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Rectal Pain and Pressure

Febuary 21st I noticed I was getting sore in my rectum when I would sit some times. I had  some bright blood earlier that month on my tp, but I have had a small hemroid for many years, so I did not think anything of it.But as the month went on I kept getting sore more and more.I went to my GI, who by the way has been seing me over the last 5 years for Acid Indegestion and IBS Symptoms. I had a Colonoscopy 2 1/2 years ago for pain in abs, came back normal, with a palyop that was sent to pathology, and was also normal. My GI Said at this visit that my pain was hemroids, and gave me some Cortizone cream...2 weeks later, i went back because I was not getting better. He said not to worry that my colonoscpy was negative 2 years ago, and he gave me supposatories this time And we schedualed a Flex Sigmoid for in his office. I seem to be getting worse , and when I called his office he was out of town, so I went to a surgeon. He did a Anoscope, and said he saw a few small Hemroids but did not think they could cause my pain, and to come back in 3 weeks if does not get better. I went back to my GI and had the Flex Sig done, and he said everything looked good , and he saw a few small Hemroids. I told him my pain was intolerable, and that we need to find out why I cant sit, for it is painful, and continues throught the day...I asked if maybe I have Levator syndrome, and he kind of shook his head, and said that was the same as IBS. Well I also asked if maybe I had endometrioses on my rectum, he said not possible... I have seen my OBGYN in between these visits and he is going to do a Laparoscopy 4-18-06 to see if I have any endo on my rectum, he says that if I am having spasms, that something has to be causing them and it could be endo. He does not see that it can be anything else...
I am at my wits end please help me......These are my symptoms
Am feel ok.....kind of
After I have a couple of bowel movements I am sore in my rectum and feel some burning sometimes, not like hemroid burn. then as the day goes by, i feel like I have to have a bowel movement and push but nothing happens and its painfull. I feel pressure in my rectum , when I sit its real painful, so I cant sit. I have a ache in my rectum all day, and some times I feel like there is something in my rectum. The pain never goes away, just varies through out the day, when I got to bed at night it seems to not be as bad, then it starts all over again in am. I take a stool softner and eat alot of fiber and water, so I m not constipated

Please help.....
58 Responses
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233190 tn?1278549801
MEDICAL PROFESSIONAL
Difficult to say without evaluation.  A negative colonoscopy and flexible sigmoidoscopy would make significant GI disease less likely.  

An anal fissure can cause some of the discomfort you are describing - however the surgeon should have considered this.  

If the pain continues, you can consider empirically treating an anal fissure - normally starting with a nitroglycerin ointment over the anal sphincter.  

Another surgical opinion or going to a colorectal specialist can be considered if the symptoms continue.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
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Avatar universal
HI there, believe it or not, I am having something similar. Mine started with a flare up of hemorrhoids, which I have had for over 20 years. But, now they seem to be under control and I am still having the rectal pain. I am seeing a GI doc this week for something unrelated and plan on asking him about it. From what I have read, rectal pain is fairly common and usually benign in nature. I suspect levator ani syndrome too. I took a muscle relaxant the other nite for a back problem and miraculously the rectal pain stopped. Hmmm...?

Am wondering if you have been under unusual stress lately that could cause the spasms? I have been and that seems to be when my symptoms began. I also notice it is worse when I am "keyed up". Please post if you get a answer to this one and I will do the same.

Hudson
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Avatar universal
I went for my Laparoscopy yesturday, and the surgeon found endo on my rectum and around the lower part of my uterus. He said that this is probably the cause of my rectal pain and pressure. I think he said it could also cause the Levator muscle spasms. He also said I have Pelvic adhesions and my Uterus was very inflamed. Doctor Kevin what is your opinion on Endo on the rectum, do you think it can cause the pain and pressure... I will see my GYN next week to discuss what we will do to solve this problem.
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Just thought I would write back again after my doc app. I wrote earlier my OBGYN said I have ENDO on and around my rectum... He said this could be causing the spasms and pain...Has anyone heard of this...? I wrote back to Doc Kevin and have not heard a response...Please some one respond, I can't possibly be the only one who has pain when I sit in the rectum.....

PIB
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Avatar universal
Hey PIB, i think I am the only one here who has something similar and mine weirdly is slightly better this week. But, I totally understand the sensation you are talking about and find it annoying. To give you background on my pain, it started in February when I was diagnosed with an ovarian cyst. Gyne thought the cyst was sitting on the bowel and causing pressure. Well, the pressure from that was more "pelvic" in nature. But, the cyst caused constipation and the constipation caused hemorrhoids. I had surgery in March, and had the cyst removed. But, after surgery I was even more constipated and the hemorrhoids returned. I finally got that under control, but was left with the strange rectal pain.

If you find a definitive answer, please post it. I googled rectal pain, and I am sure we are not the only ones with it. There are lots of articles on it. The only reassuring thing, is most causes are benign, but the treatments are kind of "sketchy". As I said, I discovered by accident that muscle relaxants work for me. Also warm baths seem to help.

Have you found anything that eases your symptoms?

Hudson

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Avatar universal
PIB, if you are still out there, just wanted to let you know I saw my family doc today and her do another rectal exam after I described my pain to her. Apparently I have both external and internal hemorrhoids. She also did the test for occult blood in the stool, which was negative. She prescribed a prescription strength cream which I haven't picked up yet from the pharmacy as well as a muscle relaxant (flexeril). I'll let you know if I see any more improvement. Since you have not responded to any of my posts, if I don't see anything from you in the next day or so, I will assume you are no longer interested in this thread. Hope all is well.

Hudson
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Avatar universal
Hi Hudson,
I am sure happy for you that your doc found out what your problem was, I on the other hand have an app. with my OBGYN surgeon who did my Lap on Tuesday for next week on Monday....He says I have endo on my rectum and under my uterus and that it could be the problem of pain and spasms he thinks I am having. I am just so tired of having pain in my rectum, its put a stop on my life, I cant go anywhere because I cant sit , and I am not working right now either.... I am trying to keep a possitive mind and not let myself get depressed..I am tired of my doc thinking I am crazy....My gastrointerologist says all my test are neg, just some small hemroids and maybe some spasms, I went to a ssuregeon who did an anoscope, and he said he only saw small hemroids, nothing that could cause my bad pain in rectum...Finally my OBGYN said lets do the Laparoscopy and see if I have any endo, and that is what he found...I am taking Vicodin for pain, but I dont know why anyone just wont try and treat me for Levator Syrome, you know with some Muscle relaxers just to see if it works....I think when I go to my doc on minday, I am going to ask if we start narrowing this down by treatment, and then think of surgery for endo...You said you doc did a test for blood in your stool? did she do that in her office?  please let me know...Thanks for all your help, and I am still here just recovering from suregery....I will be watching for your response..

Thanks PIB
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Avatar universal
HI PIB, I don't really feel like I have an answer to my pain even though the doc reconfirmed the hemorrhoids. I still think mine feels like spasms in addition to the hemorrhoids. But, since it responded to the muscle relaxant when I took it the other nite, she was willing to give me a RX for more. I really think my ovarian cyst aggravated the muscle and now it is still tense or something?

Personally I think both yours and mine sound like levator syndrome. I think your idea of asking to try a muscle relaxant before having more surgery makes sense. It sure is much less invasive and the particular one the doc gave me (Flexeril) is supposedly not habit forming. It does make me tired, so I took only 1/2 tablet at nite. But, believe it or not, it relieved me of my pain for almost the entire day.

I can relate to the not being able to sit for long because that is when this pain really gets going isn't it? I am much better standing or walking.

At any rate, I'll be thinking of you. Please let me know how things are going for you and if I find this RX cream to work, I'll post again. I'd tell you the name of it, but I haven't picked it up from the pharmacy yet. They are out of it and have to order it. I may not have it until Monday. Do you believe it? lol.

Hudson
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Avatar universal
p.s. about the occult blood in the stool. Yes, she did this test in the office. It's just a stool sample mixed with a solution to see if it changes color. No color change= no blood.
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Thanks for responding,
I dont think my doc has the correct diagnosis for me also, I think it a combination of things that end up causing these spasms and pain. I am anxious to try the Flexiril, I have heard that it works for the muscles that are tight. I read it on a Levator Syndrome web site for Treatment....I will let you know what happens after my doc app. on Monday....Take care..Oh and if you get that cream, let me know what it is...

Have a great week end.....

PIB
Helpful - 1
Avatar universal
Hi PIB, i just went back to the pharmacy to inquire about the cream. They are going to try and reach my doc and get a substitute for it tomorrow. It seems they prescribed something not common? Anyway, I can't believe you read about Flexeril on a website for levator syndrome. I tried it completely by accident as it was initally prescribed for back spasms.

Keep in touch and let me know how it goes on Monday. Maybe we can get to the bottom of this and help each other. Glad I found you. If you ever want to e-mail me, my address is ***@**** :-)

Hudson
Helpful - 1
Avatar universal
Hi PIB, you out there? How did the doctor go today?

Hudson
Helpful - 0
Avatar universal
Hi,
Well I went today to my OBGYN, he showed my husband and I the pictures of my Laparascopy he did last week. Showed Endo on and around my Uterus and Rectum, and also he said I have a Fibrus Tumor on my one overie. I was really concerned if we were dealing with Endo or something else. He assured me that my Bowels are are clear and that the Endo can cause the spasms and pain I am having in my rectum.

I chose to go the route of BC pills, and also ha gave me a scip for Flexeril and pain meds. He wants me to take the BC pill for a month or so along with the other meds and he said hopefully I should start feeliong better in a few weeks. He said the birth control pills surpress the estrogen and cause me to be like I am pregnant therefor the endo will be surpressed and I will be relieved of the rectal and pelvic pain...I hope...

He said there is no cure , and that last resort would be to have a Hysterectomy...I m not there yet..

I took the Flexeril when I got home, and it seemed to subside some of the pain but not all, he did thing the endo is causing the rectal spasms, but I do have some small hemriods that are flaring up right now, so you can imagine all the weird pain I have at one time. He said they are two different things goimg on with me . The endo and the Hemroids, they are not the same problem...

Well just wish me luck the BC pills work...I think the Flexeril will take some time to work...

How are you doing?  I am tired and going to  crash for the night. I will get back at you..

See ya  PIB
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Avatar universal
Hi PIB, well that's good you got some answers. The ovarian cyst can cause rectal pressure as well. I know this because this is how mine got started in January.

I am doing ok. Still treating the hemmorroids and taking the flexeril for the spasm feeling. It's weird as some days it is bad and others not so bad.

The cream the doc RX was called anamantle HC kit. I only used one dose of it and it made me much worse. I think I may have reacted to one of the ingredients. It is for the hemmorrhoids and I do better with PPH it think.

What did the doc tell you to do about the ovarian thing? Take the BC pills and hope it resolves?

Hudson
Helpful - 0
Avatar universal
Hi everyone,

I just got through reading the posts and I think I may have a similar situation. For the past 6 months my periods have been clotty. I have also noticed an increase in sweating and hot sensations ( I guess hot flash) I have lately discover a bruiseon my inner thighs ( both thighs)  It is very close to the rectum and then down some on the thighs. Could this be endo too? I have been so worked up about it and worried. My muscles are tight too at times. I am scheduled to see a doctor Friday. I have a buzzing sensation in my uterus from time to time too. Let me know what you think.
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Avatar universal
Hi there, Do you mind me asking how old you are? Are you going thru peri-menopause? I am 50 and also having the hot flashes.

Let us know what you learn from the doc.

Hudson
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Avatar universal
Actually I am 31 and have had these for about a year or so. I try to bear with it the best I can, but it is hard to. My mind always goes to worst case scenerio anyway! LOL
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Avatar universal
Hi there, at 31 you are awfully young to be having hot flashes. It's good you have a doc appointment. Let us know what he has to say and try not to worry.

Hudson
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Thanks!
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Avatar universal
Hi every One,

First of I am sorry to heard and read all of your said stories, unfortunately I am also going through same for last 3 month and still not able to find what is the root cause of my problem.

I am 28 y.o. mother of two, first baby was born normally in December 2000 and the second December 2005 normally. I had never taken birth control pills. After that till one month or so I had a normal bleeding and regular check-up for my stitches I got at the bottom of Virginia. I was feeling pain in one of my stitch, which is very close to my anal. I visited to GNY for the same they told me it will go and just ask me to sit in warm water. But is always remain there and now I got into big trouble.

After 40 or 50 days of delivery I had an intercourse with my husband in night the very next day I got pain started in my rectal, I was suspecting it is piles in start I started taking piles tablets, every one told me it is very common after pregnancy piles, haemorrhoids and fisher. Gradually my pain become so severe that I went to surgeon, on anoscope he told me I am having 3 very small haemorrhoids which is very common after delivery no need to worry and the fisher was heal up with suppository. Now fisher is gone, but I am having sever rectal pain, pressure and feel some thing heavy in that area, I cannot sit properly, I feel comfortable to sit on a hard object under me that
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Avatar universal
Hi there, I am so sorry you are having problems. I am still trying to get my rectal pain under control. It sounds like yours is similar to mine. I went for an exam and the doctor told me i had some internal and external hemorrhoids. But, the pain I am having in the rectum seems more severe. It really hurts, like a spasm and that is why I think it is levator syndrome. My doctor gave me a muscle relaxant, Flexeril, which i take at night and it makes it go away. But, the next day symptoms return. I am now trying a new cream called anamantle HC. It is an anestetic mixed with hydrocortisone. You could ask your doc for a RX and try it.If my symptoms don't get better I am going back to see my gastroenterologist about this. Please post again and let me know how you are.

Linda J
Helpful - 1
Avatar universal
I've just finished reading thru this entire thread and I have tears rolling down my face because I know this pain. My life has been a living hell since March 2005. My doctor sent me for a colonoscopy in that month, and ever since then, I've been living with this mysterious and agonizing rectal pain.

At first I thought it might be the small internal hemmorhoids that they had found. But thru research and doctor's visits it is said they shouldn't cause the kind of pain I'm having.
I won't go on and on with my story, but I have felt so much frustration with my doctor because it seems he doesn't take me seriously.. doesn't believe how much pain I am in. Especially during my periods. He did throw some birth control pills at me, ones that stop your periods for a matter of a few months. Thinking it might be endometriosis. It has helped some. Now instead of screaming in agony, sitting on a heating pad for weeks on end with no sleep what so ever, I am only whimpering for 7 to ten days. But I just went back to my doctor today, and now after describing my darn symptoms for the upteenth time, he doesn't think it's endo. He wants to send me to some rectal specialist. (I could just scream. I'm so sick of the hemming and hawing, and nothing getting diagnosed.)

I dread having a bowel movement because of the lingering pain afterwards. But not going is even worse, so catch 22.  It seems my life revolves around the toilet, and wether or not I have had a bowel movement or not.
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Avatar universal
Hi, I am new here and coming from another thread here.

This past month I started having dull lower back pain.  Later, I started having sharp pain in my left ovary and the back pain moved into my side and across part of my front.

I just has an ultrasound and urine sample done.  The urine sample cambe back saying I has "signigicant blood" in my urine even tho I couln't see any.  Ultrasound is clear.

Gyn has to set up a colonoscopy and MRI yet.

He gave me anitbiotics which has helped the ovary painn, but not the dull back pain which is getting worse and spreading to the other side.

My BM have chnged drastically. I used to only go once a day--now I go 4 to five with much smaller, slimmer stools.  But event hough I go, I still always feel like I still hve to go.

Any ideas?  From comments my doc made, I think he is leaning toward germ cell cancer.
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Avatar universal
Hi, I am new here and coming from another thread here.

This past month I started having dull lower back pain.  Later, I started having sharp pain in my left ovary and the back pain moved into my side and across part of my front.

I just has an ultrasound and urine sample done.  The urine sample cambe back saying I has "signigicant blood" in my urine even tho I couln't see any.  Ultrasound is clear.

Gyn has to set up a colonoscopy and MRI yet.

He gave me anitbiotics which has helped the ovary painn, but not the dull back pain which is getting worse and spreading to the other side.

My BM have chnged drastically. I used to only go once a day--now I go 4 to five with much smaller, slimmer stools.  But event hough I go, I still always feel like I still hve to go.

Any ideas?  From comments my doc made, I think he is leaning toward germ cell cancer.
Helpful - 0

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