I have been suffering from a kind of anal chronic pain for 2 years , I am Chinese, 18 , male , my English isn’t very well , please read through my description below , I beg you .
One day , I suddenly get a diarrhea after that I feel like I get IBS, irregular diarrhea and Lactose intolerance , I was a healthy man , and I had a strong Intestine , I could drink milk without any discomfort.Since that day my life changed a lot.But what bothers me most is the anal chronic pain ,I will explain that more detailedly below.The pain must happen after defecation, not in the defecation , actually , it isn’t pain, it’s a strange feeling , I feel like I haven’t finish the defecation ，there is poop left in my anal , but I can’t poop more , and 10 minutes later I feel there is fart block my anal ,only putting it out can relieve my discomfort but soon it will come back . It will last 4-6hours until next defecation .It is worth noting that the top half of my stool is normal（like banana）, but the bottom half is soft and formless , it’s in the shape of cone ,every time. So to figure out what is the disease. I did a lot of medical examinations, including gastroscope, colonoscopy , Hydrogen and Methane-Based Breath Testing , anoscope , lumbosacral portion MRI , rectum ultrasound examination , but the all results are normal , only anoscope shows anal tube thickening .The examinations are done in Chinese top 5 hospital , so I think the results are credible.So I turn to foreign medical institution.If anyone knows anything about the disease please tell me, I’ll be very grateful.Thanks for reading.
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Sorry to hear that you have been suffering. I am assuming from all those tests they finally diagnosed you with IBS? IBS is diagnosed by eliminating other conditions. Having incomplete evacuation can be one of the symptoms of IBS. Your stools actually don't sound too bad compared to a lot of people with IBS. Many people with IBS either have all diarrhea or all constipation or swing between the two. Some of the people on this forum would be very glad to have a good part of their poo shaped like a banana. This part of the stool is a classic Type 4 on the Bristol stool case which is actually considered 'perfect'. I am also wondering about whether you are consuming enough fibre or whether you require a fibre supplement to ensure that you whole stool is bulky enough. This might help to ensure complete evacuation. Ground flaxseed can be a good bulking agent if you haven't tried this already.
Being lactose intolerant is a fairly common complaint and I understand that it is very common in East Asian populations. You can also be initially tolerant to milk, but the requirement to process milk needed as babies can wear off in some people so you no longer produce the necessary enzymes. In the natural world this isn't a problem since milk is only consumed from the mother at infancy and isn't needed anymore once the infant starts consuming other foods, so becoming lactose intolerant a little later in life from an evolutionary perspective makes perfect sense.
In case some of this information is of interest to you here is some information about IBS that I have shared with others in this group:
IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.
There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. There is an interesting infographic on this here:
This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.
If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:
It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.
You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.
Nice to meet you（actually not in this place🌝）no one should suffer.Sounds like you know lot about IBS.I get a question—is Posteriority lactose intolerance possible ？I used to drink a lot of milk without any discomfort.
I have not heard of posteriority lactose intolerance. It might be the lactose is upsetting your bowels and stools a bit, which in turn is impacting your bowel movements which in turn is making your anal region uncomfortable - just a guess - I'm not a doctor.
As mentioned in my post many people are OK with milk for some years and can suddenly become lactose intolerant. Also as mentioned IBS can include pain both chronic and dull (see latter part of post).
I think it is the same in all countries. I am in the UK and the NHS (UK national health service) has limited resources, so the main focus is on chronic illnesses like you say. Doctors are less interested in 'wellness' or prevention or bringing health back into balance so that you can have improved quality of life.
I originally suffered from IBS-D (diarrhea dominant) and now I am suffering from IBS-C (constipation dominant) and visceral hypersensitivity (intestinal pain). My symptoms have improved much from the measures of I have been taking as described in the original post.
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