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Suggest Treatment For Severe Rectal Pain
Question: My wife is suffering with severe rectal sensation/pain. She got this when she was 8.5 months pregnant. Just before motion the rectal pain is at higher level and also triggers stomach pain too. After the motion, the stomach pain will slowly reduces. The rectal pain is there for almost the day. During night when she gets into sleep, she may not feel the intensity of pain. The pain increases while the day passes to evening/night. Her Colonoscopy, Anorectal Manometry, Motion analysis and blood tests are all positive and are not giving an y clue to the kind of decease. Request your expert opinion like what is the decease? Medication for her pain relief?
Brief Answer:
As detailed and have some additional points to help her.
Detailed Answer:
Hi.
Thanks for you query and an elucidate history.
The pain your wife is getting is classical and is called Proctalgia.
Since this had started when your wife was 8.5 months pregnant, it was possibly an anal fissure.
I think it continued on and the swelling might have spread to the anal canal and the rectum causing the symptoms as she has.
It is good that all the relevant tests have been done including colonoscopy, anorectal manometry, motion analysis and blood test. All look to be normal.
Also noted that your Doctor as thought that this is a type of IBS and prescribed Lactifiber daily early morning, colaspa tab daily two times, pantocid daily once and enterogermina daily three times.
I think colospa needs to be taken thrice daily, preferably half an hour before food at be spaced at 8 hourly interval. (With all these medicines, she should not breast-fed the baby).
Second opinion of a general surgeon for clinical evaluation, actual examination, and any investigations or additional treatment is also an additional good option.
Few more additions:
Vit A and Vit D in therapeutic doses,
Multiviatamins ,
probiotics,
anxiolytics help a lot.
Sitz bath in a tub with warm water.
Watch for the foods or beverages, milk and milk products if they enhance the problem and stop anything which is noticed to cause or enhance the problem.
I hope this answer helps to get her more relief and may be a possible cure.
As detailed and have some additional points to help her.
Detailed Answer:
Hi.
Thanks for you query and an elucidate history.
The pain your wife is getting is classical and is called Proctalgia.
Since this had started when your wife was 8.5 months pregnant, it was possibly an anal fissure.
I think it continued on and the swelling might have spread to the anal canal and the rectum causing the symptoms as she has.
It is good that all the relevant tests have been done including colonoscopy, anorectal manometry, motion analysis and blood test. All look to be normal.
Also noted that your Doctor as thought that this is a type of IBS and prescribed Lactifiber daily early morning, colaspa tab daily two times, pantocid daily once and enterogermina daily three times.
I think colospa needs to be taken thrice daily, preferably half an hour before food at be spaced at 8 hourly interval. (With all these medicines, she should not breast-fed the baby).
Second opinion of a general surgeon for clinical evaluation, actual examination, and any investigations or additional treatment is also an additional good option.
Few more additions:
Vit A and Vit D in therapeutic doses,
Multiviatamins ,
probiotics,
anxiolytics help a lot.
Sitz bath in a tub with warm water.
Watch for the foods or beverages, milk and milk products if they enhance the problem and stop anything which is noticed to cause or enhance the problem.
I hope this answer helps to get her more relief and may be a possible cure.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor for giving me your valuable suggestions on my Query.
1. Doctor said that it is IBS (Rahmat Nursing Home)
2. Doctor said that it is Malabsorption (SunShine)
3. Doctor said that it is because of pregnancy, baby weight on the rectum (AIG)
4. Doctor said that it is a type of IBS.
You said that it is Proctalgia Fugax.
As per my knowledge, Proctalgia Fugax is rectal pain and there is no evident reason why it will occur. It will last for couple of minutes to full day. Even in the sleep to you will be able to feel the pain.
My wife's condition is little different. She feels rectal pressure very severely. She will have an urge to pass stool throughout the day. But she will go for motion normally (1-2 times a day). Recently, she is feeling stomach pain along with rectal pressure before defecation. The stomach pain slowly goes off but not the rectal pressure.
She already had VSL3 probiotics. Now she is having Enterogermina, live bacteria. She is having Ativan, Anti-anxiety agent from last two months. She is doing sitz bath from last three days. She is having only fibre rich foods. Stopped Milk, Tea and coffee.
I am attaching her medical history. Request you to go through it and let me know her condition and medication.
Regards, XXXXXXX
1. Doctor said that it is IBS (Rahmat Nursing Home)
2. Doctor said that it is Malabsorption (SunShine)
3. Doctor said that it is because of pregnancy, baby weight on the rectum (AIG)
4. Doctor said that it is a type of IBS.
You said that it is Proctalgia Fugax.
As per my knowledge, Proctalgia Fugax is rectal pain and there is no evident reason why it will occur. It will last for couple of minutes to full day. Even in the sleep to you will be able to feel the pain.
My wife's condition is little different. She feels rectal pressure very severely. She will have an urge to pass stool throughout the day. But she will go for motion normally (1-2 times a day). Recently, she is feeling stomach pain along with rectal pressure before defecation. The stomach pain slowly goes off but not the rectal pressure.
She already had VSL3 probiotics. Now she is having Enterogermina, live bacteria. She is having Ativan, Anti-anxiety agent from last two months. She is doing sitz bath from last three days. She is having only fibre rich foods. Stopped Milk, Tea and coffee.
I am attaching her medical history. Request you to go through it and let me know her condition and medication.
Regards, XXXXXXX
Brief Answer:
Please get MRI of the whole pelvis telling the Radiologist the symptoms
Detailed Answer:
Thanks for your feedback.
Proctalgia means pain in the rectum. This is the symptom.
(I did not say it to be Proctalgia fugax or so)
Read the history again.
Gone through all your attachments. You already have mentioned almost everything.
I would suggest to go for MRI of the pelvis with informed information to the radiologist about the symptoms so that the Radiologist can see the films carefully.
I think you should keep her on normal full diet as it was before. (barring the things which she must have noted to instigate or enhance the problems)
Rest of the treatment as advised and she is taking.
Let us see the MRI report and decide further course of action.
Please get MRI of the whole pelvis telling the Radiologist the symptoms
Detailed Answer:
Thanks for your feedback.
Proctalgia means pain in the rectum. This is the symptom.
(I did not say it to be Proctalgia fugax or so)
Read the history again.
Gone through all your attachments. You already have mentioned almost everything.
I would suggest to go for MRI of the pelvis with informed information to the radiologist about the symptoms so that the Radiologist can see the films carefully.
I think you should keep her on normal full diet as it was before. (barring the things which she must have noted to instigate or enhance the problems)
Rest of the treatment as advised and she is taking.
Let us see the MRI report and decide further course of action.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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