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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Pain In Tailbone While Suffering From Diarrhea Or Constipation Be Treated?

Hello, For a number of weeks now I have been experiencing health issues related to pain in tailbone region and across lower back (sometimes it is there and sometimes it is not). Also, I have had changing bowel conditions that are obviously not normal for me... ranging from what seems like constipation (albeit I went several times per day but the effort was not norm, also sometimes it felt like I had to have a bowel movement and couldn t) to current loose stool and diarrhea. It feels like the issue (pain) is coming from the bowels. So, I have been to the doctor (GP x 4, ER x 3) numerous times over the past few weeks so I will share the process so as to give you an idea where we are at. At this point (as of today), after you review the details below, I am waiting to go to a GI specialist however my condition is such that I am starting to really worry that each day I delay further treatment I am causing more damage to my body (condition and generally feeling of good health deteriorating)… 1)     4 weeks ago I visit GP for what appeared to be dark urine and or cloudy (vs. normal). Blood tests clear (tested for being anemic along with several other items such as potassium etc.). All clear for blood test. 2)     Due to visit in item # 1 there were 3 urine tests. 1st came back with more blood red cells than normal (just barely over the 0-3 count considered normal as per GP discussion).Two additional tests (one each day for 2 consecutive days) all clear for red blood cells. Due to other visits to GP and ER in notes below I have had another 3 urine tests all clear (3 of the tests were just dips and 3 were sent for microscopic tests) 3)     Due to visit in item # 1 sent for ultrasound of abdominal and chest x-ray (checked all organs except bowel and pancreas). All clear on both tests. 4)     Urine issue cleared up without any treatment. Increased my fluid intake overall so this may be the corrective action. There was discussion with GP that I had kidney stones but none found. 5)     Pain started to build across back (kidney area, I suppose) over several days and became somewhat unbearable. Pain moved around back and sometimes was higher in back and very painful (different days = pain in different locations). Visited GP again and was given pain pills as it was stated that due to the tests done so far it would not be normal to investigate any further. I was sent to physio stating that a back issue could be present. Physio confirmed there was no evidence there were any issues with my back causing bowel issues (stated it was likely the other way around). They stated I had some posture issues which they could help with but were unrelated to my acute issues. 6)     In the interim, while not prescribe by my doctor, I took some muscle relaxer (Robax Platinum) so I could function. Pills did relieve back pain. After 2 days or so taking well below the max dose allowed on package I became very weak, pale and had dropped heart rate (happened after dinner one evening). Went to ER and was put on EKG and had urine test. At visit to ER I have been off the robax for 12+ hours and ER doctor said vitals ok and the pills likely caused the problem (so, I never took another one). 7)     Visited GP the next day she did some more blood tests which were clear (I know CBC but not sure what else was checked). 8)     Pain increased over 2 days and at 11pm one night the stabbing pain in rectal/tailbone area was so back I went to the ER (could not sleep). I had a digital rectal exam done and was clear. Doctors were at a loss as to what was wrong and sent me home. I believe my age, being only 34, is impacting their decision. 9)     I returned to my GP the next day who sent me for an x-ray of tailbone which was clear. 10)     I went to the ER the following morning after another night of unbearable pain) and the ER doctor stated I likely had acute case of diviculitis and prescribed antibiotics (2 of them, taken together, for 7 days). I was also sent for a CT scan in 64-slice scanner and put through with and without contrast (IV). After reviewing the CT scan doctor reaffirmed it was diviculitis and stated “there isn’t a whole lot going on down there” (official report was non-specific inflammation) and said the drugs would wipe out any bug causing problems (albeit he still confirmed diviculistis on official report). They noticed some inflammation of lower colon and rectum but stated not significant. 11)     With the antibiotics given the pain went away and I felt ok (although a bit lightheaded and nauseous – noted on documentation that this is side effect of pills). Also, while bowel movements had now close to the correct form they were very loosely formed. Also, the stool was close to black (not quite, but dark). Since this went away after finished drugs, and my reading side effects info on this drugs, I assume it was the pills and this did not alarm me. 12)     Now that the drugs are done the pain is coming back, but it is nowhere near where it was prior to taking the pills. 13)     I was called by my GP a few days ago who wanted to follow-up on CT scan. She stated that there was wall thickening and/or inflammation possibly showing a bit near the other end of colon (starting end) as well as the rectum/lower colon as stated by the ER doctor who ordered the CT. She stated further investigation required (required protocol). She was not convinced it is diviculitis. She also mentioned something about lymph nodes irritation by inflammation/wall thickening at the starting end of colon and mentioned this was more common with Crohn s disease but didn’t think I had this since this had come on somewhat suddenly. She stated that the CT report only stated “there may be” something showing on the starting end of colon (meaning there wasn’t much showing but there could be something, as my GP put it). Blood tests sent in to check for inflammation (I have not heard back). I was called 3 days after GP visit by nurse who stated I have been referred to GI doctor and they advised them (where I am being sent) it is urgent. When I questioned the “urgent” statement by the nurse and asked if something serious was now considered she stated “no, nothing like that” (same thing GP told me) . As I type this message I am sitting here with mild rectal/tailbone pain, recent onset of bloating (not severe or painful but noticeable – this is a new issue within the last 36 hours or so), back pain (lower and mid). Diarrhea has been issue for 2 days now along with some light coloured stools that are nor formed whatsoever (along with gas). I also feel quite sluggish (although not exhausted) and warm (mild sweaty feeling) but numerous checks for fever (home test) are negative (as have all checks at ER over the past several weeks). Unfortunately, it is true we start to really worry when it comes to our health and can over-think things. Having said that, I know something is definitely wrong and I’m curious if there is more action I should be taking immediately. There is much discussion online regarding cancer and that is obviously scary for a 34 year old that, up to now, has been quite health (6’0’ 185lbs). As a side note I am still able to do my evening run of 3.5km on nights when the discomfort isn’t too bad (went last night and will go tonight). I could not do any running prior to the antibiotics due to pain. Pain seems to be gone during the exercise (or due to all the work my body is doing to run it over-rides the pain, I am not sure how that works). I usually get in 3 runs per week in the evening. Any feedback on what I should be doing to get myself back to good health would be much appreciated.
Wed, 2 Sep 2015
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General Surgeon 's  Response
Hello! Good day! I read your concerns thoroughly and will break down all your problems systematically--

1. tailbone pain --anatomically, the rectum (lower colon), is directly sitting on the tailbone. Any inflammation in that area can cause discomfort or pain in the lower back, especially the tailbone (sacrum). However, there is also a possibility that it is a separate problem, since previously you have had lower back pains. Lower back pains can be caused by several problems-- most common is musculo-skeletal strain, other causes are kidney stones, urinary tract infection, slipped disc, scoliosis, impinged nerve. The best diagnostic to rule out spinal bone problems in your lower back is a plain Xray of the Lumbo-sacral area (AP-Lateral views), an MRI might follow if with problem noted in the Xray.
2. For your rectal pain, since it was already documented on your CT scan that there is thickening in the area, a sigmoidoscopy or a colonoscopy will give us a direct visualization of the problem, a biopsy of the inflamed/thickened area might also be a good idea to know the cause-- whether infectious, inflammatory bowel, auto immune, or cancer.
3. Diarrhea/constipation/bloating -- this problem is probably caused by the thickening of your bowels. The main diagnostic that can give us an idea of what is the underlying cause will be the sigmoidoscopy/colonoscopy.
4. Sluggishness might be a symptom of dehydration secondary to your diarrhea. I suggest you take in a lot of fluids, especially after an loose stool episode, to replenish the losses.

I hope I was able to answer your concerns. Goodluck and may you get well soon!
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How Can Pain In Tailbone While Suffering From Diarrhea Or Constipation Be Treated?

Hello! Good day! I read your concerns thoroughly and will break down all your problems systematically-- 1. tailbone pain --anatomically, the rectum (lower colon), is directly sitting on the tailbone. Any inflammation in that area can cause discomfort or pain in the lower back, especially the tailbone (sacrum). However, there is also a possibility that it is a separate problem, since previously you have had lower back pains. Lower back pains can be caused by several problems-- most common is musculo-skeletal strain, other causes are kidney stones, urinary tract infection, slipped disc, scoliosis, impinged nerve. The best diagnostic to rule out spinal bone problems in your lower back is a plain Xray of the Lumbo-sacral area (AP-Lateral views), an MRI might follow if with problem noted in the Xray. 2. For your rectal pain, since it was already documented on your CT scan that there is thickening in the area, a sigmoidoscopy or a colonoscopy will give us a direct visualization of the problem, a biopsy of the inflamed/thickened area might also be a good idea to know the cause-- whether infectious, inflammatory bowel, auto immune, or cancer. 3. Diarrhea/constipation/bloating -- this problem is probably caused by the thickening of your bowels. The main diagnostic that can give us an idea of what is the underlying cause will be the sigmoidoscopy/colonoscopy. 4. Sluggishness might be a symptom of dehydration secondary to your diarrhea. I suggest you take in a lot of fluids, especially after an loose stool episode, to replenish the losses. I hope I was able to answer your concerns. Goodluck and may you get well soon!