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BarbaraTaylor, Nurse Practitioner
Category: Health
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Experience:  Mental Health/ Critical Care/ Emergency experience with national certification
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black and blue around anus

Resolved Question:

I was constipated for 4 days and when I finally moved my bowels it almost turned my anus insideout. I had to push it back in. I am all black and blue now around my anus and up to my scrotum. Everything seems to be OK right now except for the black and blue. Should I see my doctor?
Submitted: 11 years ago.
Category: Health
Expert:  BarbaraTaylor replied 11 years ago.
It sounds as though you may have hemorrhoids that are normally up inside your rectum and with straining for the bowel movement, those hemmorrhoids slipped outside your rectum.

It also sounds as though passing the constipated BM may have bruised your anus and area around it. I would expect the discoloration to resolve after the next week or two.

One thing you really might want to do is prevent constipation. Here is some information that may help:


Constipation is an acute or chronic condition in which bowel movements occur less often than usual or consist of hard, dry stools that are painful or difficult to pass. Bowel habits vary, but an adult who has not had a bowel movement in three days or a child who has not had a bowel movement in four days is considered constipated.

Constipation is one of the most common medical complaints in the United States. Constipation can occur at any age, and is more common among individuals who resist the urge to move their bowels at their body's signal. This often happens when children start school or enter daycare and feel shy about asking permission to use the bathroom.

Constipation is more common in women than in men and is especially apt to occur during pregnancy. Age alone does not increase the frequency of constipation, but elderly people (especially women) are more likely to suffer from constipation.

Although this condition is rarely serious, it can lead to:

* Bowel obstruction
* Chronic constipation
* Hemorrhoids (a mass of dilated veins in swollen tissue around the anus)
* Hernia (a protrusion of an organ through a tear in the muscle wall)
* Spastic colitis (irritable bowel syndrome, a condition characterized by alternating periods of diarrhea and constipation)
* Laxative dependency.

Causes & symptoms

Constipation usually results from not getting enough exercise, not drinking enough water, or from a diet that does not include an adequate amount of fiber-rich foods like beans, bran cereals, fruits, raw vegetables, rice, and whole-grain breads.

Other causes of constipation include anal fissure (a tear or crack in the lining of the anus); chronic kidney failure; colon or rectal cancer; depression; hypercalcemia (abnormally high levels of calcium in the blood); hypothyroidism (underactive thyroid gland); illness requiring complete bed rest; irritable bowel syndrome; and stress.

Constipation can also be a side effect of:

* Aluminum salts in antacids
* Antihistamines
* Antipsychotic drugs
* Aspirin
* Belladonna (Atopa belladonna, source of atropine, a medication used to relieve spasms and dilate the pupils of the eye)
* Beta blockers (medications used to stabilize irregular heartbeat, lower high blood pressure, reduce chest pain)
* Blood pressure medications
* Calcium channel blockers (medication prescribed to treat high blood pressure, chest pain, some types of irregular heartbeat and stroke, some non-cardiac diseases)
* Diuretics (drugs that promote the formation and secretion of urine)
* Iron or calcium supplements
* Narcotics (potentially addictive drugs that relieve pain and cause mood changes)
* Tricyclic antidepressants (medications prescribed to treat chronic pain, depression, headaches, and other illnesses).


Everyone becomes constipated once in a while, but a doctor should be notified if significant changes in bowel patterns last for more than a week or if symptoms continue more than three weeks after increasing activity and fiber and fluid intake.

The patient's observations and medical history help a primary care physician diagnose constipation. The doctor uses his fingers to see if there is a hardened mass in the abdomen, and may perform a rectal examination. Other diagnostic procedures include a barium enema, which reveals blockage inside the intestine; laboratory analysis of blood and stool samples for internal bleeding or other symptoms of systemic disease; and a sigmoidoscopy (examination of the sigmoid area of the colon with a flexible tube equipped with a magnifying lens).


If changes in diet and activity fail to relieve occasional constipation, an over-the-counter laxative may be used for a few days. Preparations that soften stools or add bulk (bran, psyllium) work more slowly but are safer than Epsom salts and other harsh laxatives or herbal laxatives containing senna (Cassia senna) or buckthorn (Rhamnus purshianna), which can harm the nerves and lining of the colon.

A woman who is pregnant should never use a laxative. Neither should anyone who is experiencing abdominal pain, nausea, or vomiting.

A warm-water or mineral oil enema can relieve constipation, and a non-digestible sugar (lactulose) or special electrolyte solution is recommended for adults and older children with stubborn symptoms.

If a patient has an impacted bowel, the doctor inserts a gloved finger into the rectum and gently dislodges the hardened feces.

Alternative treatment

Initially, alternative practitioners will suggest that the patient drink an adequate amount of water each day (6 to 8 glasses), exercise on a regular basis, and eat a diet high in soluble and insoluble fibers. Soluble fibers include pectin, flax, and gums; insoluble fibers include psyllium and brans from grains like wheat and oats. Fresh fruits and vegetables contain both soluble and insoluble fibers. Castor oil, applied topically to the abdomen and covered by a heat source (a heating pad or hot water bottle), can help relieve constipation when used nightly for 20-30 minutes.


And here is info re: hemorrhoids:
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