Pelvic Floor Dysfunction

Fissure like pains...anyone?

A sub-forum for those with pain, but no explanation for it. Vent, share, ask, and help others. That is what this little corner is all about!

Return to Chronic Anal and Rectal Pain




Pelvic Floor Dysfunction

Postby Alyssa » 11 Aug 2014, 17:36

Has anyone been diagnosed with Pelvic Floor Dysfunction after they suffered from a fissure? If so, what are your symptoms and what have you done to treat this? I've never had pain in the a** like this until I got a fissure.

P.S. I had a fissure for 2-3 months and it healed, the issue is that I continue to have fissure like pains, no visible fissures have been detected since it was 1st diagnosed 6 months ago. The first doctor, referred me to physical therapy and the therapist stated that I have Pelvic Floor Dysfunction (tight muscles)... the chronic pain doctor believes that my chronic pain is due to "Myofascial Pain"; she suggested I try Botox in the pelvic muscles. During our consultation, I asked her what do I do if the pain comes back? she stated that we would book another round of Botox. Does that mean that I have to depend on Botox for the rest of life to fix this or is it only temporary?

I was feeling hopeful last week but now that I am decompressing all this information, it has left me at a standstill.. Most of you have a clean cut diagnosis (fissure, botox, LIS) but mine is much more complicated!

I have pain during bowel movements almost every day (hot, stinging, burning) and dull rectal pain throughout the day; paper cut feeling around my anus, soreness and bleeding some days.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby pafen » 23 Aug 2014, 04:31

Hi,

I have had the LIS yet my burning rectal pain remains. Mine seemed to started from a colonoscopy which led to hemroid surgery followed by a fissure as a complication of my healing. I had the LIS but it didn't seem to fix the problem.

I have had multiple scopes and been told that I don't have a fissure anymore, but I have the classic symptoms of burning pain following each bowel movement. My pain seems to last all day long and varies in intensity but can at times get to a level where I need to rest for most of the day.

A senior colorectal surgeon examined me and upon internal examination I could feel extreme pain when he palpitated the left side of my rectum. I asked him what he was pressing on and he said "That's Muscle". This was with a proctoscope.

I have spent a fortune on multiple opinions all with the same conclusion that everything is normal except a spasming pelvic floor.

I have seen a pelvic floor therapist for multiple sessions costing $100 each. Massaging and trigger point release seemed to help somewhat but the spasms always returned a few days after each treatment.

I somehow believe they have missed something so the next plan for me is the hidden fissure treatment....stool softeners, psyllium husk etc and no straining. Because what I have found is the more harder the bowel movement the more pain I have.

I am located in Australia and 35 years old. Currently this is putting my life on hold.

I am still very active and cycle 10kms daily, some moderate weights and push ups.

However I am only able to do these things thanks to painkillers. I have found lyrica gives me some relief along with endep. I am not sure about giving up the exercise to see if it helps my symptoms because I have always even the type to just get on with things.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
Topics: 8
Joined: 18 Aug 2014, 04:30
Location: Queensland Australia
Has thanked: 6 times
Been thanked: 12 times
Gender: Male

Re: Pelvic Floor Dysfunction

Postby mmklinemm » 23 Aug 2014, 08:59

Alyssa - if you're bledding on occasion, that doesn't sound like the issue is muscular, unless you maybe have hemorrhoids or something like that, too.

Have either of you considered acupuncture? I've read great things about it relieving pain. My OBGYN recommended it to relieve pain and nausea a few years ago when I was trying to avoid my hysterectomy.
Status: LIS 20 Oct 2014, 2nd LIS 05 March 2018.
mmklinemm
VIP
 
Posts: 317
Topics: 13
Joined: 13 Jun 2014, 09:13
Location: US
Has thanked: 38 times
Been thanked: 23 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 11:51

Pafen,

Have you been diagnosed with pelvic floor dysfunction? How long did you have the fissure?

The doctor told me that my muscles are so tight that they are causing minor lesions during bowel movements... Lesions that may not be visible upon examination.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 11:53

Mm,

I have not yet tried acupuncture since my pt suggested I wait on it... But I am open to anything that will hopefully relieve this chronic pain.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby pafen » 23 Aug 2014, 17:00

Hi,

I had an anal manomentary studies I think it was. They stick this special ultrasound probe up your back passage and perform various tests such as asking you when you would feel like going to the toilet etc.

It was found I had an irritable rectum where the sensation to need to pass stool came earlier than average.

It was also found that my anal resting pressures were quite high.

The conclusion of the examination was no abscess/fistula, and that I should perhaps consider physiotherapy. They told me my pain was coming from muscle spasm but didn't state pelvic floor dysfunction specifically. Given my symptoms though, muscle spasm would mean pelvic floor dysfunction?

I have had a recent MRI to rule out pathology. I remember the radiologist also saying to me that there is thousands of nerves in the pelvis. These cannot be seen on an MRI she said. If these become damaged due to trauma ie surgery it can cause chronic pain.

If that is the case I am hoping my nerves will recover eventually.

A colorectal surgeon said we can inject Botox into the pelvic floor/sphincter but he said he doesn't like to do it because of the incontinence risks I could have for about 6 months. But it's definitely another option to try. The thought of having to wear a diaper for 6 months puts me off the idea though.

I use a heat pad for when I sleep at night and I find this helps quite a bit and is something for you to try.

I haven't tried any acupuncture yet....
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
Topics: 8
Joined: 18 Aug 2014, 04:30
Location: Queensland Australia
Has thanked: 6 times
Been thanked: 12 times
Gender: Male

Re: Pelvic Floor Dysfunction

Postby pafen » 23 Aug 2014, 17:05

Hi,

I had the fissure a long time. After everything healed from my hemroid surgery the pain was still there, investigated further and the fissure was found. Then I had the LIS but didn't fix the pain.

It's possible I had the fissure for well over a year and might have already been there, hemroids were seen easily so that was originally thought to be cause of my pain.

Or maybe the main cause of my pain has been pelvic floor dysfunction all along!!!

I have been in chronic pain for over 2 years now.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
Topics: 8
Joined: 18 Aug 2014, 04:30
Location: Queensland Australia
Has thanked: 6 times
Been thanked: 12 times
Gender: Male

Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 17:54

Pafen,

There are people here that have used botox on the pelvic floor and/ or sphincter and have minor urgency issues... I am also worried about it but at this point, I have no other option. My PT told me that she has not had a patient that has had any major issues with Botox but don't know if she is actually telling me the truth. You can check out other forums of sufferers who have tried Botox.

Did you have high resting pressure before surgery or after LIS?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby Alyssa » 23 Aug 2014, 18:06

I have had a recent MRI to rule out pathology. I remember the radiologist also saying to me that there is thousands of nerves in the pelvis. These cannot be seen on an MRI she said. If these become damaged due to trauma ie surgery it can cause chronic pain.

Perhaps can they do an MRN?


Magnetic resonance neurography (MRN) is the direct imaging of nerves in the body by optimizing selectivity for unique MRI water properties of nerves. It is a modification of magnetic resonance imaging. This technique yields a detailed image of a nerve from the resonance signal that arises from in the nerve itself rather than from surrounding tissues or from fat in the nerve lining. Because of the intraneural source of the image signal, the image provides a medically useful set of information about the internal state of the nerve such as the presence of irritation, nerve swelling (edema), compression, pinch or injury. Standard magnetic resonance images can show the outline of some nerves in portions of their courses but do not show the intrinsic signal from nerve water. Magnetic resonance neurography is used to evaluate major nerve compressions such as those affecting the sciatic nerve (e.g. piriformis syndrome), the brachial plexus nerves (e.g. thoracic outlet syndrome), the pudendal nerve, or virtually any named nerve in the body
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: Pelvic Floor Dysfunction

Postby pafen » 23 Aug 2014, 19:28

Hi,

I too have had specs of blood on occasion but have been told I have no fissure anymore.

I have tried the physiotherapy and it seems to loosen things up....ie less pain. I had been given a male pelvic floor wand which is much smaller compared to the female one.

I was instructed to massage the area daily, but I have found it to be not a cure but just a temporary fix.

Also if either of us did have something such as a hidden fissure, the massage might only make things worse and the hidden fissure would never heal?

I have moved past that step seeing there was no permanent improvement and trying the high fibre diet/stool softener routine now.

Botox at least can be used to treat a fissure as well as muscle spasm so might be worth a go. However the specialists I have asked about it are cautious to use it.

I had paid $1000 up front for Botox injections and a EUA by a colorectal surgeon. However because he thought I had a small fissure he did the LIS instead.

There has to be a reason for the muscle spasm and my thoughts are it's either it's hidden pathology or nerve damage.

I have just had a MRI done last week investigating my PIRIFORMIS muscle ordered by my pain specialist. I should have the results next week. Piriformis syndrome is another cause for pudendal nerve pain because the muscle can entrap the nerve.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
Topics: 8
Joined: 18 Aug 2014, 04:30
Location: Queensland Australia
Has thanked: 6 times
Been thanked: 12 times
Gender: Male


  • Similar Topics
    Replies
    Views
    Last post

Return to Chronic Anal and Rectal Pain



Who is online

Users browsing this forum: No registered users and 10 guests