internal examination : hi has anyone experienced... - IBS Network

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internal examination

Nerissa profile image
33 Replies

hi has anyone experienced this I went to physiotherapist about pelvic floor she said mine was very bad probably after uterus removed. But while I was having the internal I felt terrible pressure towards the back that I was going to have a bowel movement. Does anyone have experience of this as I’m sure something is leaning on my bowel as I have such trouble going to the toilet. But always feel as if something is leaning on it.

any ideas would be great.

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Nerissa profile image
Nerissa
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33 Replies
Blearyeyed profile image
Blearyeyed

I've not heard of Physiotherapists in the UK doing this level of examination .Have you been referred because you have a prolapse and need to strengthen the pelvic muscles to help reduce this pressure on your bowel?

Have you seen a specialist to check for a prolapse and had other tests or a scan?

It might be worth having this checked if it is effecting your ability to go to the toilet.

Nerissa profile image
Nerissa in reply to Blearyeyed

yes I’ve had a scan when I had so many uti but didn’t show anything. My urologist referred me for relaxation of pelvic floor but definitely wasn’t relaxing 🤪I’m in Hong Kong was so shocked by the whole experience. Spoke to my urologist yesterday and she said it can happen because nothing separating the bladder and bowel as hysterectomy but she didn’t agree with the physio as too long as had hysterectomy 11 years ago. So she said not to carry on with physio and carry on with tablets for the bladder and hopefully it will get better as I’ve constantly had water infections since last July. I’m moving back to U.K. in 2 years can’t wait. Thanks for your reply

Luisa22 profile image
Luisa22

You might have some ligaments that are looser since the hysterectomy? Or adhesions? I am not sure how that is scanned or what method they'd use to tell. I think maybe you should ask your doctor and ask for a referral to A Gynaecologist?

Nerissa profile image
Nerissa in reply to Luisa22

I’m not sure how they work it out either. Urologist did an examination into bladder under sedation and she said she couldn’t see anything and I’ve had a ct scan of abdomen so I guess it would have showed up then. Thanks for your reply

Nerissa profile image
Nerissa

thank you so much I will check out that now.

MyStar86 profile image
MyStar86

have you ever been checked for endometriosis because I was told I had a prolapse in 2016 I had terrible issues going to the toilet even though it was loose and shooting pains up my rectum and the pressure feeling you described in 2021 I saw a gynaecologist who did a laparoscopy where they found endometriosis wide spread on bowel and particularly in the pounch of Douglas (the pouch that separates the rectum and vagina).

I would see w gynaecologist if not. I know you have had a hysterectomy but that doesn’t preclude you from endometriosis. Do you still have your ovaries?

Nerissa profile image
Nerissa in reply to MyStar86

hi yes I’ve still got my ovaries. I asked my urologist but she said she doesn’t think need to see gynaecologist but I will ask her again could it be endometriosis on my bowel. Thanks for your reply

MyStar86 profile image
MyStar86 in reply to Nerissa

I highly doubt the urologist would know as endometriosis is very difficult to diagnose they can do an mri but this will only show deep infiltrating endometriosis the only way to truly diagnose endometriosis is via laparoscopy. Regardless of what the urologist says I would speak to your gp mention what I have said re endometriosis and that you want to see a gynaecologist and they should refer you. I went private as the nhs wait times for laparoscopy are way too long but even if you just pay for an initial consultation with an endometriosis specialist gynaecologist they if they suspect endo they can put you on the laparoscopy list nhs which means you will be higher up the list to get it done sooner which will help massively rather than waiting 6 months just for the consultation to then be put on a list. I asked re ovaries because endometriosis is driven and fed by oestrogen so if you still have your ovaries it will be aiding endometriosis to continue to grow. Do you take any contraceptive pills? The progesterone only pill is recommended to help endometriosis given you would have to wait a while for any help it’s worth a thought.

A lot has been done to raise awareness for endometriosis but it still took 5 years for me so you have to scream from the roof tops to doctors to get them to acknowledge it.

Have a Google and see if your symptoms match up.

Good luck

Nerissa profile image
Nerissa in reply to MyStar86

that’s interesting I thought when you didn’t get periods anymore the endometriosis wouldn’t grow. I will look into it thank you

MyStar86 profile image
MyStar86 in reply to Nerissa

no not at all it’s driven by oestrogen not your periods so having your uterus removed will do nothing to stop endometriosis so please do check. That’s why they recommend progesterone only whilst waiting for surgery as it turns off the ovaries over time but either way if you do have it you would neee surgery to remove it. Hopefully one of your doctors can point you in the right direction as it’s worth it to stop the pain as endometriosis only gets worse it doesn’t go away unless it’s removed by a surgeon.

Let me know if you need any info or advice before appointments.

Take care and good luck x

Nerissa profile image
Nerissa in reply to MyStar86

oh thank you for your reply. I will get an appointment with my gynaecologist that did the hysterectomy. Thanks again

MyStar86 profile image
MyStar86 in reply to Nerissa

Are you based in the uk? Do check if they are an endometriosis specialist or you could ask your original gyne to refer you to and endometriosis specialist. May I asked why you had the hysterectomy just removing the uterus? Take care and good luck with it hope your gyne can help!!

Nerissa profile image
Nerissa in reply to MyStar86

thank you. I’m in Hong Kong but I’m British hoping to move back in 2 years. Had my uterus removed because of endometriosis and very large fibroid inside it. But left my ovaries because my mum had breast cancer after hrt. Thanks again for your reply.

MyStar86 profile image
MyStar86 in reply to Nerissa

so you already have had endo wow then definitely go to see a gyne you will need a full diagnostic laparoscopy and especially mention the pounch of Douglas!!!!

Nerissa profile image
Nerissa in reply to MyStar86

I was just reading up and it says you can’t have endometriosis after menopause which I’m post menopause according to blood tests. So I don’t think it can be endometriosis 😢

MyStar86 profile image
MyStar86 in reply to Nerissa

that’s not totally true because if you had endometriosis that was never found and removed prior to your menopause then it will still be there…..yes it might not be growing more but whatever was there previously and not removed will not go away on its own. So whilst you can’t grow fresh endo you can still have it left from before and it will cause all sorts of problems untreated so I would still discuss with gynaecologist and ask if you ever had a diagnostic laparoscopy to investigate everywhere.

Nerissa profile image
Nerissa in reply to MyStar86

oh so could still be the cause then, I will definitely get a appointment then to check. Thanks again for your support

MyStar86 profile image
MyStar86 in reply to Nerissa

definitely just make sure you ask about the pounch of Douglas have a Google before you go it explains but basically even a speck of endo in there pills part of the bowel towards it and part of the vagina towards it so it creates a kink in the rectum making it painful and difficult to go also creates a kink in the vagina making it painful when having Sex etc. main symptoms are for the bowel like you mentioned. You could have it anywhere on the bowel causing you issues too or even just in the pelvis but personally the pounch of Douglas was what caused so many problems with going even tho I have very loose stools my surgeon explained re the kink endo causes. Good luck let me know how you get on any questions just shout I’ll be here xx

Poppycat999 profile image
Poppycat999

Hi Nerissa It could be a prolaspe. The bowel and bladder can prolapse especially with a weak pelvic floor. A gynecologist can tell you and some doctors I've been told l hadn't by one who was wrong. Be careful having too much fiber in your diet as it can makes your stools larger. You need stool softeners which add water to them making them easier to pass. Macrogol is good as it's not harsh comes in sachets taken with water at main meals brand names cosmocol movicol and laxido

Good wishes

Nerissa profile image
Nerissa in reply to Poppycat999

no prolapse according to urologist as they did a ct scan of abdomen and also a investigating into my bladder under sedation and she said she couldn’t see any prolapse but I will try getting hold of macrogol see if that helps as I’m trying Metamucil but doesn’t seem to be working. Thanks

Poppycat999 profile image
Poppycat999 in reply to Nerissa

Macrogol is great for me that's the ingredient name. You need to ask for Cosmocol Movicol or Laxido at the chemist comes in sachets 30 in a box usually. I take one sachet with large glass of water with main meal. I wouldn't be without it. It changes to clear after stirring it so no one has ever noticed when l take it even when out with anyone.All the best let me know if it suits you?

Nerissa profile image
Nerissa in reply to Poppycat999

oh that sounds promising I will have a look for it. Thank you

Brainfoglady profile image
Brainfoglady

The bowel sinks to fill the space left from the hysterectomy, and can cause different pressures in difficult places.

Have never heard of a physio doing an internal.

Nerissa profile image
Nerissa in reply to Brainfoglady

yes that makes sense Thank you

Gold22 profile image
Gold22

Did you tell the physio what you were feeling during the examination, they may have been able to explain. I have a rectocele ( prolapse of the bowel towards the vagina) from giving birth and constipation. This can make it feel like there is pressure because the stool gets trapped in the bulge and makes it difficult to fully clear the rectum.

Nerissa profile image
Nerissa in reply to Gold22

she could tell it was painful but haven’t been back as my urologist said it’s not going to relax my pelvic floor in so much pain. What did they do about your rectocele? Thanks

Gold22 profile image
Gold22 in reply to Nerissa

I learnt to manage it and have been doing pelvic floor exercises

Nerissa profile image
Nerissa in reply to Gold22

ok great I try that thanks

Edgar77 profile image
Edgar77

Yes my physiotherapist regularly manipulated my muscles from the inside for weak ilio sars (don't know how to spell it)) muscles. It did help in the long run. There was a lot of tension on one side.

Nerissa profile image
Nerissa in reply to Edgar77

that’s good but was just to pain full at the moment

MOLLYMILO007 profile image
MOLLYMILO007

Hi you prob have a prolapse maybe a bowel abs bladder so yes stenghting your pelvic floor would help ..I had a posterier and anterior repair last year as I had the same problem all good now..I used a kegal 8 exerciser for years prior to this ..so if u Google kegal 8 on the Internet u will see about them they are a god send x

Nerissa profile image
Nerissa in reply to MOLLYMILO007

oh thank you. How did you find out about the prolapse my urologist checked she said there was nothing but I still feel there might be. Glad you’re feeling better

MOLLYMILO007 profile image
MOLLYMILO007 in reply to Nerissa

My surgeon was poss going to do me a hysterectomy as I had a bladder prolapse and thicknkng of my uterus wall when I was on hrt...however after the op he said he hadn't taken my uterus out as it was OK and he felt it would make my prolapse worse as your uterus supports the bowel.and bladder so he did a anterior repair and posterier repair..I never knew about my pelvic floor no one ever told me 36 years ago after my kids you Need to do pf exercisers .abs I use to struggle with constipation so that also put pressure on it..so in my opinion all woman should try to do pf exercisers..I use a kegal 8 and use it once a week now but at first u can use it everyday ..it strengthens ur pelvic floor they have been a godsend to me as I managed it for 10 years..if you Google kegal 8 you can read more about them...Good luck x

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