Unexplained Severe Rectal Pain/Varicies/Tailbone Pain/Bad Doctor(s) etc...The saga continues...

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bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 7/4/2009 2:06 PM (GMT -6)   

Hi all.

 

For the most part I've been feeling pretty good as of late with nice firm stool and some mild ab pain after a large bm but nothing like it was before. But for the past week or so I have been experiencing severe burning after a BM, I am using anucort HC suppositories but they do very little (I also use Cortifoam twice per week for my UC). It appears the pain is coming from the area right at, or just before my anal sphincter as I can feel the greatest discomfort as the suppository goes in past that area; the feeling is like that of broken glass. I have complained about this to both my GI docs and colorectal docs several times in the past but whenever they look in there the see only mild hemmies or very mild inflammation from my UC or a very old small fissure and tell me this should not be causing so much pain AND they all leave me with no diagnosis, cause or treatment for this terrible pain.  Anesthetic hemmie cream even when used with the long applicator tube does very little to nothing for the pain.

 

I recently had an MRI for the tailbone pain and although it came back normal for the tailbone, it showed small varicies in the perirectal and presacral areas, which in most cases would be caused by Portal Hypertension, which is a very serious condition...my GI ordered a cat scan to rule out portal hypertension and thankfully it came back negative.

The interesting thing is my pain is in the exact areas where the MRI showed varicies (varicies are veins that should not be there...kinda like varicose veins/hemmies). I asked my colorectal doc and my GI doc if these things are causing all my pain especially since they are right in the painful areas...they replied no and basically sent me on my way with the GI guy referencing the colorectal guy and the colorectal guy referencing the GI guy etc etc, leaving me with nothing.

 

I decided that I needed to pursue a vascular surgeon that knows about these things (varicies) and when I called their receptionist was extremely knowledgeable and said that they treat hemmies and varicies all the time and these things could be pushing on a nerve which would really exacerbate the pain.

 

My pain seems to be right at or before the anal sphincter which becomes very irritated by a BM and I am wondering if anyone here has had this issue and what you did to treat it? I'm also wondering if I now have proctitis? Does proctitis produce these symptoms? I have an appt with the vascular surgeon next week and my colorectal doctor has not returned my last two calls; this was after I wrote him a very complementary letter a few months back! My God some of these doctors are just beyond insensitive...I certainly would not want their karma! 

 

If the vascular doc cannot help then I'm off to the Mayo Clinic to find out what is going on...geez just when I thought I was turning the corner...kinda par for the course with UC I guess : (

 

Appreciate the input and thanks very much.

 


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) : 7/4/2009 1:18:06 PM (GMT-6)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31005
   Posted 7/4/2009 2:16 PM (GMT -6)   
Well, UC flares could cause rectal pain, but considering you have actual other issues happening, I'd say it's the other issues. Any type of inflammation, especially swollen veins such as varicies or hemmies or a fissure would be my first guess. Especially with the pain upon inserting the supposisitories.

I would suggest for now that you try sitz baths to ease some of the inflammation until you see the vascular surgeon.

I don't get why some patients suffer endlessly with issues that could be dealt with once they're simplified....in the way meaning at least diagnosed with the clarification of what they, in themselves, could cause regarding pain, discomfort or future complications.

Have you been diagnosed with CD and not UC?


Maybe requesting another med such as proctocedyl for the non-UC-related issues could be better than the Anusol.?

Have you upped your fibre intake such as with supplements? Maybe that would be helpful...

I do hope this doctor comes to the aid of your long and dragged out plight...sheesh.

Definitely keep us posted.
quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 3rd 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 7/4/2009 2:36 PM (GMT -6)   
Hi Q and thanks for the reply.

I have UC not CD (via numerous biopsies) although I certainly understand why you might think that, based upon the rectal/anal pain.

I have upped the fiber big time, as you may remember this was the key to reducing the terrible spasms I was getting after a BM.

The pain is right at the sphincter and was/is always there when it presents itself and usually after a week or so if this it subsides but to always return. It appears that if i have normal stool (which I now have) it is too firm for my anal rectal area to handle which is certainly not normal. This pain is way too severe for hemmies, a fissure yes but not hemmies, and I don't think a fissure could be that far up next to/on the sphincter.

I am wondering if my former Pancolitis ended up as Proctitis and is this a symptom of it?


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) : 7/4/2009 1:53:42 PM (GMT-6)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31005
   Posted 7/4/2009 3:01 PM (GMT -6)   
Are you on oral 5asa meds? As the colon heals downward, the rectum is last to heal....and for many, the most difficult.

If you also have cecum involvement with no oral meds, it could be that it's inflamed and not being taken care of....but I think that if the rectal inflammation was seen on the scan, the cecum would have been also.
Just throwing that in....

Regarding the fibre...what are you taking again?

Are you also on any probiotics?

I suggest you expand your siggie regarding meds/supplements so we don't keep asking you the same questions..lol! my bad habit.

This is a way out thing, but a suggestion that might work....what about Kegel exercises while you're on the sitz bath?? meaning, it's exercises you can control regarding the sphincter...not automatic as when stressed, etc.

quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 3rd 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 7/4/2009 3:12 PM (GMT -6)   
Q,

I take Pentasa and Cortifoam for my UC which worked well; I also take probiotics and Benefiber.

Something is causing inflammation to my sphincter area and when the stool passes through it really exacerbates it to where it feels like broken glass...any idea if UC can do this to the sphincter area?
 
Perhaps it's the perirectal and presacral varicies as I initially described, as they are right in the areas where my pain is.

My entire detailed sig was deleted when I was made a mod so I'll have to add all the information back.

Thnx


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) : 7/4/2009 2:49:07 PM (GMT-6)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31005
   Posted 7/4/2009 4:23 PM (GMT -6)   
All I can say is "possibly" UC flaring can cause that feeling...especially if there is more going on than just inflammation from UC. It likes company when it reacts...

quincy
*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 3rd 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 7/4/2009 6:12 PM (GMT -6)   
Hopefully the vascular surgeon can figure out what's what...this has gone on long enough (sigh)

thnx


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) : 7/4/2009 5:15:24 PM (GMT-6)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31005
   Posted 7/5/2009 3:12 AM (GMT -6)   
You're welcome....I agree with the sigh....you've had a very rough go of this, it would be nice for something to at least be a solid diagnosis with some result of resolve.

quincy

The good Lord willing :-)

Post Edited By Moderator (bbc) : 7/5/2009 5:14:00 PM (GMT-6)

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