Rectal Pressure and Pain

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Dear Doctor,
I posted a question last month to you about my rectal pain, I gave all the info on doc visits and tests that were preformed. My nick name was PIB....Since your response to my concerns, I have had a Laparascopy done by my OBGYN, the results showed Endometriosis on my uterus, he also said there was endo on my rectum, and down between my uterus and rectum I think in the culdesac area. He also stated that my uterus was very inflamed, and had some adhesions. He said he removed the adhesions from my uterus, but he does not like to go near the rectum.
I asked him if this could be the cause of my rectal pain, pressure and burning, and he replied I think it could be the cause.
Again let me remind you, I have seen my Gastrointerologyst, and have had a Flex Sigmiodoscopy, which he said was normal, and he only saw a couple of small internal hemroids. I also have been to a surgeon who preformed an analscope and he said he could not see anything but some small hemroids, but these could not be causing my rectal pain and pressure when I sit. So I went back to my OBGYN and he had me have a CT scan with barium of my pelvic, results were no abnormalaties. I have had blood work done, nothing abnormal.
My OBGYN said that he thinks the symptoms i have(Rectal pain, Pressure, burning in anus area, also can not sit anymore for only a breaf moment then the pain gets horrible) is from the endo causing rectal spasms which causes the pain.
He has started me on Birthcontol pills Yasmin, and also gave me some Fexeril, and Vicodin. The flex seems to help a little, but the Vicodin I only use twice a day, becauseI don't want to get hooked on it. My pain is still around just minimal with pain meds. I have taken the Yasmin for three days now, and so not see a difference.

Can you tell me if you think endo on my rectum can cause all these symptoms or is this something else and nobody is seeing it. Like Levator Sydrome,or Pudental Nerve problem or some other kind of rectal desease....

I am in pain all the time, when I get up in am I feel ok, and then after bowel movement, or sit for awhile the pain comes, and does not stop unless I take a pain pill or take a hot bath.

I dont have any fissures, I know you stated that in your response letter that it could be, but not so.

Please help me, I am really loosing my patients with this pain, and trying to keep a positive mind. Do you think I have seen all the doc I need to see or did I miss something.

Thank you,

Note

[teresa303]

A related discussion, How long should I wait? was started.

[rainbow16]

A related discussion, Rectal pressure was started.

[Thuney]

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.

[Kalio1]

rectal bleeding can be a sign of serious conditions you should be seen to right away. Tell your parents right away ven if it is embarrasing. Get to your doctor and have it checked out as soon as possible.

[soccer_star_14]

I'm not really sure how to start this so I'll give you some background first.  I'm 17 years old and a serious athlete.  The only problem is that most of the time after games, and lately it's been during the day, I am plagued with stomach cramps and rectal bleeding.  The pains have gotten so bad that I have to stay home from school.

Is this something I should be worried about?  Or should I stick to taking Pepto Bismol?

[Kevin Pho, MD]

It is difficult to say what the cause is without examination.  

Endometriosis is certainly possible.  I am not a GYN, so my insight into this is limited.  In addition to oral contraceptives, medications like progesterone and danazol has also been used to treat endometriosis with varying success.  About 70 to 80 percent of patients find relief with medical therapy.  Surgical options can be considered for refractory cases.

Biofeedback testing can be considered if levator ani is suspected.  Medications directed at relaxing the pelvic floor muscles are normally indicated if this is present.  

These options can be discussed with your personal physician.

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_