Part 1: Gastroenterology Issues
Last Tuesday, I had an upper and lower GI endoscopy. By Thursday morning, I experienced watery diarrhea and abdominal pain, which led me to visit the local emergency room.
A contrast CT scan of the abdomen was performed. The results indicated severe constipation and some bowel twisting (volvulus/kinking), but no other major abnormalities were found. I followed up with the outpatient clinic this past Monday. The doctor concluded that my symptoms were due to constipation caused by insufficient food intake and prescribed Magmil (Magnesium Hydroxide).
Since taking the medication:
I am able to pass stool, but I still have to strain, and I feel a sense of incomplete evacuation (tenesmus).
I consistently experience abdominal pain and bloating/gas after bowel movements.
The gas and bloating are worse at night, making it difficult to sleep.
I still feel a sharp, "electric" pain in my abdomen.
In the areas marked in red in the photo: I feel a lump-like sensation in the oval area. Below the navel, I feel something thick, like a large blood vessel. When my stomach is bloated and I press on the right side, I feel a mass.
Pressing these areas causes gurgling sounds and pain.
I feel a constant tension/pressure in the anus, and it feels "blocked" when I actually try to defecate.
I have intermittent pain in the lower abdomen and genital area, along with difficulty with ejaculation.
Part 2: Urology & Manual Evacuation Issues
In January of this year, due to severe constipation and the feeling of incomplete evacuation, I attempted manual disimpaction (inserting a finger into the anus to remove stool) 1–2 times using a vinyl glove.
The first attempt was unsuccessful.
During the second attempt, I noticed light red blood and a thin, white fluid.
Since that incident, I have experienced:
Intermittent genital pain and inability to ejaculate.
Lower abdominal discomfort (pressure, pulling sensation from the lower belly to the flank) and decreased libido.
Increased urinary frequency.
Pain and heaviness in the area marked in red.
Visible swelling in the lower abdomen when standing.
Regarding my prostate: during a previous ultrasound, the technician mentioned that my prostate seemed "spread out widely" but said there were no major issues at the time. I want to know if my current state requires treatment for prostatitis or other conditions.
Part 3: Questions for the Doctor
I would like to confirm if the manual disimpaction I performed is related to my current symptoms, if it worsened a pre-existing condition, or if it could have caused Pelvic Floor Dysfunction or Chronic Pelvic Pain Syndrome (CPPS).
If Pelvic Floor Dysfunction or CPPS is suspected:
Testing: Do I need specialized tests like Anorectal Manometry? Or can a diagnosis be made clinically without further testing?
Treatment: Would Biofeedback therapy be helpful in this case? Should I also begin rehabilitative physical therapy?
Medication: Is it correct to use medication only as a supplementary aid?