Hi, these symptoms are seen in mild gut inflammation.  It causes the incomplete emptying and mucus you’re noticing.  No major worry right now as it's inactive on biopsy.  Feel free to consult for further guidance.

Kindly do connect and consult with me for better treatment plan and advice on your case

Hello, thank you for your question and for sharing your detailed medical history. I have reviewed your 3-year history of bowel symptoms alongside your test results. Your case is quite interesting and complex because there is a slight disconnect between your physical symptoms and what your scans/biopsies are showing. Your colonoscopy showed some superficial ulcers at the very end of your small intestine, the ileum, and the biopsy mentioned "chronic inactive ileitis." However, because your CRP and Fecal Calprotectin are completely normal, it suggests that there is no major, highly active inflammatory bowel disease driving this at the moment. Sometimes, mild, inactive inflammation here can be an incidental finding or related to past medications like pain killer usage . That's my first question. Do you use use pain killer often ? Your sensation under the right rib matches the endoscopy finding of mild antral gastritis , especially since it worsens after meals. It can also be aggravated when you are constipated, as a full bowel can increase pressure in the abdomen. Your complaints—straining daily, a feeling of incomplete emptying, spending 20-30 minutes on the toilet, and fragmented or flat stools—actually point away from a simple dietary constipation and more toward an evacuation or pelvic floor issue. When the muscles in the pelvic floor do not relax properly during a bowel movement, stool gets trapped or comes out in small, flat, or sticky fragments, leading to prolonged toilet times and significant straining. That's my second question - Even though you strain heavily, is the stool itself physically hard and dry, or is it soft/sticky but  incredibly difficult to push out? Have you ever noticed actual blood in your stool (bright red or dark black)? Have you experienced any unexplained fevers or joint pains? Also a very important part of reaching the correct diagnosis is , What laxatives, fiber supplements, or treatments have you already tried, and did any of them give you relief?

Indigestion

Avoid fried and spicy food Water intake more Green leafy vegetables more Fiber meal Do connect and consult

Can help you, kindly consult and provide detailed history for proper diagnosis and further management

There are multiple possibilities in this case. 1. Functional bowel disorder like inflammatory bowel syndrome (constipation) or defecatory disorders 2. Intestinal ulcer such as chrons disease Since there is no weight loss , no mention of anemia I am hoping possibility of ulcers is very very less. Some more information on sumptoms like blood in mucus and frequency of passing stools will help narrow down the diagnosis a little bit.

Based on your symptoms and test results, the most likely causes are: • Functional defecation disorder (pelvic floor dyssynergia) – difficulty relaxing pelvic floor muscles during bowel movements, causing straining, incomplete evacuation, fragmented stools, and prolonged toilet time. • IBS with constipation (IBS-C) – can cause mucus in stool, altered stool consistency, bloating, and chronic bowel symptoms despite normal inflammatory markers. • Mild inactive terminal ileitis/Crohn's disease – possible because of terminal ileal ulcers and chronic ileitis on biopsy, but less likely to be active given normal CRP, normal fecal calprotectin, weight gain, and absence of significant diarrhea. The overall pattern appears more consistent with a functional bowel disorder rather than active inflammatory bowel disease, but further evaluation by a gastroenterologist may be needed, including consideration of anorectal manometry if an evacuation disorder is suspected.