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Severe Pounding Headache During Bowel Movement

I have had a problem for some time now and am now very worried.

Background:
I have had this on and off for quite some time, over a year.

I'm a 33 man and at the time it started I was 194 pounds and had cholesterol of 216. I admit I was out of shape. One thing to note is my tolerance for pain is very high.

I was tested for everything, CAT scans, bowel X-rays, scoped from one end to the other. Tried fiber, lots of fiber, Nothing. I gave up on answers about the time the symptoms subsided.

Since then, I shaped up. I am now 165 pounds, cholesterol of 136 and can run 4 miles a day. At no time during the workouts or other strenuous activity do I experience this issue or other issue.

Symptoms actually went away for quite a while, several months in fact, but are now back as of this last week and worse. I now can tell when I need to have a BM because it starts very mildly.

During the BM, without straining at all, it starts. It will start on the back of my neck as a small soreness or stiffness and very quickly I will feel my heartbeat in my neck. Within seconds the pounding in my head starts on the left side and goes up to the top and down the bottom. With each heartbeat there is excruciating searing pounding pain. A pain that feel like someone hooked a bicycle pump to the left side of my neck and is pushing pressure very hard into my head. Each heartbeat is torture and afterward it slowly subsides over a few hours until only a stiff sore neck remains. However this last time the dull headache lasted into the next day.

The pain is so severe I have blacked out once however I fight not to. I am not straining, pushing, or doing anything. Most of the time I am trying to relax. This happens with hard or soft movements and diarrhea. I would consider this pain to be a 8-9 out of 10. (A motorcycle accident with broken bones was a 6 to me for comparison sake)

I have tried to identify changes or habits that may have changed or repeated and so far cannot find something. I am truly worried that I will have a stroke or brain aneurysm during a bowel movement to the extent that I call my wife on the phone.

Can someone help? No doctors around here are able to.
49 Responses
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Avatar universal
MT I have been going through sort of the same thing with my wife.Sunday night one week ago tonight it started with her.She took a soap suds enema I made it up here at home.I did use some liquid dish detergent,Which I found later is a very very big NO NO. I don't know why it just said never use liquid dish soap.Anyway My wife did the enema and while sitting on the toilet after she had evacuated the enema she got what she said was the worst headache she ever had.We fought with it for about an hour and it eased off, So next night she needed some relief from her constipation so she used a fleets enema and got the same results accept it was 100 times worse I even had to call the paramedics to come and take her to the local ER, But after cat scans and blood work nothing showed up.So we got inn touch with her regular doctor he said the enemas may have effected her spinal fluid so we done the fluids thing for a whole week she seemed to be getting better so I started her on stool softeners and the next BM it was the same thing.So now we are going for an MRI and an MRA to look for vessel problems I certainly hope we find what is wrong and it can be fixxed because it is terrible to sit here and watch the person that I love the most in the world suffer so badly and can't do a damn thing for her.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,
How are you?  Have you tried taking preventive medicines before taking a bowel movement? This is usually done in exertional vascular  type of headache. However, as mentioned by newbidder, additional tests such as MRI and MRA will rule out any vessel problems. Talk to your doctor about this. Take care and do keep us posted.
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Avatar universal
MEDICAL PROFESSIONAL
How is your wife? I'm sorry to hear what you've been through for the past few days.  Uncommon exertional headaches associated with bowel movement do require a careful work-up to exclude potentially serious underlying problems.
In its classification system, the International Headache Society (IHS) includes exertional headaches in the group of headaches unassociated with a structural lesion. Do keep us posted with the MRI and MRA results. Best regards.
Helpful - 0
Avatar universal
Thank you for asking, I am doing better. My doctor put me on medication to lower my blood pressure. Although my blood pressure wasn't high at all, very normal, he thought that the inter abdominal pressure was causing the headaches and lowering my blood pressure may help.
For now the headaches are gone which addresses one of the issues I was having. I still feel as though there is something physically wrong with my bowels or something in there. I can go for a week without a BM and gain 10 pounds during that time. I feel pressure and backed up to the point where I cannot even eat anymore.
Fiber, probiotics, and stool softeners do not help. I just can't go and don't usually even have the urge to. Then suddenly without warning it will happen, and very fast, diarrhea. What is odd is it will happen after I do something like jump up and down for 30 seconds with the nephews or bend over to pick something up. Running on the treadmill sometimes does it but not usually.
I almost feel as if there is a pocket or something inside me that collects waste and doesn't let it out until I shift to the right position and cause it to empty. I have told all this to my doctor and both (I have a new one) think I am crazy. Yet no one can explain why I will gain 10 pounds and get a large stomach and then empty out all of a sudden.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,
Can you elaborate on these bowel movements? Do you have diarrhea every time you move your bowels?  I was focusing on the headaches and did not realize that there is also a possible gastrointestinal issue. The nerves that control the anal sphincters or the nerves that sense stool in the rectum may have a problem.  Another differential would be pelvic floor dysfunction or abnormalities of the pelvic floor muscles and nerves can lead to impaired ability to sense stool in the rectum. Either way, it is best that you have this evaluated further for proper management. Talk to your doctor about this. A referral to a gastroenterologist may also help.
Helpful - 0
Avatar universal
Typically my bowel movements are either one of two types.

1. Severe diarrhea where there is absolutely no solid matter. Typically this happens after a period of a week or more of no movements and happens very, very suddenly. Typically the only warning sign is an extreme stomach noise, rumble, gurgle seconds before.

2. Very soft ribbon like flat stool that is very difficult to pass. These can be in excess of 18" long and are 1/2" wide and flat.

I have had a colonoscopy, CAT scan (3), and nothing was found. I actually have another doctors appointment today with a new doctor to discuss this. Although the sharp painful headaches during bowel movements are gone I have had a lingering headache similar to the sharp ones only very dull for three weeks now.
Helpful - 0
620923 tn?1452915648
Hi...not to give u one more thing to look at, but, strain headaches are typical with chiari malformation and so r the bowel issues u describe.

A Brain MRI and a cervical spine MRI can help rule this out, but it is a possibility as well...

There r sooooooo many conditions that have overlapping symptoms it can get frustrating and take a while to get a dx....if ur PCP is a good one he will keep looking until u have an answer.

U may want to try Miralax after discussing it with ur dr to see if that may help u go on a reg basis and eliminate the strain.

Best of luck
"selma"
Helpful - 0
1140344 tn?1266547759
I only get these when I strain, but my sister says she gets them no matter what, especially if she has a... well, "big one." her doc put her on stool softener (no help) and eventually went with topamax which worked after a while, but we're not sure why that even helped. I hope you get some relief!
Helpful - 0
Avatar universal
I have tried the Miralax, Ex-Lax, U-Name-It-Lax with no results as well as stool softeners.

He put me on a new med starting yesterday, dicyclomine I think and we shall see how that helps.

The other night I was up over 15 times for bowel movements and each was only about 2oz of liquid, no solids, and I still felt as if I had to go even the next day. I lost almost six pounds that night.

He also wants me to use Milk of Magnesia every other day so it doesn't go any longer than that.

I still have the dull headache with stiff neck that has no been here for the better part of a month. Getting to the point that it takes four to six Ibuprofen every four hours to keep it away.

I'm very bothered by doctors after all this. One PCP and now a new one, two gastro specialists, and not one seems to care all to much about anything but me paying the bills. None of them will acknowledge that I usually gain five to ten pounds in a week from this and always feel like I am full in my gut.
Helpful - 0
620923 tn?1452915648
Hi...I would suggest a MRI of the brain w/wo contrast....the symptoms u mention could be a sign u have a condition that requires attention.

A neurologist generally will do the testing and find a dx....once u have a dx they in turn will send u to the dr that is best to treat possibly a neurosurgeon.

I understand ur frustration with the medical community...we all tend to get that runaround and it can take it's toll....but it  is ur health...so keep pushing until u get that dr that does know and understand : )

Godspeed
"selma"
Helpful - 0
Avatar universal
All of the problems you are describing I have too. I think the doctors think I am a hypochondriac. My doctors have diagnosed me with fibromyalgia, which I don't feel any better, just more tummy issues from the meds causing more constipation. Augh!! I also gain a lot of weight to the point of looking pregnant, then I will get abdominal cramping or back cramping. I soooo feel for you.

Amy
Helpful - 0
620923 tn?1452915648
HI Amy....u may want to look into chiari malformation for the head pains while straining.Many have been mis dx'd with fibro and drs keep saying or making us feel it is all in our heads...and they r RIGHT!!

SO at least rule it out....

Good luck
"selma"
Helpful - 0
Avatar universal
Yes, I also have the weight gain and expansion of the abdomen. Looks like I am pregnant as well and I am a guy!

Good news, the headaches are gone and have been for a couple months but the other issues are still there.

Since last messages I have discovered that my body doesn't react the same to any type of laxative. I was put on a prescription laxative, forget the name, and same effect.

What happens is I will take them and get no result. Take another dose and still nothing. After multiple doses I will start to feel "bubbling and gurgling" in my stomach and the urge to go but no result. During this time I will start to experience horrible gas.

After two or three days of multiple doses each day I will start to have small movements of only liquid and only about 1 - 2 oz at a time about two hours apart. After just a few of those nothing further will happen.

I stop the laxative and will have no movement for a few days and then after a buildup in my stomach that makes me look huge I will get extreme cramping just below my belly button and have a large bowel movement of diarrhea.

I feel as if there really is a blockage but no doctor will even listen.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,
How are you? I'm glad that the headaches are now gone. Were you able to check with a gastroenterologist?   Abdominal distention may be from irritable bowel syndrome, lactose intolerance, or even partial bowel obstruction. Diagnostic tests such as abdominal CT scan, colonoscopy, stool analysis and x-rays of the abdomen may help. You can always have a second opinion if your present doctor  does not listen. Take care always.
Helpful - 0
Avatar universal
Hello, I am better but not 100%.

I did see a gastroenterologist and he said he didn't see a need to redo any of those tests that were done in 2004. (CT scan, small bowel X-Ray, colonoscopy).

I have tried explaining that there has been the weight gain, like a softball or larger object slamming around in me when I try to exercise that is very uncomfortable. I also have it where I will suddenly get a 'flushing' feeling that literally feels like a large bottle of liquid has been flipped upside down inside me on my left side and when this happens I have about 1 minute to get to the bathroom before massive diarrhea. This event is not as frequent but is preceded by some physical event like jumping up and down, leaning over and putting pressure on my abdomen or something similar.

With the infrequency of my bowel movements, the massive weight and size gain of my abdomen, the very sudden flushing that happens after some event, and finally that no laxatives work for me even in quantities that are as much as ten times the normal does makes me feel as if there is a physical issue but no doctor will listen.

I have tried a second doctor but because of my insurance I need a referral and my doctor only works with one gastro office. To be honest I don't know if I want to go through the trouble of trying yet another doctor. At this point I just eat much less, drink lots of water, and minimize how much I put in.

Also, I don't have lactose intolerance and I have drank milk and had no issues and have been tested with a negative result.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,
It is good to know that you are feeling better . Make sure that you also watch your laxative intake, especially if not prescribed, because this may do more harm than good. Eating less may also cause nutritional deficiencies, that is why supplements or nutritional advise from an expert may be indicated.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,
How are you? If your medications are causing you more constipation, inform your doctor about this for proper management. were you able to check with your gynecologist? This is just to rule out other gynecologic issues such s ovarian growths that cause abnormal abdomen distention. Best regards.
Helpful - 0
Avatar universal
I have also been having this issue as of late. However, I am not a normal case. I do have Chiari Malformation(I had decompression 11-09) and the Chiari is fixed. I NEVER had this as atom before surgery. I had an MRI yesterday, Dr. said everything is fine. I also have a shunt in my had, but the MRI showed my ventricles are fine(pressure is not too low or high) so that was eliminated. I had a discectomy last week on my L4 area, but the Dr. said he doesn't see how that would affect anything. The first time this happened was the first BM after my surgery, and now happenes every time. Not sure what to do from here. Guess I'm just going to be working wil all my Dr's to see what they find.

One thing that might help you that helped me though..the other night I did some "experementing" if you will while having a BM. I hunched forward some and tucked my head all the way down so my chin was pressed into my neck. This helped somewhat. The headache only lasted about 20 minutes after, as opposed to 1-2 hours!

When this happens to me the pain starts in the back of my head(base of skull where Chiari incision is) then soon my entire head is throbbing, I break into a cold sweat and become very nauseated.The pain is a 10.

Has anyone gotten any answeres as to what this is?!?!?!
Helpful - 0
Avatar universal
What did you find out? You have the exact symptoms that i have been having. Severe pain, left side of neck going up over and back down . Very severe. feel like I will black out and now it leaves me with a mild throbbing in my head on the back left side of my head. My bowel movements are not strained, and the pain radiates up and gets so severe. i feel like I will black out also. I do suffer from what they call IBS also.

Hope things are better for u.
Helpful - 0
Avatar universal
The first time I experieced this horrible throbbing painful headache all over my head, I thought my brain would explode inside my skull.  There was not a spot that did not hurt.  I began massaging my head while still on the "throne" the pain started in my sides and throughout the entire top of my head, to the back of my neck.  I really thought I was going to have a strone while taking a movement.  I went and took 3 tylenols, and placed ice pack all over my head and told my husband that if I don't get better in 15 min. we have to call and ambulance.  That is how bad it was.  After 15 min. I felt some relief.  The headache lasted 6 hrs. plus my eyes were thobing too.  I have no health issues other than allergies and asthma.  I started taking ZYRTEC recently, and wonder if this could be the cause.  Yesterday I purposly did not take it and today, even though I was afraid to go to the bethroom, I went had a movement without any painful headache.  But I did take 2 tylenols when I woke up, just in case.  I would appreciate your opinions on this.  Because it really is horrible, you get fear of the toilete, and its no joke.
Helpful - 0
2 Comments
I'm shaking right now because of how terrifyingly exact my symptoms are to yours and most others on here.
I have another question are you on opiates? I heard prolonged usage can cause some sort of damage maybe even that malformation they're talking about. I've been on opiates for a long time.  

I'm 29 female first time it happened almost 2 years ago I was 150lbs and these last 2 nights that weren't as bad as the first I'm like 160lbs. I suffered from migraines when I was little it was written off as allergies causing me headaches. The first time @ the hospital they kept treating me like I was in opiate withdrawal. Despite me explaining I take methadone something with a half life of 30 hours trust me I'm not sick.
And the migraines I got in middle/high school were no joke I'd have sensitivity to sound & light nausea all I wanted to do was sleep. Now this pain isn't a migraine we all know that.
I don't have this abdominal mass you're talking about but I am across intolerant & the last 2 nights it started with getting woken up ready to go diarhhea and my heads pounding. I know what's coming.
I'm going to try my chin to my chest thing next time.

Here are some possibilities I've researched
Psuedoaneurysm
Actual aneurysm
C something malformation (discussed in earlier replies)

On a Canadian medical website i saw a section about aneurysms going unnoticed or untreated when a persons bearing down for a bowl movement.(not necessarily straining but getting ready to poo) And the headache is referred to as a thunderclap or worst headache of your life.
They say if this happens go to the ER & ask them for a spinal tap to check cerebral spinal fluid levels.

I have my appointment in 4 days and I'll be showing her these posts so she can understand it better.
If I get a definitive answer I'll let y'all know
Its  most painful in the lower back left of my head. And it's still sore.

Idk if any of you have your medical marijuana cards, if you do try some BlackBerry Kush. It got rid of my sore neck pain
Avatar universal
As I posted before, I came to the conclusion that in my case it was the fact that I started to eat chicken to which I am allergic.  If you read my posts I explained it in detail.  Now I stopped eating chicken again and no more of these horrible headaches.  Find out what you're allergic to stop eating it and you will be pain free and enjoy the "throne" again.
Helpful - 0
Avatar universal
Just to follow up on the excruciating headaches, I no longer have them. I have not under any circumstances eaten CHICKEN, to which I  am allergic.
I can go to the bethroom normally again, no discomfort at all.  I no longer fear the fact that I have to have a bowel movement.  People, please believe me find out what your allergy is and STOP EATING THE CAUSE OF YOUR ALLERGY.  You will be pain free.  I was so scared when I experienced those headaches 3 day in a row, that I thought I was going to have a massive stroke.  I thought I would die on the toilette.  So please believe me and take my advice.  Those headaches were unreal, brain explosive.
Helpful - 0
Avatar universal
I'm glad to hear that you're better, but please find out about your allergies. See if you have any and then stop eating what you're severely allergic to and your headaches will go away.  It worked for me and I had the same symptoms and you.
Helpful - 0
Avatar universal
The bowel will act up just as you describe, will hold for a number of days and then all those symptoms as you describe happen,  The reason is because the allergen you ate can not be digested properly by your intestants and you get blowded, gasy, uncomfortable, I bet belching too.  Once it finally digests the allergen you have your BM as strange as it may be.  But if you eliminate the allergen from your diet.  Believe me you will be "normal" again.  Allergies can cause havoc with your system and a cure is so simple, just stop injesting it.
Helpful - 0
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