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Complex set of long-lasting gut symptoms


I am female, 28, athletic, slim, eat a healthy diet. I have a complex set of gut symptoms...

5 years ago, I was diagnosed with IBS (constipation type) and hemorrhoids 2nd to 3rd degree, which were treated with elastic ligation. The symptoms (urge to have a BM, constipation, mucus in the stool) came and went.

4 months ago, I had blood in the stool a couple of times. Results of the allergy tests (fructose not tested yet though), blood and stool examination (Elastase, Helicobacter, Calprotectin), ultrasound of the abdominal region were all good, except elevated bilirubin levels, bland cyst in the left lobe of the liver, ancillary spleen, small hernial orifice. The rectoscopy (16 cm / 6.3 inches) showed hemorrhoids 2nd to 3rd degree with signs of bleeding. As advised, I started taking a preparation out of diosmin and flavonoids against the hemorrhoids.

Soon thereafter, my usual symptoms got much stronger: feeling of incomplete emptying (3 BM a day), anal pressure sensation, sitting uncomfortable, hard and pen-shaped stool, rectal ‘pulling’ sensation e.g. when I bend down, flatulence, winds that could not pass. Symptoms occurred mainly in the evening or during/after exercise. The rectal bleeding had stopped though. I tried different fibre supplements (while eating plenty of veggies anyway), but stopped the supplements due to insane bloating. Additionally, I suffer from muscle and joint stiffness.

I did another rectoscopy (10 cm, 3.9 inches), which showed improved hemorrhoids. The doctor said, they shouldn’t be treated with elastic ligation now, because ‘they sit so low that the treatment would hurt badly’. He said I have a weak pelvic floor and should do pelvic exercise (note: I have an increased urge for urination, also at night). I started with a low Fodmap diet, which made me much less bloated. But all other above described symptoms stayed and really worse my life.

What could this be, apart from hemorrhoids? And what can I do?

Thanks for your answers!

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15695260 tn?1549593113
Hello and welcome to the forum. Sorry you are having such a difficult time.  It definitely sounds challenging.  I'm glad you are working with a doctor and I'd continue to do so until you feel you've got a satisfactory causation for your symptoms.  How are you controlling your IBS?  This would be what I'd consider first to make sure that this isn't the cause of the continued symptoms.  Have you also had a recent gynecological exam just to rule out anything from that end.
Helpful - 0
Hi Sara, thanks for the welcome and for your reply. :)
About your questions: As mentioned, I am sticking to the Low Fodmap-Diet to learn which foods upset my body. It helps a lot against the bloating, however, it does not improve the other described symptoms. This is also why I suspect that it's not 'just IBS', but that there is something else going on. And I do gynecological exams at least once a year (standard in Europe where I am). I have one that is coming up this month.

What bothers me and reduces my life quality the most is that I do have plenty of BM every day, but the stool is hard / pen-shaped and the quantity of stool is not enough. It always leaves me with the feeling that there is still 'something stuck in there', hence all the anal pressure, hard stool and alike.
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