A patient whose rectum has been totally excised may experience rectal-type symptoms. This is primarily a neurologic phenomenon analogous to phantom limb pain in amputees.
Patients who may have a complete rectal excision:
(1) anal or lower rectal carcinoma
(2) Crohn's disease
(3) ulcerative colitis
(4) polyposis coli
Frequency: about 66% of patients at some time. The feelings may fluctuate over time and can disappear or persist.
Many patients will have a colostomy.
(1) urge to defecate
(2) feeling of feces and/or flatus at the rectum (internal pressure)
(3) hard stool distending the rectum
(4) pain that is prickling, shooting or hemorrhoid-like
(5) secretions from the rectum
(6) vague sense of tightness
(7) any other feeling that the rectum is present
Many patients will not mention the symptoms unless specifically asked.
Some patients with more severe symptoms may be anxious and depressed.
The differential diagnosis includes:
(1) pain associated with the surgical scar (cicatrix pain)
(2) recurrent carcinoma (often show onset of symptoms >= 3 months after surgery)
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