What Is Vaginal Flatulence?

Anal bloating is a discomfort that occurs in the rectum, anus, and perineum. The main manifestations are: local fall, pain, foreign body sensation, convenience, ant feeling, burning sensation. In severe cases, there are symptoms of radiation to the lumbosacral and lower limbs. The condition is prolonged, and mental symptoms such as anxiety, suspected illness, insomnia, and even suicidal thoughts are often associated. Anal bulging is not only a common symptom of many diseases in the anorectal department, but also one of the common complications after anorectal disease. The cause of anal bulging is complex and there are many uncertain pathogenic factors, which can exist alone or be accompanied by other diseases. There is a problem of poor efficacy in treatment, and no treatment plan has been formed.

Basic Information

Visiting department

Anorectal

Common locations

Rectum, anus, perineum

Common causes

unclear

Common symptoms

Local fall, soreness, foreign body sensation, sensation of infestation, antagonism, burning sensation, often accompanied by mental symptoms

Common Anal Swelling

Prolapsed anal disease

(1) Internal hemorrhoid prolapse, rectal mucosal prolapse, polyps, etc. can stimulate the tooth line area (highly specialized sensory nerve terminal tissue band, which is the area that induces defecation movement) to produce anal swell and then cause defecation.

(2) Uterine prolapse and vaginal prolapse also often have a feeling of falling. In patients with rectal prolapse, the mucosa sinks into the anal canal, stimulating the nerve endings of the dental floss to produce a swollen sensation.

2. Inflammatory diseases

(1) Colitis, proctitis, anal cryptitis, and anal papillitis can all cause anal swelling due to inflammation in the tooth line area.

(2) The rectal submucosal abscess, pelvic rectal space abscess, etc. due to inflammation stimulate the pelvic floor nerves, most of the anus and rectum fall.

(3) Perineal bulging may occur in acute bacterial prostatitis.

(4) Anal canal foreign body can cause rectal mucosal bleeding and ulceration, poor bowel movements, and anal bulging.

3. oppressive disease

(1) The contents of the pelvic floor hernia compress the rectal and anal canal, which can cause the anus to swell. The innervation of the rectum and surrounding organs mainly comes from the pelvic plexus. Once the phrenic nerve of the pelvic plexus is compressed by the lumbar disc herniation, the patient may show discomfort in the anus.

(2) The posterior uterus can cause anus to swell. If blood accumulates in the rectal uterine depression, anal swelling can occur.

(3) Anal swelling may also occur in the late stage of cervical cancer when the rectum is compressed.

4. Surgical stimulation

Anorectal swelling after anorectal disease may be related to surgery and inflammation to stimulate bowel movements. For example, if the swelling occurs 1 to 2 days after the injection of internal hemorrhoids, it is due to the temporary enlargement of the hemorrhoids by the injection of the medical fluid; the external hemorrhoids and internal ligation of mixed hemorrhoids can stimulate the anal canal to cause infestation when the internal hemorrhoid ligature has not fallen off Anal canal bulging occurred; high anal fistula incision and slinging procedure, in the early period of rubber band fall-off, due to severed anal muscles, anal fall often occurred. He felt anal swelling after undergoing hemorrhoids negative pressure suction ligation treatment. After complex anal fistula, large scars can cause discomfort in the anus. Anastomosis of the anus after the hemorrhoidal supramucosal circumcision (PPH), the main reason is that the operation plane is too low, may also be related to anastomotic inflammation, rectal stretch reflex.

5. Autonomic dysfunction

Anal bloating caused by autonomic dysfunction is also called anal bloating, which is an anal neurosis. The condition is real, but there are no positive signs, and it is mostly related to emotional changes. About 70% of the patients are female, which is related to the paranoia and fear of cancer.

Clinical manifestations of anal bulge

The main manifestations are: local fall, pain, foreign body sensation, convenience, ant feeling, burning sensation. In severe cases, there are symptoms of radiation to the lumbosacral and lower limbs. The condition is prolonged, and mental symptoms such as anxiety, suspicion, and insomnia are often associated.

Anal bloating check

Specialist examination

(1) Inspection may be without positive signs, and may also be accompanied by symptoms of anal diseases such as external hemorrhoids and internal hemorrhoid prolapse.

(2) Patients with digital rectal internal hemorrhoid prolapse can touch smooth and soft masses near the dental floss, and some masses can prolapse outside the anus. Patients with anal papillary hyperplasia and anal papillitis can touch one or more masses near the tooth line, which is smooth, soft or tough. Patients with anal sinusitis and proctitis may have a burning sensation and may also be accompanied by local tenderness. Patients with rectal prolapse can touch the rectal mucosa to fold and accumulate during digital rectal examination, which is soft and smooth, moves up and down, and has a sense of stagnation. There is an annular groove between the prolapsed part and the intestinal wall.

(3) sigmoidoscopy or anorectal examination of mixed hemorrhoids, anal papillary hyperplasia, anal papillitis, rectal polyps in the anus, rectal microscopy can be seen in the internal hemorrhoidal bulge, near the floss, rectal mass. In patients with anal sinusitis and proctitis, congestion and edema of the intestinal mucosa can be seen with erosion. In patients with prolapse of the rectal mucosa, a slight increase in abdominal pressure can be seen under the rectal mucosa, and a cork-like protrusion protrudes into the opening of the lens barrel, and a ring or cervical mucosa inversion occurs at the junction of the rectal and anal canals; It can be seen that it is embedded in the cavity of the mirror or appears below the dental floss during the defecation movement. The patient can see mucosal edema, brittleness, congestion, or ulcers, polyps and other lesions.

2. Defecation radiography

Defecation angiography is an inspection method in which the rectum of the anal canal is combined with dynamic and static observations by injecting a contrast agent into the patient's rectum. It can show functional and organic lesions of the anorectal rectum. Patients with intrarectal intussusception or prolapse can see images of intestinal mucosa or full-layer intussusception during defecography.

3. Other imaging studies

CT and magnetic resonance examination can help identify abnormal tissue structures around the anal canal and rectum.

Diagnosis of anal bulge

The patient's self-conscious symptoms are mainly anal discomfort. Patients often feel that the anus is unbearable. Sometimes they radiate to the lumbosacral, buttocks and thighs. And even irritability and anxiety symptoms.

Anal bulging is a subjective symptom of patients. At present, it can only be judged by the patient's narrative, which lacks objectivity. How to enhance the objectivity of anal bloating diagnosis, how to accurately explain the mechanism of anal bloating, how to improve the effect of anal bloating treatment, these problems need to be further solved.

Differential diagnosis of anal bulge

Prolapsed anal disease

Prolapse disease can be confirmed by digital rectal examination, defecation angiography and other imaging examinations to see the prolapsed tissue or image.

2. Inflammatory diseases

(1) Colitis, proctitis, anal cryptitis, and anal papillitis can be seen through colonoscopy, straight microscope, and anuscopy to see the corresponding mucosal changes, combined with the history can be clearly diagnosed.

(2) Subrectal abscesses, pelvic rectal abscesses, etc. may be associated with pain near the anus or buttocks. Digital rectal examination can touch areas of undulation, induration or tenderness in the rectum. Anorectal ultrasound or magnetic resonance examination can help clear diagnosis .

(3) Acute bacterial prostatitis is often associated with abnormal urination, and can be diagnosed by digital rectal examination, ultrasound of the prostate, blood routine, and urine routine.

(4) Anal canal rectal foreign body can also be diagnosed by inquiring medical history and rectoscopy.

3. oppressive disease

Pelvic floor hernia, posterior uterus, and cervical cancer can be clearly diagnosed by imaging examination.

4. Surgical stimulation

The cause is the easiest to clarify, and recent surgical history is the most obvious diagnosis.

5. Autonomic dysfunction

After excluding all organic and functional reasons, the patient still has a long-term feeling of anal bulging, and the possibility of neurosis can be considered. Patients with this disease often have psychiatric symptoms.

Anal bulge treatment principles

Those with primary disease first treat the primary disease. With the cure of the primary disease, most of the anal bulges can be relieved by themselves. Patients with an indication for anorectal surgery in the primary disease can be treated with surgery, and those without surgery can be treated symptomatically.