His and Her Health

HELP!!! I AM A 45 YEAR OLD FEMALE THAT WORKS IN A BUSY ER AS A NURSE.JUST OVER 2 YEARS AGO I STARTED TO DEVELOP RECTAL PAIN AND PRESSURE.I INITIALLY THOUGHT THAT IT WAS MY IUD AND THAT IT HAD DISLODGED.TOOK THAT OUT,HAD A PARTIAL HYS AND THEN A RECTOCELE REPAIR.NUMEROUS TESTS,STUDIES AND EVEN TRIED RECTAL STIM.NO CHANGE.I CAN'T TELL YOU HOW THIS HAS AFFECTED MY LIFE.I CAN'T GO FOR WALKS,CAN HARDLY GET THROUGH MY 24 HOURS AT WORK WHICH I LOVE AND I AM DEPRESSED AS I CAN SEE NO END.I FEEL SOOOOO ALONE.I AM NOW SCHEDULED TO HAVE SURGERY AT THE BEGINNING OF NOV. TO TRY INTERSTIM.I AM PRAYING THAT IT WORKS.IS ANYONE ELSE OUT THERE GOING THROUGH THIS.I DO NOT HAVE CYSTTITIS,INCONTINENCE;IT'S CHRONIC RECTAL PRESSURE AND PAIN.THE ONLY TIME I GET RELIEF IS WHEN I AM SITTING OR LYING IN BED.I JUST WANT THIS TO END!!!!!!!! THANKS CHRIS

Chris,
interesting that there isn't pain with sitting. this is possibly levator ani syndrome. is there any back pain or sacral pain too? why r u considering interstim? do u have urinary frequency/urgency? bladder pain? I highly recommend being assesses for Pelvic muscle dysfunction by an appropriate physical therapist. there are many in boston area. i would try this be4 surgery. also there are medicines out there that can help along with PT. of course PT is only appropriate if there is a muscle or nerve issue,yours sounds like muscle.
niva

<small>[ 02-22-2009, 12:39 PM: Message edited by: Moderator ]</small>

HI NIVA,
THE FUNNY THING IS IS THAT I HAVE A REALLY BAD BACK.I WAS OUT OF WORK LAST YEAR FOR 6 MONTHS AND I HAVE BEEN HOSPITALIZED BECAUSE I HAVE SO MUCH PAIN AND SPASM THAT I CAN'T WALK.AT PRESENT I CAN'T SAY THAT I HAVE ANY BACK PAIN BUT I DO THINK THAT THE PROBLEM I HAVE IS IN SOME WAY RELATED.I HAVE TRIED PT BUT IT DIDN'T HELP NOR DID THE RECTAL STIM.THE REASON I AM DOING THE INTERSTIM IS BECAUSE I AM AT MY WITS END AND JUST WANT THE PAIN AND PRESSURE TO GO AWAY.I WENT TO SEE A DOCTOR IN BOSTON AND HE WAS THE ONE WHO RECOMMENDED ALL OF THIS.HE SAYS THAT THEY ARE USING INTERSTIM FOR PELVIC PAIN AND PRESSURE WITH GOOD EFFECT.WHEN I DID SEE THE PT SHE SAID THAT MY RECTAL MUSCLES WERE IN SPASM.DO ALOT OF PEOPLE SUFFER FROM THIS?I WISH THAT THERE WAS A SUPPORT GROUP THAT I COULD GO TO BUT THIS SITE IS HEPFUL TO! THANKS FOR ANY ADVICE I REALLY DO APPRECIATE IT AND I WILL GO JUST ABOUT ANYWHERE FOR TREATMENT.ARE THERE ANY OTHER MEDS THAT WOULD HELP?I AM PRESENTLY ON ELAVIL,DURAGESIC.CELEXA AND CYMBALTA BECAUSE I ALSO SUFFER FROM FACIAL AND LEG PAIN BUT THANK GOD THEY ARE ALL CONTROLLED ON MY MEDS.I ALWAYS SEEM TO GET THESE STRANGE PAIN SYNDROMES!!!! I WISH IT WAS JUST GOUT OR SOMETHING THAT WAS MORE CLEAR CUT AND TREATABLE.LOOK FORWARD TO HEARING FROM YOU OR ANYONE ELSE THAT IS GOING THROUGH THIS. CHRIS

<small>[ 09-26-2008, 08:38 AM: Message edited by: Moderator ]</small>

WADULDI1/chris
Did the PT work intra-rectally? did they also work on your back simultaneously? i don't often find stim helpful. i would also recommend warm baths. there are meds in fact some can be used intravaginaly or rectally, but as a PT i cannot recommend meds-sorry.

if you want PT recommendations in boston just email me personally. i know some b/c i lived and treated there for 1 1/2 yrs
niva

This breaks my heart to hear as I have been going through the same thing for about 4 months. I would not wish this nightmare on anyone. I have been in and out of obgyns, pain specialists, gastrointestinal specialists, several gp's and noone can tell me what is wrong. I have been put on birth control which seemed to help the first month and after that the pain and discomfort came back.

Mine started suddenly while we were on vacation. I felt a little different in the rectal area but didn't know what it was. When I laid down that night all of the sudden I felt like I was in labor. I had pressure sensations in my bum and bladder. The only thing that felt better was to sit on the toilet. I went to the er the next day because I felt like I had a bladder infection(squeezing and frequency). No bladder infection. They did a ct scan which showed some fluid in my abdomen and an ultrasound which showed a small cyst. I was exactly mid cycle so they said I might have a leaking cyst and the fluid was causing the pressure.
Since then I have had a second ultrasound which showed the cyst was gone so why am I still having all of this pressure and pain?

My pain ranges from rectal pressure to feeling like I have something stuffed up there to pressure in the tailbone region that radiates out towards my hips and through my rectum. I also get vaginal pain and achiness and sometimes my bladder starts to squeeze or burn which sends sensations(not pleasant ones down to my clitoral region).

I am feeling extremely hopeless and cry everyday. When friends and family ask me how I am feeling I tear up every time. I can't even talk about it without getting upset.

I was feeling better when I stood up and walked around versus sitting but now I am not so sure. No when I stand I feel like something is going to drop out. After laying down for awhile I begin to feel better although when I first lay down I get this pressure. My pain also comes and goes throughout the day. I will be fine for about 15 minutes and then get the sensations/pressure/pain for awhile and then it will go away for a bit and then come back.

Does this sound familiar to you? Does yours come and go throughout the day? Does yours affect other areas down there?

Have you been checked for any prolapses, cysts, or endo? I have found that all of these can cause rectal pressure. Levator ani syndrome. Pudendal nerve entrapment. I asked my pain specialist about the last one because I have a lot of the symptoms that go along with that but he said I PROBABLY didn't have it although he could'nt be 100% sure.

I hope you find what is wrong...let me know if you have any other symptoms or if your rectal pressure sounds like mine.

Take care...I am desperate too.

I have these symptoms as well and finally found help from the third PT that I saw. My first two PT's said they were women's health specialists, but when I finally got proper treatment, what they were doing wasn't helpful.

The rectal pain is my least favorite symptoms. Feels like a golf ball in there to me.

I've tried the InterStim, but I have urinary issues, most predominately retention. It was not successful. And when I had mine, pain relief was considered a possible side effect. It's designed for urinary issues. The scar from the test implant has caused me a fair amount of additional pain. It could work for you, but you really might consider getting a second or third opinion.

You can feel better from this dreadful condition, but it takes a team effort and putting that team together can be long and hard.

What I did was travel to see a PT that is considered a top expert. My PT from home was willing to along and now I'm getting better.

Are you using any meds? there are some really helpful ones. I can't imagine working an ER shift with this type of pain.

Hope this helps.

tacy

I have simalar issues and have gone to univ of SF and Stanford in CA as well as several other docs in town. They all told me my issue was pelvic floor dysfuntion and i am working on my own solutions since they seem to have none. Biofeedback was a joke for me... they just say... relax... but how can you relax muscles that are subconciously tight. They gave me a compound ointment that you can only get at a compound pharmacy. You place it rectally 3 times a day. It is called.. NIFEDIPINE, it relaxes the rectum. It helped TONS. I am not fully cured but things are much more manageable. less pain...
It is possible you have a fissure way up there like i did as well. this medicine they gave me helped to heal that since the fissure was causing spasm as well. Now i am trying acupuncture since western medicine didn't have much else to offer.

lucky1111girl,
pelvic floor dysfunction, in my opinion, needs to be treated by MORE than biofeedback. You need some manual therapy from a physical therapist who specializes in this area with tools such as trigger point release, myofascial release, etc...
niva

<small>[ 10-05-2008, 02:09 PM: Message edited by: Moderator ]</small>

I second Niva's comment. Pt is the best treatment modaility for PFD. It can be augmented with warm baths, muscle relaxants, biofeedback, e-stim, and Botox injections but these are not the primary treatment modality.

<small>[ 10-05-2008, 05:09 PM: Message edited by: Moderator ]</small>

it's nice to hear that i am not the only one out there going through this. not that i would wish this on anyone!!!!!!! i went to see dr.kohli today as i am going to try the interstim sooooo pray for me that it works. he said that i have a 70% chance of relief. i figure that i have gone through a partial hys and a rectocele repair with no relief what the hell i have to give it a try!! this has ruined my quality of life and is so debilitating for me. everyone talks about meds that help or other modalities of treatment.....could anyone out there be more specific!!! i am a nurse and it would be very helpful for me to know what they are????? i'm sorry that i haven't responded to anyones post but i was in florida for a while and was away from computer access. thanks christian

WADUDLI1:
First of all, I used to work in Boston with a few urogynecologists, so if you want a 2nd opinion form a great MD email my private email and I will get it for you. Also in terms of medications, and please be aware I am NOT recommending anything, but just telling you the types of meds my patients are on when they come to see me or prescribed sometime during treatment by the MD! ie. Valium, Lyrica, Neurontin, Cybalta, Elavil are the most common- people are also having trigger point injections to the pelvic muscles as well as Botox and some nerve blocks.
niva

HI NIVA,
I JUST CHECKED OUT YOUR SITE!! I WISH THAT YOU WERE IN RHODE ISLAND OR EVEN THE AREA.I AM ON CYMBALTA AND ELAVIL FOR DEPRESSION; THE ELAVIL WORKS GREAT FOR MY LEG PAIN AND I AM ALSO ON DURAGESIC 25MCG WHICH TREATS MY FACIAL PAIN.....NONE OF THEM TOUCH MY RECTAL DISCOMFORT.I WASN'T SURE HOW TO E-MAIL YOU PRIVATELY AS I WOULD LOVE TO KNOW THE NAMES OF SOME GOOD PT'S AND UOROGYNO MD.LET ME KNOW. THANX CHRISTIAN

Christian/WADUDLI1
You can either click on my name and it has info there or go back to my website and there is a general email address that comes to me:)

I have also worked with patients that get medicines which are compounded and can be used rectally or vaginally (ie valium)

Niva,

Up above, you asked if Wadudli1 if she had pain in the sacrum or bladder frequency/urgency. I have both of those things off and on with the rectal pain and pressure. The bladder pressure/squeezing frequency doesn't happen as often anymore but I have the rectal stuff daily. The sacrum/coccyx pain I have more often now and came on about a month and a half after the rectal/vaginal/bladder stuff.

Just wondering why you asked her that as I still have no idea (neither do the 7 some odd doctors I have seen) what is wrong with me.

Thanks for any help or advice you can give.