Dyssynergia with obstruction

[katiescarlett887]

Does anyone have incomplete bowel movements, like a strong urge, a push, then anal muscles tighten up? Then you have the urge again within the hour and you're chained to a toilet in the morning? This is what I have. I dont gave pain, but a pressure. This has created a secondary problem of hemorrhoids, prolapsed, external and internal. It is difficult to live like this as no Dr. will even touch the hemorrhoids with the dyssynergia.

[Skye22]

I was diagnosed with levator-ani syndrome, rectocele prolapse, pelvic floor dysfunction and slow transit colon.

Symptoms very similar to yours whereby my colon "locks"in painful spasms preventing normal bowel function. I use daily trans-anal irrigation and manual extraction as I have little "push"function. Pain is all consuming and especially in morning when I practically camp out in the bathroom. It's not until you lose a normal daily function till you realize how debilitating a condition is. It took 5yrs of endless tests to get a definitive diagnosis.

I have a specialist bladder and bowel physio who does internal/external trigger point therapy to try to loosen spasms. I also get botox injections into pelvic floor. It doesn't eradicate symptoms but rather helps to release painful spasms for short periods.

It's one of those conditions that nobody really talks about and understands, unless you are a fellow sufferer and realize how all consuming the condition is.

Do you receive any treatment or take any medications? I also discovered that laxatives have absolutely zero effect on my colon.

[Hidden in reply to Skye22]

Hello

Thank you for your posting.

I have exactly same symptoms.

Very distressing. Hard to get anyone to take you seriously.

Are you in the UK please and have you any recommendations who to see?

Have you ever been prescribed diazepam for muscle spasms?

Thank you from Korin

[Breathless1943 in reply to Hidden]

I take diazepam for spasms,they don’t really stop them ,but they do relax me which helps when the pain is intense. Should have said I’m in the U.K. but there don’t seem to be much help out there.

And I’ve travelled from one end of the country to the other,for help.

[Hidden in reply to Breathless1943]

Have you seen Mr Siddiqui in Chelmsford?

Thank you for your reply.

Korin

[Skye22 in reply to Hidden]

I stay in West Coast scotland. After being brushed off by male colorectal consultant (had haemmorage from colon) I decided to change hospitals and have an all female care team. I just feel that regarding pelvic conditions they can truly understand.

I take amitryptiline for spasms, and tramadol for pain. It has taken me 5yrs to get a diagnosis and a comprehensive care plan and treatment.

[Konagirl60 in reply to Skye22]

I had pudendal nerve entrapment and my nervous system was agitated for years.

At one time I used Compounded vaginal and Lidocaine suppositories at bedtime for over ten years.

Recently, due to very slow healing I stopped using them; I was tired of the sedation effect.

When I’m in bad pain I use a .1 mg clonodine pill at bedtime.

I believe my rectum ( my right inferior rectal nerve was pinched ) isn’t working properly anymore.

I use zinc to stop incontinence and it’s helped.

As long as I’m hydrated, I pass stool semi normally. It’s never all at once like it was before my neuropathy started.

I’ll go walk a little go again walk a little and go again. I’m not sure if it’s structural or a muscle issue?

[katiescarlett887 in reply to Skye22]

I have had this

[katiescarlett887 in reply to Skye22]

I have had this for years, slowly progressing to my current situation. I have seen 4 colorectal, 3 GYN, neurologist, uroGYN, physiatrist, 2 GI, acupuncturist, chiropractor, nutritionist, psychologist, countless pelvic floor PT, the Cleveland Clinic, all of which not offered much. I tried valium/baclofen suppositories which did not help. I use squatty potty, music, mood lighting, aromatherapy, the PT techniques, exercises; I have had internal and external biodeedback. Botox was not offered, said it would not work.

I had anal manometry done, ultrasound, defacography, Pelvic CT scans, sacral MRI, etc.

I go back to colorectal in 9 days to see if anything else can be done. I'm also going to a new out of pocket PT. I just had a stretching session from massage therapist, but did not help. My initial problem seems to be the pressure I experience in rectum. It can be maddening. Like I have to have a BM, but when I try, nothing. Then that puts strain on veins of which are already compromised, my secondary problem. Last resort would be colostomy. Sad because I have BMs, but they're destroying my rectum.

[kalecolbe12 in reply to katiescarlett887]

I read your post and I was wondering if you get pain with bowel movements also or after the bowel movements it sounds like you have a slow Transit colon so pelvic floor dysfunction of course ...would you seriously consider a colostomy and would that really work for you did the doctor say?

[katiescarlett887 in reply to kalecolbe12]

I don't have pain. After bowel movements, I have pressure in rectum. This has progressed from years of struggling with bms. At first, it wasn't bad. But as years went by, I feel I'm pushing against a closed door. The Dr. did mention a stoma. I don't know if she would agree to do surgery, though. This would be a last resort for me. I'm still hoping this new PT will help. It's all I have left. I almost believe I have a hypertonicity of anal sprincter muscles.

[kalecolbe12 in reply to katiescarlett887]

Interesting that you have seen pts for the pelvic floor and nobody's told you if you have hypotonicity of anal sphincter.... Did anyone they suggest sphincterotomy to relieve some of the pressure in there or if they have given you some diltiazem cream to relieve the pressure.... I have a lot of pressure too... I used cyclobenzaprine muscle relaxer for 3 months and that relieved a lot of the pressure they also gave me gabapentin because I think the nerve is involved pudental inferior rectal nerve but I still haven't tried it. I'm finding the lidocaine Valium suppositories help.. I really hate taking medication but I will if I have to as Long as I know it's temporary... But if I keep getting difficulty and pain with bowel movements after a few years I would consider a colostomy

[katiescarlett887 in reply to kalecolbe12]

I have taken the valium suppositories to no avail. I was given Gabapentin, but I had side effects. I am now working with another pelvic floor therapist and using a thera wand via the vagina for pressure on anal spincture muscles in between bms. We will see what this new PT does. I am done with drs. They don't seem to understand our problem.

[Hidden]

Hi

So sorry to hear of your problems. Just wondering if you live in the UK? Am seeing a colorectal pelvic floor surgeon tomorrow. He sounds very good.

Korin

[kalecolbe12 in reply to Hidden]

Hi Korin,just wondered if you'd seen the pelvic floor colorectal surgeon yet and how was it?

[Hidden in reply to kalecolbe12]

Hi

Yes I saw him on Thursday.

He's firmly of opinion I need a multi disciplinary approach to pain I have including Meds, CBT, specialist physio, mindfulness. He no longer does the Botox as he didn't find they were beneficial in most cases.

Now with Corona virus things getting difficult to get treatments.

How are you?

[kalecolbe12 in reply to Hidden]

I am okay I guess.. I wish this thing would go away but doing everything that you're doing...i know what everything else is that you said but what is CBT

[Hidden in reply to kalecolbe12]

Know what you mean. Just want it to go away and life can be normal again.

CBT is cognitive behavioural therapy. He reckons much started in childhood before limbic system mature at age 30. The result is overly protective pelvic posture and the exercise machine and gynaecologist exam were last straw.

Dysfunctional pelvic floor and my brain need retraining.

[kalecolbe12 in reply to Hidden]

Yep mine too... That just resonates with me what you said about play me training and I'm trying to do some myself but I might go see a counselor who specializes in it

[Hidden in reply to kalecolbe12]

Have you ever thought your coccyx could be involved in terms of cause?

[kalecolbe12 in reply to Hidden]

Yep it could be ...had mri and ct scan and it showed coccyx is all normal but I think the nerves in there could be involved

[Hidden in reply to kalecolbe12]

On MRI coccyx will be flat in lying so problem won't show. PT says ligaments can pull on it causing pain.

How long does pregamblin take to work? I'm having problems tolerating it. Also started on Baclofen. Feel dreadful and in such awful pain.

[kalecolbe12 in reply to Hidden]

Sorry talk messaging I meant brain retraining

[lucyp]

It sounds like you have obstructive defacatio , I,m surprised a colorectal surgeon was,nt more helpful, as it is a condition in their remit.

For a start you could try a swatty potty, this changes the angle at which you go, many countries still use this position, as it is much more natural. A pelvic physio would also be a good step. If all else fails a good colorectal surgeon can correct this, but do your homework first if you can and try and find someone who is well recommended.

Lucy

[kalecolbe12 in reply to lucyp]

I was wondering what surgery the colorectal surgeon would do for this as I have same but I have a lot of pain which they think it's the pudendal nerve irritation

[lucyp in reply to kalecolbe12]

A ventral mesh rectoplexy would help with defacation symptoms, sadly this would not help pain. I don,t know if there are any doctors who could address both issues, maybe the French team!

Lucy

[kalecolbe12]

Sounds like you have pelvic floor dysfunction

[Hidden]

Sounds alot like my issues, the worst problem is the incompleteness leaves me with sever anxiety its like a constant tickle sometimes more of a sharp stabbing sensation at the anal outlet. every time i do a search on this issue if i add another word to my search i get more names for the same problem. being male its even harder to find any help.

[kalecolbe12 in reply to Hidden]

yes I know being male it's very difficult. I'm a female but I have male friends that have issues but I was wondering where you live?I think the first place to go is always a pelvic floor physical therapist because they're so educated I mean mine has helped me so much physically and emotionally and the gastro the colorectal doctor the pain doctor they do their part but no one helps like the pelvic floor physical therapist...

[Hidden in reply to kalecolbe12]

I am in USA West Coast I have been seeing a chronic pain doc for over 15 years and take the max pain meds the DEA allows. I suffered a fall in 2018 that caused an old 5 level lumbar fusion to move. Causing my back to become seriously unstable luckily one of the few Spin Restoration facilities in the state is close by. My Spine surgery was a 2 day Surgery 16 level fusion S1 to T3 with a month of hospital recovery. The fall also caused the Pelvic Floor issue and my biggest issue in the beginning was that I did not know what my gut problem was strange things started happening I could not Defecate the issue was found to be my Pudental Nerve and the puborectalis muscle not relaxing when it should . I have had 3 different nerve blocks. Fortunately I have several good pelvic floor therapist in the area Sarton Physical Therapy is one and a therapist I just found that is focused on Males with this issue its called "Dynamic Contraction Technique" dctforpelvicpain.com . My biggest issue is that I am restricted because of my back on what exercises i can do to help my pelvic floor and the reverse. Its been a very hard year for me and my wife without her it would be impossible . One amassing thing that happened with my spine surgery was , before surgery I was 6ft 8in now after I am 6ft 10in

[kalecolbe12 in reply to Hidden]

Wow!!you're super tall!!yes I have the pudental nerve issue also but ...tight muscles we think compromised it from pelvic surgeries and extreme stress and there you have it...I have a fantastic pelvic pt here in Phx and my have meds but I try not to take them if I don't have to ... I have gotten so much better in a year but of course I do get flare-ups which bowel movements seem to exacerbate sometimes but that's the pelvic floor dysfunction I do my exercise is my stretches and I have heard of David McCoids dct and in fact I emailed him and talk to him about becoming certified in it and I was feeling ambitious for a minute but then I'm not able to take on anything like that just yet but I may look into it I am also doing the curable app to calm my nervous system way down... I don't know if you've gone on the Pudental hope website but that's very informational and helpful too....let's stay in touch for support....I am thankful I have my fiance and my son around that they give me great comfort when I feel like I'm losing it!! Last question where exactly are you? in California?

[Hidden in reply to kalecolbe12]

I have been all over the Web reading all I can, at times its disappointing when after you finish the article you find out the information is 10 to 15 years old. I was happy to see this thread being so new and relevant to my condition. And yes I am in Southern California, where are you located ?

[kalecolbe12 in reply to Hidden]

I am in Phx, Arizona

[trishj46]

I have pn and neurogenic bowel----its been a problem for nine years. I find NO colo-rectal doctor of any help or empathy. I take laxative and have to do some manual release. My problem is after I go, I continue to have soft stool in lower bowel constantly. It has to be flushed out day & night and I feel like I am going to go crazy. No one can tell me why this happens. I have tryed meds to stop it with no help. I am afraid if I did not flush it, I would be incontinent. Has anyone had this problem or found any help? Thanks &God Bless!

[Konagirl60]

Try taking a 15 mg zinc supplement every afternoon. It has helped me. This might help you.

[Frankieandgracie]

You poor darling don't be afraid, I too was the same as you at the beginning of my terrible journey of hell. Your symptoms sound the same as mine were at the beginning of where I was when it all started. I am still learning about my problem and not quite sure my full diagnoses I've been told quite a few, pudendal nerve latency, obstructed defecation and pudendal nerve pain to levator syndrome all big to put in one box but as the journey develops I am learning new ways to cope I went to a colorectal surgeon who did the whole bunch of tests which I now realize was extremely important as it then informed me of my next steps to take. Then I was referred to bio-therapy for help to relax pelvic floor muscles to actually use bowels, this helped in being able to at least go, also stool softener at night after dinner.l I take coloxyl 120mg, only the softener this helps to keep stool soft and formed not hard . The pelvic floor needs to be re-trained to relax, I still have problems with morning bowel movement but it is not as bad as the beginning now might have to go 2 times a day instead of one. I too ended up with piles so have learnt not to push stop walk away distract yourself with some movement and wait for the urge later this is all very hard I know but the body eventually follows, once you see a good pelvic floor therapist help you with this. They teach you breathing exercises to help with this it is a big thing to re-learn how to function like normal again in which I am still doing. Your diet needs also to have fiber so your stool is formed , water is also key. I ended up having rectal pain all day dare say was due to the pushing I had done as I too didn't know what was happening to my body. I am currently getting treatment for my rectal pain which is another journey im on however thanks to this forum we can learn from each other.Try to get to see a pelvic floor therapist they do help with this. I will keep you in my prays you will get there as I am still learning .

[paine321 in reply to Frankieandgracie]

Hi frankie & gracie.

Have you tried an oesteopath specialized in pelvic floor, it is a non invasive alternative which it is worth to try.

Best of luck.

[nieldy]

do you bleed with your hemorrhoids????

[katiescarlett887 in reply to nieldy]

Thankfully no.