The first part of my stool comes out on its own without much straining and is of normal thickness. However, after sitting for a while and applying slight pressure, the remaining stool that comes out is noticeably thinner.
There is no bleeding and I do not have any significant pain or discomfort. However, when I strain more during bowel movements, a small reddish fleshy tissue protrudes slightly from the anus. It goes back inside automatically when I stop straining.
I am taking 1 tsp isabgol husk 2 or 3 times in a week.
A few weeks ago I visited a surgeon and the DRE was normal (within limits).
Answers (18)
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What you're describing — reducible tissue protruding only on straining, going back in on its own, with no bleeding or pain — is a fairly classic pattern for early internal hemorrhoids (grade I-II). The stool caliber change you're noticing in the later part is very likely related to this same prolapsing tissue partially narrowing the passage as you strain, rather than a separate issue, especially since your DRE was normal. Isabgol 2-3 times a week is a reasonable start, but for it to actually help you'd want to take it daily with adequate water, along with avoiding prolonged straining/sitting — irregular use won't control the constipation-straining cycle that's likely driving this. Since a DRE alone doesn't fully characterize the internal hemorrhoids or rule out other causes of the caliber change, a proctoscopy would give a clearer picture. Happy to guide you through the right routine and next steps in a consult.
Donot sit and strain in the toilet for long
Take diet rich in fibers for avoiding constipation
Take lots of fluids
If bleeding occurs in stool consult a gastroenterologist
Otherwise its normal and will go back on its own
If you’d like, you can book a consultation so I can assess your symptoms in detail and guide you appropriately.
This will also help confirm whether any further examination or treatment is needed.
1. **First stool is normal thickness and comes out easily** → reassuring and argues against a fixed obstruction.
2. **Remaining stool becomes thinner only after prolonged sitting/straining** → commonly occurs because of altered anal-canal contraction and pressure during repeated straining.
3. **Small reddish fleshy tissue protrudes during straining** → most suggestive of **prolapsing internal hemorrhoidal tissue**.
4. **It goes back inside automatically after stopping straining** → this pattern is compatible with **Grade II internal hemorrhoids**.
5. **No significant pain** → also fits internal hemorrhoids, which are often painless.
6. **No bleeding** → reassuring; hemorrhoids do not necessarily bleed.
7. **Recent normal DRE** → reassuring, particularly regarding a palpable rectal mass, but DRE cannot reliably exclude internal hemorrhoids.
8. **Isabgol 1 tsp only 2–3 times/week** → relatively intermittent. Consistent fiber intake may be more helpful if you are straining.
.**If the protruding tissue persists**, an **anoscopy/proctoscopy by a surgeon/colorectal specialist** can confirm whether it is an internal hemorrhoid.
Next Steps
* Take adequate dietary fiber regularly.
* Use psyllium consistently if tolerated.
* Drink sufficient water.
* Avoid prolonged toilet sitting.
* Avoid repeated/forceful straining.
* Don't try to completely empty the rectum by force
Health Tips
Overall:** Your description is **more suggestive of internal hemorrhoidal prolapse with straining-related change in stool shape** than a fixed colorectal obstruction.
Seek reassessment sooner if** you develop:
* Persistent pencil-thin stools even without straining
* Rectal bleeding
* Unexplained weight loss
* Anemia
* Persistent abdominal pain
* Progressive change in bowel habits
* Prolapse that remains outside and cannot be reduced.*
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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