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Anal spasms, stomach pain, need help

Anismus Pelvic pain Rectal Anal Pain Cramps Ibs Constipation Laxative

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#1 GilmoreGirl

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Posted 08 May 2017 - 06:17 PM

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Hi all,

I've posted here before but I'm doing it again out of desperation.

I had a lateral internal sphincteronomy one month ago to help relax the anal sphincters which were in spasm apparently due to a fissure. The surgery has reduced the ability of the muscle to spasm as tight, but it still does every time I stand for more than a few min or have a bowel movement (or to be honest when I have an orgasm). Bowel movements are not painful, I only have pain when the muscle begins to tighten up. The most pain is in the rectum, but I also feel an ache through my whole pelvis and tailbone.

I have been to pelvic floor physio with no luck - I was told the surgery would be my fix.

I've been told all along that the spasms were due to a fissure. But my fissure has healed. And I distinctly remember having this tightness appear out of nowhere one day, and the fissure pain appearing 3-4 days later. Before this happened I was a personal trainer and weight lifted daily - I'm wondering if it's possible I hurt a muscle in my pelvic floor or nerve/disc in my back that could cause this sudden pelvic hypertonicity. Has this happened to anyone?

On top of it all I have horrible ibs (pain dominant) that is o lay relived when I have a bowel movement. So I'm having to resort to enemas, suppositories, manual stimulation and laxatives to stimulate a bowel movement just to relieve the horrendous cramps - and all this aggravates the butt even more.

Any advice anyone? Am I alone in this? My surgeon and physio don't know what else to do and my gastroenterologist (not a great guy) has refused to offer me treatment anymore as he doesn't think there's anything he can do for ibs (have had negative colonoscopy, endoscopy, small bowel MRI). Exercise helps the ibs but I can't with the pelvic pain.

Thanks guys for reading.

Here is the list of all things tried so far:

- ibgard peppermint capsules (help some)
- 10 mg amytriptiline nightly
- senokot laxative (helps me to go)
- miralax (helps me to go and keeps bm soft)
- tuzen probiotic
- muscle relaxants
- nifedipine ointment
- FODMAP free diet, gluten free, lactose free
- low fibre diet (can't tolerate any veg, fruit, fibres)
- Metamucil and normacol fibre (horrible reaction)
- Reglan 3x daily
- pantoprazole
- sitz baths (still do three daily)
- mezavant
- pepto bismol
- gas x 3x daily
- pelvic floor physio (relaxation focused)
- all sorts of hemorrhoid ointments ( I now have about 4 hems also).

#2 GilmoreGirl

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Posted 08 May 2017 - 06:19 PM

Oh also tried antibiotics for a 10 days, see a pain psychologist and do daily meditation/hypnosis tailored toward ibs.

#3 annie7

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Posted 09 May 2017 - 07:36 AM

have you tried baclofen suppositories or baclofen/valium supps?  they can help relax those muscles down there and prevent spasming.

 

shame on your gastro doc for refusing to treat you anymore.  time to see another gastro.  often  gastro docs who work in the gastroenterology department at a university hospital or motility clinic are more up to date, knowledgeable and proactive about treating constipation, pelvic  problems, pain  etc than other gastros. 

 

about the pelvic pain--there are a number of  good books available about pelvic pain, such as "A Headache in the Pelvis", "Healing Pelvic Pain" etc.  people have told me that they found a lot of help by reading these books.

 

and maybe try another pelvic floor physiotherapist.  one who is more helpful.   i was advised to do this.  different PTs  have different methods plus it's always useful to have "another pair of eyes" so to speak.

 

good luck. i hope you can somehow find relief. 


these are just my own thoughts. for expert medical advice please contact a health care professional.


#4 GilmoreGirl

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Posted 09 May 2017 - 07:43 AM

Thanks so much for the reply! I can't tolerate Valium (it gives me hallucinations and sends my heart rate up through the roof) but the suggestion of baclofen suppositories is a great idea - I will ask my surgeon about it next week!

I'm hoping to get another gastro soon but it's going to be difficult - most refuse to see me as I've had so much testing done already and even when I do find one it may be 6-8 months wait before I can see them. Frustrating!

I have been thinking about trying another physio - so your advice there is spot on also. I figure it won't hurt to get another opinion as you say. My physio is very focused on conscious relaxation which helps a lot with the spasms in the front area of the pelvis but not the anus - it just seems to do whatever the heck it wants.

Thanks again

#5 annie7

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Posted 09 May 2017 - 07:51 AM

thanks, glad i could help a little.

 

yes, the wait time to see a new gastro doc is very frustrating.  i'm really surprised, though, to hear that most of them are just refusing to see you like that.  you really have a whole lot more going on than ibs.  maybe your surgeon would have some recommendations. 

 

and yes, do see another physio.  there must be another way(s) to approach and treat this.  

 

good luck.  keep us posted. 


these are just my own thoughts. for expert medical advice please contact a health care professional.


#6 Raw015

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Posted 09 May 2017 - 10:33 AM

hi, 

 

noticed you used 10 mg amytriptiline.

did this helped you in any way?

​my doctor prescribed and have it laying in my room butt i really dont want to take anything from doctors anymore because i really dont trust them.

every thing they gave me made all my symptoms worse and i really had no issues ever in my life before the meds came. 



#7 GilmoreGirl

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Posted 09 May 2017 - 03:30 PM

Thanks annie7 - I've been told that since I've had a lot of testing done already, most gastros consider it to be a second opinion.

I did get a new gp who is fantastic - she just sent the request to release my chart from the old gastro to her. Hopeful that she or the surgeon will be able to find me someone new.

Raw015 - I don't think it has helped too much besides helping me to sleep. Although, 10mg is normally a starter dose to help you get used to the medication, and a more therapeutic dose for ibs lies between 20-50mg I believe.

I didn't have many side effects beyond dry mouth and slowed colonic transit for maybe a week, but that soon passed. I would say it's worth a try - just be careful to have your doctor help you to wean off if you decide to stop taking after more than a week or so.

#8 annie7

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Posted 09 May 2017 - 03:35 PM

oh good--glad to hear you have a good gp.  and yes, fingers crossed that she or your surgeon can refer you to a good gastro doc--one who is proactive, knowledgeable and caring.

 

good luck. 


these are just my own thoughts. for expert medical advice please contact a health care professional.






Also tagged with one or more of these keywords: Anismus, Pelvic pain, Rectal, Anal, Pain, Cramps, Ibs, Constipation, Laxative


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