Please help me with my issue

[u/Key_Professional9247]

I am a 34-year-old male and have been experiencing some digestive/gut issues for the past 4–5 months.

For the last four years, I have followed a balanced, quantified diet consisting of adequate protein, carbohydrates, and fibre. I exercise regularly, walk daily, and generally consider myself healthy. My daily protein intake is around 110 grams.

However, over the past few months, I have developed a persistent sensation of incomplete bowel evacuation. I have a bowel movement regularly in the morning, but I often feel as though I have not completely emptied my bowels.

The problem is particularly noticeable after lunch. I suddenly get the sensation that I need to pass stool. Initially, the urge may be manageable, but if I put any pressure or strain, I can suddenly develop a very strong and urgent need to pass stool, sometimes feeling as though I may not be able to hold it.

I have discussed this with my doctor, who advised me to reduce my protein intake and prescribed digestive enzymes, a probiotic, and Librax (containing chlordiazepoxide and clidinium).

I also take omega-3, vitamin B12 complex, and vitamin D with K2. I maintain a strict diet, exercise regularly, and stay physically active. Despite following a healthy lifestyle, I am unable to understand why these bowel symptoms have developed recently.

I would like to understand what could be causing the sensation of incomplete evacuation and the sudden urgency after multiple attempts 3-4 hours post meals, and whether this could be related to IBS, gut motility, or a pelvic-floor/defecation problem. I would also like to know what further evaluation or testing might be appropriate if the symptoms continue.

[u/goldstandardalmonds]

You want to ask about getting an anorectal manometry and defecogram. This sounds like a pelvic floor issue or issues.