Patient's question:
There are no major symptoms that cause great pain during a bowel movement, where the stool cannot be passed, and then one has to manually push it into the anus.Doctor's answer:
Haha, I first want to question the medical attitude of the doctors at the provincial hospital. From your description, I didn't see the doctors perform a thorough examination of the child's anus, such as even basic visual inspection and digital rectal examination. If they didn't do that, their diagnostic approach is questionable. I would like to ask, how big is the mass you mentioned? Is it connected to the intestinal wall by a thin stalk, or is it a semilunar-shaped mass visible outside the anus? If it has a stalk, it should be considered a neoplasm of the intestinal wall, requiring surgery and pathology. If it is semilunar-shaped, while it doesn't rule out a neoplasm, it is more likely to be a prolapsed rectum, i.e., rectal prolapse. After the age of 4, the likelihood of this being a congenital disease decreases. It's relatively unlikely for a polyp or tumor of that size to develop at age 4. Moreover, the appearance of the mass is related to increased abdominal pressure during defecation, so the first consideration should be rectal prolapse. It is best to have the doctor examine the mass when it appears during defecation. If it is rectal prolapse, it is a self-limiting condition in children. As the child grows, the formation of the sacral curve will gradually make the rectal prolapse disappear. It can heal on its own within 5–6 years. If constipation is corrected and good bowel habits are developed, non-surgical treatment should be the primary approach. (Disclaimer: Online consultation does not bear any responsibility for the consequences.)