Rectal/Anal Pain While Sitting

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bbc
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Date Joined Mar 2008
Total Posts : 1580
   Posted 7/12/2009 12:09 PM (GMT -6)   
Anyone get pain or increased pain in the rectal or anal area after sitting and is it normal to get more pain from a fissure when sitting?
 
Thanks


Dx'd with moderate Pancolits 05/07 better with Pentasa and Cortifoam.
I also take Probiotics, Curcumin, Benefiber and cannot tolerate
artificial sweetners (never could even before UC).
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.


quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 7/12/2009 1:10 PM (GMT -6)   
it can if it's inflamed as anal pain would if you have an external hemmie (or a thrombosed internal hemmie)

The other thing is if it's unrelenting, it could be an abscess??

Have you taken a look-see to determine of it is indeed a fissure?

Are you doing any extra external topical meds to help with the discomfort and healing of the fissure?

There are a lot of nerves in that area, so if you are sitting, I'd assume the extra pressure would exacerbate whatever is going on there. Even sneezing or excess gas would make it worse.

You could ask the doc for proctocedyl ointment..it has a bit of a pain reliever as well as healing agents in it...I like how it works.


Have you tried sitz baths?

quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


Judy2
Forum Moderator


Date Joined Mar 2003
Total Posts : 8907
   Posted 7/12/2009 2:24 PM (GMT -6)   
Whenever I have slight inflammation/tenesmus, I may have pain when sitting. In flare, the pain could be severe. Right now I have some anal inflammation from antibiotics, so have to move around frequently to stay comfortable.
Judy
 
Ulcerative colitis forum co-moderator
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 


bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 7/12/2009 4:49 PM (GMT -6)   

Hi Q,

Yup have a fissure. located just before the sphincter according to the colorectal doc...I just dont remember them burning so much when sitting in the past. I got an rx for anesthetic cream but it did not help which has me concerned and I am not flaring.I am doing the baths and also using dilitiazem ointment which kinda burns a bit.

 

 thnx

 

 

quincy said...
it can if it's inflamed as anal pain would if you have an external hemmie (or a thrombosed internal hemmie)

The other thing is if it's unrelenting, it could be an abscess??

Have you taken a look-see to determine of it is indeed a fissure?

Are you doing any extra external topical meds to help with the discomfort and healing of the fissure?

There are a lot of nerves in that area, so if you are sitting, I'd assume the extra pressure would exacerbate whatever is going on there. Even sneezing or excess gas would make it worse.

You could ask the doc for proctocedyl ointment..it has a bit of a pain reliever as well as healing agents in it...I like how it works.


Have you tried sitz baths?

quincy


Dx'd with moderate Pancolits 05/07 better with Pentasa and Cortifoam.
I also take Probiotics, Curcumin, Benefiber and cannot tolerate
artificial sweetners (never could even before UC).
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.


bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 7/12/2009 4:53 PM (GMT -6)   

Hi Judilyn,

I am a bit worried I may have PNE (pudendal nerve entrapment) as the discomfort when sitting can be severe and I am not flaring.

 

 

Judilyn said...
Whenever I have slight inflammation/tenesmus, I may have pain when sitting. In flare, the pain could be severe. Right now I have some anal inflammation from antibiotics, so have to move around frequently to stay comfortable.


Dx'd with moderate Pancolits 05/07 better with Pentasa and Cortifoam.
I also take Probiotics, Curcumin, Benefiber and cannot tolerate
artificial sweetners (never could even before UC).
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.


quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 7/13/2009 1:24 AM (GMT -6)   
that sounds scary bbc...what's the treatment for PNE?
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 7/13/2009 10:35 AM (GMT -6)   
Its very scary...the folks that have Prudendal Nerve entrapment experience burning in their anual/rectal area when they sit down and severe pain in their genitals etc...I am praying I dont have this, but the burning I'm getting in the anal/rectal area has been the most intense I've had...I'm just hoping its the fissure. I know my old fissure has opened again per my colorectal doc so there's a chance this is causing the pain, but it's much worse when sitting and that why I started the thread to see if any others with fissures have trouble sitting.

Treatment fpr PNE is usually surgery after many attempts to correct it via PT, meds and lifestyle changes (kinda sounds familiar to UC)

I had an MRI for tailbone pain and it showed small varices in the perirectal and presacral areas which is where most of my pain is, so I'm wondering if the varices might in fact be pressing on the Pudendal nerve and if so it should be straight forward to treat vs those with PNE. I am having a neuro surgeon look at my mri to see exactly where these varices are in relation to the nerve. I really hope and pray I dont have PN/PNE as its VERY hard to treat and the pain is horrible. Geez, having UC and IBS is bad enough.

Thanks Q


Dx'd with moderate Pancolits 05/07 better with Pentasa and Cortifoam.
I also take Probiotics, Curcumin, Benefiber and cannot tolerate
artificial sweetners (never could even before UC).
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.

Post Edited (bbc) : 7/13/2009 10:46:00 AM (GMT-6)


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 6625
   Posted 7/13/2009 10:40 AM (GMT -6)   
Don't folks with Crohn's get fissures more often than we do? I'm not telling you to go away or anything, but maybe you'd find more people who've had anal fissures over there.

I hope that you get some relief soon, no matter what the problem is!
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 7/13/2009 10:48 AM (GMT -6)   
Thanks fruit girl great suggestion!

It seems whenver my stool firms up and gets to normal size my anal area cant handle it probably being used to years of the mushy stuff, and it opens up.
Dx'd with moderate Pancolits 05/07 better with Pentasa and Cortifoam.
I also take Probiotics, Curcumin, Benefiber and cannot tolerate
artificial sweetners (never could even before UC).
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.


quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 7/14/2009 2:09 AM (GMT -6)   
fruitgirl..you're thinking of fistulas, not fissures. Anyone can get a fissure that's caused by constipation/hard stool/tight sphincter....
But, there are some CDers who have anorectal disease....I would assume then that fissures could be high on the list of maladies. It's not something that's caused by CD or UC, however.... but once you have one, it's basically a weak area that can open repeatedly after bms or wiping.

Fibre supplements, stool softeners and eating foods that aid in loosening and softening the stool are helpful as well as sitz baths to relax and clean the area to help prevent infection should stool remain in the fissure after wiping..



q
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 7/14/2009 2:12 AM (GMT -6)   
bbc...it sounds even scarier now that you've explained it more and regarding treatment.

It makes sense that the varices could be pressing on a nerve area causing even more extreme pain.

Does it hurt when you squeeze your sphincter or more if there's downward pressure?

There are suppositories that are numbing agents..wonder if that could help?

quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 6625
   Posted 7/14/2009 10:53 AM (GMT -6)   
Thanks, quincy! I got the "f words" confused, I guess! I have a cold on top of a nine-month old who is teething (yes, no teeth yet!) and not sleeping well! :)
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 7/15/2009 1:34 AM (GMT -6)   
LOL...hope your son gets some sleep finally to give you a break from this fussy stage, plus so that that you can recuperate from the cold.

quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


JD47
New Member


Date Joined Aug 2010
Total Posts : 4
   Posted 8/6/2010 8:11 AM (GMT -6)   
I visited a forum called Tipna. This is a forum for people who have Pundenal Nerve Enrapment. Most of the people who post on this forum have Levator Spasms or Anismus. This may be worth checking out before you have colostomy surgery. According to what information I have read on Tipna, they say that that pundenal nerve entrapment can cause the levator and rectal muscles to go into a spasm.These nerves run down each side of the buttocks and branch off to the levator muscles. When these nerves are pinched or inflammed, they cause the levator muscles to go into severe spasms. Some of the people who had PNE surgery, say that their symptoms are 50 to 75% better , one year after the surgery. I have suffered with Levator Spasms for 18 years.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 8/6/2010 12:01 PM (GMT -6)   
Interesting info, how unfortunate you're suffering from it.
Welcolme to the forum. Do you have UC as well?

q

bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 8/7/2010 9:53 PM (GMT -6)   
JD47,

I'm so sorry you are suffering, I've learned there are many causes of levator ani etc. Valium helps my retail pain and sitting on a well cushioned heating pad helps my tailbone pain. Visit this site also: http://pudendal.info/phpbb3/

I am still trying to get to the bottom of all of my pelvic floor pain and hope(and pray) is from an acetabular labral tear and detachment; seehttp://pudendal.info/phpbb3/ my sticky at the above forum for part of my story.

I'm also dealing with spinal pain from a lumbar epidural that pierced my spinal dural tube pumping Depo Medrol into my CSF... Stay away from these injections, they are very dangerous and the disabling complications are highly under reported.

Feel better.
Dx'd with moderate Pancolits 05/07 better with Pentasa and rectal meds as needed.
I also take Probiotics, Fish Oil, Curcumin, Benefiber and cannot tolerate artificial sweetners (never could even before UC) I also stay away from products with high fructose corn syrup.
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.

Post Edited (bbc) : 8/7/2010 10:27:16 PM (GMT-6)


luv2ride
Regular Member


Date Joined Jul 2010
Total Posts : 452
   Posted 8/7/2010 10:27 PM (GMT -6)   
<<Yup have a fissure. located just before the sphincter according to the colorectal doc...I just dont remember them burning so much when sitting in the past. I got an rx for anesthetic cream but it did not help which has me concerned and I am not flaring.I am doing the baths and also using dilitiazem ointment which kinda burns a bit.>>

I had this too and used the same ointment. They told me NOT to put the ointment directly on the fissure, but more around the anal opening. The goal of the ointment is to increase circulation to the area to promote healing, not to be on the fissure. It helped reduce the size of the fissure after about 3 months, but it never went completely away until after the surgery where they cut the internal sphincter muscle. That fixed it within days once the incision had healed.
UC since age 28 following childbirth, female.
Lialda

JD47
New Member


Date Joined Aug 2010
Total Posts : 4
   Posted 8/15/2010 3:37 PM (GMT -6)   
bbc, thanks for your reply. Levator Spasms can cause constipation.I hardly ever was constipated for the last 18 years. In the last 2
 or 3 months I have been constipated. I had an appointment with my colon -rectal doctor last Friday. He examined me and said my levator muscle was not in a spasm.If the Levator Muscle is not in a spasm,then what is causing the golf ball in the butt feeling? It could be the pudendal nerve acting up because it is either pinched or inflammed. When I do have a BM, I have to strain some to push the stool out,but when the stool comes out ,it doesn't feel like the problem is in the rectum. I know this doesn't make to much sense, but that is the way it feels.The pudendal nerve could be causing the increased tightness close to or around the rectum, and the increased tightness causes me to strain to have a BM,and it could be causing the constipation. I have another appointment with the colon doctor next month,and I am going to ask him about this.

bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 8/15/2010 4:34 PM (GMT -6)   
It took seeing 3 different colorectal doctors until the last one found the levator ani, he made sure to take his time and palpate the external and internal sphincters plus the levator. He prescribed valium which is great for getting the levator to calm down and really helps me with the burning feeling after some bm's due to the levator bring in spasm. There are quite a few other problems in the pelvic floor which can cause the golf ball in the rectum feeling. Unfortunately once you are diagnosed with uc the colorectal docs like to blame everything on it. My stool too always used to be on the mushy side but since the pelvic floor stuff began I am on stool softners. Try to find a good pelvic floor pt and have them check you out.
Dx'd with moderate Pancolits 05/07 better with Pentasa and rectal meds as needed.
I also take Probiotics, Fish Oil, Curcumin, Benefiber and cannot tolerate artificial sweetners (never could even before UC) I also stay away from products with high fructose corn syrup.
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.

JD47
New Member


Date Joined Aug 2010
Total Posts : 4
   Posted 8/25/2010 5:29 PM (GMT -6)   
Quincy,  Does UC mean ulcerative colitis?  I don't have ulcerative colitis,but I do have IBS.

JD47
New Member


Date Joined Aug 2010
Total Posts : 4
   Posted 8/25/2010 5:49 PM (GMT -6)   
bbc, The last physical therapist I seen said I probably have PNE(Pundendal Nerve Entrapment).She was a specialist in pelvic floor problems.

bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 8/25/2010 6:08 PM (GMT -6)   
That may or may not be the case ( hopefully it's not ) as other disorders can mimic pn/pne... I would make sure there is no other pathology causing your pain as pure pudendal nerve pain is not easy to treat. I would also recommend getting the book Headache in the Pelvis; this is an excellent book and can be purchased on Amazon.

Did the pt suggest a specific protocol for you?
Dx'd with moderate Pancolits 05/07 better with Pentasa and rectal meds as needed.
I also take Probiotics, Fish Oil, Curcumin, Benefiber and cannot tolerate artificial sweetners (never could even before UC) I also stay away from products with high fructose corn syrup.
 
 
UC Forum Co-Moderator
I am not a healthcare provider. I am offering support and guidance based upon my own conclusions and/or research. ALWAYS consult with a qualified healthcare provider.

tx213
Regular Member


Date Joined May 2012
Total Posts : 39
   Posted 8/18/2012 11:44 AM (GMT -6)   
I don't necessarily feel pain, but the added pressure from sitting makes me want to go again when I don't have to! That can be really annoying!

RangerDivine
New Member


Date Joined Jan 2013
Total Posts : 1
   Posted 1/3/2013 8:13 PM (GMT -6)   
bbc did you problem get cured?

quincy
Elite Member


Date Joined May 2003
Total Posts : 25135
   Posted 1/3/2013 9:08 PM (GMT -6)   
bbc hasn't been here since 2011.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!
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