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We Are In Complete Despair; Male Age 81, Worked As
Posted on
Sat, 5 Sep 2020
Sat, 5 Sep 2020
Answered on
Last reviewed on
Question : We are in complete despair; male age 81, worked as Dental surgeon NHS Scotland until age 77, for several years now has terrible pain after going to pass 'motion' in morning, if he can stay away from the 'loo' for the day re Diarrhoea, he manages ok, had tests and visits to hospital never ending but results of Colonoscopy always ok, no answers from Consultants here in Glasgow, any ideas what it may be and what we can do about it please? Thank you,
Brief Answer:
Need few more details.
Detailed Answer:
Hello and thank you for choosing " Ask a Doctor" service for your query"
Have gone through your details but just want to clarify some doubts.
1)The pain started when he went to pass stools in morning?
2)Is the pain constant or off and on(comes only while passing stools)
3)Can he localise the area of pain i.e rectal or anal area or ano rectal area?
4)Nature of pain i.e stabbing,Numbness,Sharp,Dull,Electric shock type?
5)If he can stay away from loo....re diarrhoea? what does this mean? If he dont pass stool for a day he gets diarrhoea?
6)His bowel habits?
7)Type of stool he pases generally?(Hard soft watery?
8)Prostrate ever checked? while doing per rectal examination?
9)MRI lumbo sacral area ever done? Sarcral plexus supplies ano rectal nerves.
10)Only symptom is passing stools is painful?
11)How long does it lasts?
12)Medications tried?
13)Any other ailments?
Waiting
Need few more details.
Detailed Answer:
Hello and thank you for choosing " Ask a Doctor" service for your query"
Have gone through your details but just want to clarify some doubts.
1)The pain started when he went to pass stools in morning?
2)Is the pain constant or off and on(comes only while passing stools)
3)Can he localise the area of pain i.e rectal or anal area or ano rectal area?
4)Nature of pain i.e stabbing,Numbness,Sharp,Dull,Electric shock type?
5)If he can stay away from loo....re diarrhoea? what does this mean? If he dont pass stool for a day he gets diarrhoea?
6)His bowel habits?
7)Type of stool he pases generally?(Hard soft watery?
8)Prostrate ever checked? while doing per rectal examination?
9)MRI lumbo sacral area ever done? Sarcral plexus supplies ano rectal nerves.
10)Only symptom is passing stools is painful?
11)How long does it lasts?
12)Medications tried?
13)Any other ailments?
Waiting
Above answer was peer-reviewed by :
Dr. Raju A.T
Doctor's reply to your question above...
Brief Answer:
Need few more details.
Detailed Answer:
Hello and thank you for choosing " Ask a Doctor" service for your query"
Have gone through your details but just want to clarify some doubts.
1)The pain started when he went to pass stools in morning?
He has worked out that if he doesn't have a motion early morning as usual,
he doesn't have the same amount of bad pain all day long.
2)Is the pain constant or off and on(comes only while passing stools), it's off and on but lasts all day, and comes after passing stool, a miserable amount of pain it seems.
3)Can he localise the area of pain i.e rectal or anal area or ano rectal area?
Pain is mostly in anus.
4)Nature of pain i.e stabbing,Numbness,Sharp,Dull,Electric shock type?
Dull, numb pain.
5)If he can stay away from loo....re diarrhoea? what does this mean? If he dont pass stool for a day he gets diarrhoea?
Sorry not to be clear....If he doesn't pass any stool, then no pain that day and no diarrhoea
6)His bowel habits?
He usually has a movement regularly every day or second day.
7)Type of stool he pases generally?(Hard soft watery?
Soft.
8)Prostrate ever checked? while doing per rectal examination?
Don't know for sure, never mentioned after exams or GA's. CT scan 2019 and showed diverticulitis and IBS.
9)MRI lumbo sacral area ever done? Sarcral plexus supplies ano rectal nerves.
May have had MRI done a few years ago but not for this present pain.
10)Only symptom is passing stools is painful?
It is more after passing stool, pain for rest of day.
11)How long does it last?
Pain in anus and stomach immediately follows motion, lasts all day 'til evening
12)Medications tried?
Suppositories, (Anusol), diltrisel, fibrogel fludrocortison 100mg, Lansoprozole 30mg, Loperimide
13)Any other ailments?
Quadruple bypass 30 years ago, and recent heart attack December 2019, but had an op for 3 small problems on same artery, released from hospital same day, no further problems with it. 2 new knees 2 years ago, no issues with that either.
Thank you for your time, Dr XXXXXXX please let me know if you need any other information, apologies for not getting back to you instantly, my husband was not here until later. Cheers, Diane Macdonald
Waiting
Replied by Dr. XXXXXXX XXXXXXX , 19 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute
for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest
physician before acting on it. The advice is not valid for medico-legal purposes also.
Brief Answer:
Need few more details.
Detailed Answer:
Hello and thank you for choosing " Ask a Doctor" service for your query"
Have gone through your details but just want to clarify some doubts.
1)The pain started when he went to pass stools in morning?
He has worked out that if he doesn't have a motion early morning as usual,
he doesn't have the same amount of bad pain all day long.
2)Is the pain constant or off and on(comes only while passing stools), it's off and on but lasts all day, and comes after passing stool, a miserable amount of pain it seems.
3)Can he localise the area of pain i.e rectal or anal area or ano rectal area?
Pain is mostly in anus.
4)Nature of pain i.e stabbing,Numbness,Sharp,Dull,Electric shock type?
Dull, numb pain.
5)If he can stay away from loo....re diarrhoea? what does this mean? If he dont pass stool for a day he gets diarrhoea?
Sorry not to be clear....If he doesn't pass any stool, then no pain that day and no diarrhoea
6)His bowel habits?
He usually has a movement regularly every day or second day.
7)Type of stool he pases generally?(Hard soft watery?
Soft.
8)Prostrate ever checked? while doing per rectal examination?
Don't know for sure, never mentioned after exams or GA's. CT scan 2019 and showed diverticulitis and IBS.
9)MRI lumbo sacral area ever done? Sarcral plexus supplies ano rectal nerves.
May have had MRI done a few years ago but not for this present pain.
10)Only symptom is passing stools is painful?
It is more after passing stool, pain for rest of day.
11)How long does it last?
Pain in anus and stomach immediately follows motion, lasts all day 'til evening
12)Medications tried?
Suppositories, (Anusol), diltrisel, fibrogel fludrocortison 100mg, Lansoprozole 30mg, Loperimide
13)Any other ailments?
Quadruple bypass 30 years ago, and recent heart attack December 2019, but had an op for 3 small problems on same artery, released from hospital same day, no further problems with it. 2 new knees 2 years ago, no issues with that either.
Thank you for your time, Dr XXXXXXX please let me know if you need any other information, apologies for not getting back to you instantly, my husband was not here until later. Cheers, Diane Macdonald
Waiting
Replied by Dr. XXXXXXX XXXXXXX , 19 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute
for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest
physician before acting on it. The advice is not valid for medico-legal purposes also.
Answers to questions on this page (above), thank you. Apologies for not answering immediately, did not have my husband to answer questions at that moment. Hope the answers above clarify the situation, but if we can help, please just ask.
Thank you, Regards, Diane MacDonald
Thank you, Regards, Diane MacDonald
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Thanks for the follow up,
Dull pain associated with numbness is usually sign of nerve involvement.
When ever nerve supplying a particular area is inflammed numbness could be felt.
Pain starts after passing stool again suggests that there could be inflammation in ano-rectal wall.
He has been given medicines related to gastro intestinal tract as i can see but no medicine to calm nerves which supply the area were ever used.
I would initially suggest you to consult a urologist(in person) to get his prostrate checked for prostatitis.
Secondly a nerve relaxant like Pregabalin 75mg along with Nortyptallin 10mg should be used for minimum 4 weeks.
Thank you and hope he get well soon.
Follow up.
Detailed Answer:
Hi again,
Thanks for the follow up,
Dull pain associated with numbness is usually sign of nerve involvement.
When ever nerve supplying a particular area is inflammed numbness could be felt.
Pain starts after passing stool again suggests that there could be inflammation in ano-rectal wall.
He has been given medicines related to gastro intestinal tract as i can see but no medicine to calm nerves which supply the area were ever used.
I would initially suggest you to consult a urologist(in person) to get his prostrate checked for prostatitis.
Secondly a nerve relaxant like Pregabalin 75mg along with Nortyptallin 10mg should be used for minimum 4 weeks.
Thank you and hope he get well soon.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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