I got my MRI results back. The report says no pelvic floor relaxation was observed during the test, indicating dyssynergia. Plus a moderate rectocele was found, no surprise there. I have my follow up doctor visit in about 3 weeks, will see what she says. I've also asked my PT for her opinion on the results. I wonder if the pelvic floor can even relax when one tries to poop lying down, seems to me a sitting test would be more useful in this regard.

Be interesting to see what they say patience and what is recommended for you. Good to also get PT opinion as well.
Poop lying down - I agree must be hard for those muscles to relax properly. Hopefully that is somehow taken into account. Keep us posted.

Thanks Sue. I hope you can find the right treatment for yourself. I found this helpful video on pelvic floor and rectal pain, thought I would post it here: https://youtu.be/cF2_OEjFLtA

thanks I will take a look. Just going through a mountain of emails right now!

I got my manometry results as well and the nurse told me the test showed that the sphincter doesn't relax when I try to make it. Interestingly she said that the test is not diagnostic of a fissure, and that is something the doctor would diagnose upon visual examination. I'm due for a follow-up appointment on Tuesday to see what the next steps are. My PT says I should go ahead and get pelvic floor Botox if that's what they recommend. I'll update here after my visit.

If it’s not relaxing, does that mean you are a good candidate for LIS?

If you can't control it, doesn't it mean that it is the external sphincter? I wonder what treatment they will suggest. It seems like you're moving in the right direction and I hope that you can sort this out soon.

owmybum wrote:If it’s not relaxing, does that mean you are a good candidate for LIS?

At my first visit with the current CRS, she didn't think I had a fissure. I'll ask her about it again today, but she didn't mention surgery as an option during the visit. I personally doubt that I have an active fissure, but I may have some scar tissue that gets irritated once in a while.

chachacha wrote:If you can't control it, doesn't it mean that it is the external sphincter? I wonder what treatment they will suggest. It seems like you're moving in the right direction and I hope that you can sort this out soon.

Not necessarily I think, because the second layer of pelvic floor muscles can affect the internal sphincter if they are not relaxing. But you've given me a good question to ask the doctor today. :)

I met with the CRS today and she gave me some options. She said I could try doing yoga regularly to see if it would make a difference, or she could do a Botox + Kenalog injection into the pelvic floor muscles through the perineum. This would be done under twilight sedation but without ultrasound guidance. Also, the burning pain which I get upon irritation of the anal canal sounded like a nerve issue to her, so she might bring in another doctor to do a nerve block, but that may take time to schedule. I would need to continue with PT after Botox, so that the root problem can be fixed.

The nurse sat down with me and explained my manometry results, basically saying that I have normal resting and squeeze pressures, but no relaxation of the sphincter upon bearing down, indicating dyssynergia. She said biofeedback could also be an option for treating it, though the doctor didn't mention it.

I'm going to wait for the doctor to discuss with my PT and then decide what to do next. The injections sound scary and invasive, but the doctor seemed very confident that there would be minimal side effects, and she's never had anyone develop an infection afterwards. One thing she did warn about was the possibility of fecal incontinence which would take time to wear off if it happened, but she's using a lower concentration of Botox so hopefully that won't happen.

Oh and I forgot to ask the question that you brought up, chachacha. :-/ I might message and ask her about it once she's talked to the PT.