Q: I am very flatulent and sometimes pass mucus. I also have constipation, so I take a laxative. But even after going to the bathroom I still feel like I need to go again. Are these problems related? Is there a cure?
Name and address provided.
Dr. Martin Scurr: Many people find it difficult to talk about these types of symptoms, so I commend you for raising this important topic.
The feeling of not being able to completely empty the rectum is called tenesmus. It’s a constant feeling, a feeling that you didn’t get everything out and you need to try again. Sometimes it also causes abdominal pain.
You haven’t mentioned bleeding, which is reassuring, but the passage of mucus is not normal.
Tenesmus is a symptom of an underlying condition and you should talk to your doctor about it and request a referral for further investigation.
Tenesmus is a symptom of an underlying condition and you should talk to your doctor about it.
The most common potential cause is inflammation in the lower part of the intestine, for example due to an inflammatory bowel disease such as Crohn’s disease.
The initial investigation, called sigmoidoscopy, involves passing a thin scope through the rectum and large intestine. The specialist may also suggest a colonoscopy to examine the entire length of the large intestine.
Mucus and tenesmus may be related, but not necessarily, to flatulence. The important thing is to find an exact diagnosis.
Q: My 65-year-old brother suffered a blood clot in his leg six months ago and has been taking blood-thinning medication daily since. But during a recent hospital checkup, doctors said the clot is still there and always will be. Is this correct?
Jo Whyley, via email.
A: I understand your confusion. His brother was diagnosed with deep vein thrombosis (DVT), presumably through a scan after developing symptoms; The most common DVT is an unexplained swelling in the leg. It can also cause pain and an unexplained increase in visible veins in the lower part of the affected leg.
The veins below the knee are more superficial, so if a deep vein is blocked by a clot, these superficial veins have to carry most, if not all, of the blood flow and become very prominent (the more above tend to be deeper and obscured by fat).
The danger of a DVT is that the clot, or part of it, can break off and travel through the bloodstream back to the heart.
Because the clots are soft and gel-like, they would be pumped through the chambers of the heart and into the lungs, causing a potentially fatal blockage in a blood vessel there, known as a pulmonary embolism.
In his longer letter he mentions that his brother was prescribed rivaroxaban, a blood thinner designed to reduce the risk of pulmonary embolism.
But this medicine does not completely dissolve the clot. Rather, it “stabilizes” it; That is, within a few days and over the next few weeks, the clot shrinks and becomes, in effect, scar material that does not fall off. When his brother was examined again months later, it was this residual material from the healed clot that the doctor identified.
It is no longer a blood clot, in the same sense, and it is no longer accurate to describe it as a DVT.
Even though it may wither further, it will always be there.
An important question for anyone with DVT is to identify the cause. When there is no obvious source, such as immobility imposed by a long trip, the patient should be tested for thrombophilia, a condition that increases the risk of clots.
This can be caused by many factors, from genetic diseases such as protein C deficiency to liver disorders.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk.
- Dr. Scurr cannot correspond personally. Answers should be taken in a general context. Consult your GP if you have any health problems.
In my opinion… The link between chemical herbicides and male fertility
As chair of the ethics committee of a fertility clinic, I am interested in male infertility and have long been concerned about declining sperm counts. Between 1951 and the 1970s these fell by 50 percent, from an average of 107 million sperm per milliliter to 48 million.
Then, in 2017, a review of 185 studies conducted between 1973 and 2011 revealed an additional 50 percent drop.
Among the possible causes of this worrying decline are pollutants called endocrine-disrupting chemicals and, in particular, glyphosate, a herbicide.
A 2022 study, published in the journal Environmental Science and Pollution Research, suggested that more than 99 percent of people in France had glyphosate residue in their urine, which is not surprising considering that the chemical is sprayed on fields of wheat before harvest.
Environmental pollution is more than just global warming: some estimates show that the number of healthy sperm is declining by 1 to 2 percent a year, so it could be that within 20 years we will lose the ability to reproduce, which which will put an end to all other environmental concerns. in a three-cornered hat.
