I can't understand pelvic floor mechanism. Stabbing pain when poop - they say it is not a fissure.

[Undiagnosed93]

Please help.

I can't understand what's going on in my body. I used to have a fissure, which was treated with a laser. Now 3 excellent proctologists can't see a fissure (anoscopy) or anything disturbing in my anus, and I have symptoms such as pain during the day and a stabbing pain or thorns during defecation. The entire Internet says it's a fissure, but doctors can't see anything.

Doctors say it's from excessively tense muscles in this area, the sphincter and pelvis.

Can someone explain to me what mechanism happens that I get stabbing during defecation? Or maybe they are wrong and I have a fissure?

[Lolaso]

I would say I have the same problem

Had a fissure or a bruise in my rectum which cause a lot of pain but after 2 years it got better , but what got me almost 100% back I would say is “stretching” sometimes because of the pain you are afraid to move and that can make your pelvic floor muscle tight and cause pain because they are compressing the nerve but depends maybe you are still healing , question is how long has is been since the laser surgery

[Undiagnosed93 in reply to Lolaso]

3 years since laser surgery

[Lolaso in reply to Undiagnosed93]

Yea you should be good all heal by now

And your pain is during bowel movement, mine is during the day and no pain when I have a bowel movement, it’s different than mine , I would say maybe you have a scar and when you have your bowel movements it stretches, is it stopping you from living the life you want ? Or how is it affecting you

And how is your diet , are you eating fibre or stool softeners? Are you pushing when going to the washroom? Do you have a step to poop in the right position which is essential to avoid straining and pushing ?

[Rocky68 in reply to Lolaso]

Have you tried Duloxetine 60mg? It is antidepressant which also helps with pain. I take 400mg of Lyrica in addition to Duloxetine. I have not experienced any emotional problems. You should ask your Dr about including Duloxetine with Lyrica. Rocky68

[Konagirl60]

Can you see a physiotherapist and get some insight? They can do internal work to…there are PT’s who specialize in pelvic pain.

[Hope4PN]

I have had rectal pain (as well as vaginal/urethral/clitoral) and it was partially attributed to pudendal neuralgia. Perhaps they can evaluate that. I have had some relief from nerve blocks and physical therapy. Am going to try a dorsal root ganglion (DRG) stimulator next month. It is to interrupt the pain signals going to my brain. I hope you are able to find some relief. Wishing you success.

[BlueLagoon007 in reply to Hope4PN]

Is the DRG that same as a neuromolulator, where they implant something under the skin on your back which interrupts the pain signals?It was suggested to me to try a neuromolulator. You can trial it for a week before deciding whether to have it implanted permanently.

[BlueLagoon007]

Hi, I am sorry you are experiencing this. I, too, am experiencing the same symptoms as you.

I also had a fissure but it has healed. I was diagnosed with pudendal neuralgia about 3 years ago and since then have suffered terrible pelvic pain alongside searing pain after bowel motions. I also get pain in my perinem and vaginal area. I have just had a pelvic MRI to see if they can find out what is going on. It seems to be a mystery to all the doctors and trust me I have done nothing but go to medical appts for 3 years now.

I see a pelvic floor physio who helps as my pelvic floor is very weak but also tight. It might be worth having an appt with one to see if he/she can shed some light on it. With me, the pain goes away at night but as soon as I have a bowel motion the searing pain returns.

I do hope you can find someone to help you. It is like trying to navigate your way through a maze and frustrating when you can't get the help you deserve. I think our medical system is overloaded and doctors just don't have as much time these days as the used to.

Good luck and let me know if you find any answers.

Take care

[Hope4PN in reply to BlueLagoon007]

Oh my, it sounds like our stories are SO similar. I have lichen sclerosis and erosive lichen planus in addition to the pudendal neuralgia and genito -femoral nerve pain. I am doing everything and anything I can for pain relief… Physical Therapy and Softwave Therapy as well as medication’s. They don’t seem to make much of a dent in the pain. They tell me I have a hypertonic pelvic floor and all of the symptoms of pelvic congestion even though they don’t see it in the imaging. I had a venous ablation in my left leg and it seemed to help some of the pelvic pain so I do think there may be a vascular component as well. It is SO frustrating to go to SO many doctors and still not get relief.

Yes, the DRG is a neuromodulator specifically designed for chronic pain(as compared to a spinal cord stimulator). Here’s the url for the site:

neuromodulation.abbott/us/e...

Are you in the States? If not, you may need to look elsewhere in the site for your locale.

Anyway, would love to keep in touch. Let me know if you find any solutions. Best regards…