Brief Answer:
In this age group, an endoscopy is desirable.

Detailed Answer:
Hi Mr. L XXXXXXX white, I am Dr Shareef, a general surgeon answering your query.

If I would have been your treating doctor, I would have advised you for an ultrasound for ruling out any prostatic pathology, and an endoscopic evaluation of your colon to rule out any colonic pathology in your age. in the endoscopic test, I would exclude mucosal prolapse of rectum and also diverticular disease of the colon.

I would have also gone for a routine stool test to rule out the possibility of amebic infection, which is not uncommon specially for those who eat frequently from outside.

Till all these investigations are done, I would prescribe you some kind of probiotic drug, and anti amebic, if it is documented.

If you have got any further query, you are welcomed to ask.

Thank you for using XXXXXXX for clearing your doubts on health. Wishing you an early relief of your symptoms.

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Brief Answer:
Bleeding is not a must in early pathology.

Detailed Answer:
Hi L XXXXXXX White.

Thanks for responding so soon. This shows your concern on your health issues which I consider a positive sign in remaining healthy.

Yes, you are right in saying that any colonic pathology is expected to cause bleeding in the stool, but it is not a must in all cases specially if the pathology is at its stage of inception. The colonic pathology was just a possibility which I had mentioned.

Mucosal prolapse is a kind of partial prolapse of rectum which can create a sensation of incomplete evacuation due to a weak pelvic floor(on which the rectum lies). This can be diagnosed by clinical examination by your treating doctor.
XXXXXXX hemorrhoids may not cause a sense of incomplete evacuation or feeling of defeacation in emply bowels. I will not advise you to take daily suppository treatment and as such it has not benefited you.

I do not know about your dietary habits. You may add more of roughage with enough liquids in your diet and see if this helps. If not, I will insist on going for some investigations like an ultrasound and a colonoscopy for you. It is good that amebic infection is rare where you live.

Thanks and take care.

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Brief Answer:
It was nice interacting with well informed person.

Detailed Answer:
Hi

My regrets for the delay in responding due to odd night hours in this region.

Please do not get apprehensive on seeing a doctor. This could just turn out to be normal and a routine check up for a later follow up in case of need. So all the best and it was nice interacting with you.

Thanks.

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