Anus is tight/hurts especially when I sit

[Catsandsunsets]

Is anxiety causing anyone to have symptoms in their anus/rectum?Feels painful, sore, feels inflamed especially when sitting down.

Can the anus become tight and not relax properly?

Thank you

[Skye22]

Levator ani syndrome can cause these symptoms.

[cattailabroad]

I don't have the exact symptoms but I do have pain and spasms that involve my rectum. A quick fix for sitting pain is a memory foam donut pillow. That was my lifesaver and still is from time to time.

I'm sharing what helped for me but this was literally after years of PT and finally going to urogynecology and a highly recommended gastroenterologist, who both agreed that I was still constipated and retaining stool and that being more aggressive with softening my stool could relieve symptoms.

The hopeful message is that they were right and adding Metamucil and more Miralax quickly made a huge difference for me. I still think there is something structurally wrong that is causing the pain but I can at least relieve it while we figure that out. The amount of metamucil and miralax and high fiber food that I can consume and still have "normal" stool according to the Bristol Stool Scale is kinda shocking. I thought I had it under control before but Metamucil and even more Miralax made things "fluffier" and requires zero straining. My rectal and tailbone pain improved within a few days. This is obviously not medical advice, just sharing that some simple things did give me relief while we are figuring out the root cause of my pain.

So, this is absolutely a thing and its probably not anxiety, even though that is the go to diagnosis for women. Pain with sitting is a classic symptom of issues with your pudendal nerve or many different issues with a hypertonic pelvic floor, or a pelvic floor that is constantly holding the muscles tight or even in spasm.

In my EXTENSIVE experience of finding doctors that will actually believer you and help you, the best place to start with is a very experienced Pelvic Floor Physical Therapist. So see if you can get your GP or anyone to refer you to PT.

PTs will not dismiss your pain as anxiety and usually know the best doctors in your area that also won't dismiss you and have the best bedside manner, or who have not great bedside manner but will believe you and do the diagnostic detective work or treatment that will help.

The bonus is that the PT will very likely help relieve you pain and discomfort and fear and anxiety around not know what the heck is going on with your body while you also figure out the cause.

It is just so particularly upsetting when our issues surround our bottoms and bladders. It makes me feel just incredibly vulnerable all the time, plus brains are not supposed to ignore signals from your rectum or bladder because eliminating is a pretty important thing to keep track of, so it is a constant distraction.

Don't dismiss the breathing exercises the PT will likely start with as chalking your symptoms up to anxiety or being all in your head. They are actually INCREDIBLY helpful and effective at getting those muscles to relax in the moment and you can do them anywhere, at your desk at work, driving, standing in line at the grocery store, etc. I can lay down and spend 20 min focused on the pelvic floor breeding and completely shut down my pain. It always comes back, but it is very comforting to be able to have the ability to shut it down for a little while. The breathing is something easy and soothing that can easily become a habit because it requires no equipment or stopping what you are doing and no one knows what you are doing

[Catsandsunsets in reply to cattailabroad]

Thank you for being so detailed and taking the time to share what's helped you

I've definitely thought of a pelvic physical therapist I'm trying to find the right one and one that's not too pricey

When you say taking metamucil helped you mean it bulked up your stool because before taking fiber your stool was too soft?

[cattailabroad in reply to Catsandsunsets]

Where are you located and do you have insurance? Some of the best pelvic PTs only work out of network anyway and have lower fees sometimes as a result. They definitely focus on giving you the skills to take care of yourself moving forward, or referring you to doctors that you need to treat the underlying cause. I just find they are great resources for finding the doctors that will listen and believe you and get you on the path to recovery.

You are welcome! I also want to acknowledge that what made me feel better has the possibility of making you feel worse if your anus isn't going to relax and allow stool to pass. So don't just do what I did or definitely do it slowly!

Adding a bunch of fiber may make things worse if the upper part of your colon is pushing things down but your anus won't relax and let go. This is called defecatory disynergia, where your muscles won't or can't coordinate to allow stool to pass. I had to re-learn out to poop after my hysterectomy. There is a wonderful Youtube video that introduces "moo to poo". She is awesome! It really helps too! The muscles involved in making the mmmmmmm then ooooooo sounds involve different parts of your diaphram and pelvic floor and relaxes things in the correct order. It's pretty funny to be mooing on the toilet but it has helped me!

Getting into some real TMI, but my stools were soft and sticky, not hard with my previous regime of daily miralax and high fiber cereals and adding things like beans, and other high fiber foods to my diet. They became more slippery and just fluffier, like there were lots of air pockets inside, so less dense, after adding Metamucil before meals 2x a day and drinking a liter of flavored water with a dose of Miralax throughout the day plus maybe a 2nd dose in my morning tea. I used to just take the same amount of Miralax in a couple of single doses, but now I spread it out throughout the day. I always drank the same amount of water so I didn't add liquids, except I guess 2 extra 8 oz glass of water to chug down the Miralax.

It has been a dramatic change in pooping! I think I pooped very little because it happened so fast and I didn't have to strain at all and I don't feel it passing. Then I look and I've had a complete bowel movement and I feel completely empty too. It has made me realize how dysfunctional my bowel and bowel movements had become.

The problem with a doctor asking you if you are constipated or if your bowel movements are normal, if you've only experienced one thing then that seems normal to you! Also, when things decline very slowly over time it is easy not to notice the changes.

Honestly, I think my issues with stools and not emptying completely got worse when I had to give up coffee because it destroyed my stomach. Coffee always really stimulated things and cleaned everything out! It definitely wasn't a healthy relationship but I loved my coffee and caffeine but have had to give up both and I didn't realize that I needed to replace them with something else to really keep things moving down there.

Pooping is so much more complicated than we think!

[Catsandsunsets in reply to cattailabroad]

You've been so helpful thank you

I just wanted to clarify this part you wrote:

"It has been a dramatic change in pooping! I think I pooped very little because it happened so fast and I didn't have to strain at all and I don't feel it passing. Then I look and I've had a complete bowel movement and I feel completely empty too. It has made me realize how dysfunctional my bowel and bowel movements had become.'

What do you mean by you, "pooped very little because it happened so fast and I didn't have to strain at all"? You feel that's a bad thing?

I'm guessing because you didn't feel the pressure of a the stool since it was softer so after taking the fiber that helped feel the pressure of a bulky stool?

[Skye22]

Diagnosed with levator ani syndrome, causes anal and pelvic floor spasms, pain when sitting and problems with toileting. What has helped me are specialist womens pt who performs internal/external vaginal trigger point therapy and 3mthly botox injections into pelvic floor.Hope you find a treatment that works for you.

[Catsandsunsets in reply to Skye22]

Thank you for sharing and happy to hear you are feeling better

I didn't know levator Ani could cause providing floor spasms

May I ask, what kind of toileting problems did it cause you? Changes in your stool? Feeling it all didn't come out?

I'm trying to see if I need to go to a pelvic physical therapist