Rectal pain - no clear diagnosis

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Rectal pain - no clear diagnosis

Postby dmcff » 17 Feb 2016, 06:22

I'm in the U.K., 71 years old. Last year I suffered a lot of rectal pain, ended up in hospital several times. I had numerous tests, including a sigmoidoscopy, two MRI scans and a CT scan of my pelvis. The doctors were unable to give me a definite diagnosis, but all emphasized that everything was "benign" - i.e. no cancer present. My GP took a stool test for calprotectin, and it showed a relatively high reading of 343. But of the specialist consultants I saw, none thought this was especially significant. I was seen on several occasions by a urologist and a colorectal surgeon, also by a gastroentrologist. None of them wanted to "claim" me for their special area of expertise - I was shunted from one to the other. In the end, a doctor I saw at the hospital told me he thought the source of my trouble was anxiety, and suggested a course of psychotherapy. Yet the sigmoidoscopy revealed a couple of healed fissures, and my GP after examining me confirmed that there was an active fissure at 6 o'clock. He prescribed diltiazem, but it gave me a rash.
A pain specialist said if the pain got bad again I could have another sigmoidoscopy and, if a fissure is the problem, a course of Botox injections. I'm reluctant to have the sigmoidoscopy because of pain in my lower legs and feet which began after the first one.
For several months I decided to live with the condition, and stopped consulting doctors and specialists. This was the situation until recently, when the rectal trouble started to flare again, with a sharp increase in pain. I'm prepared to admit that I'm anxious about it - there is again likely to be no proper diagnosis. But anxiety can't be the sole factor at work - there is clearly something physically wrong with my back passage and pelvic area. It's awkward for me to walk, and as stated before I also have pain in my lower legs and feet.
Wondering what to do. There seems to be a lot of guesswork.
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Just living with it
2021 Better, but still have AF
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Re: Rectal pain - no clear diagnosis

Postby brokenbottom » 04 Mar 2016, 12:53

Totally sympathise with your situation! It's like they look for the really serious things and if they don't find them you're a bit of a disappointment! I guess that's because they haven't worked out how to fix it. And blaming it on psychological problems is such a cop out! One of the GPs I saw wanted to give me anti depressants because I "seemed upset". But I wouldn't have been upset if I wasn't in so much pain!
Sorry I don't have an answer, but I certainly agree with what you're saying.
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: Rectal pain - no clear diagnosis

Postby dmcff » 04 Mar 2016, 13:22

brokenbottom wrote:And blaming it on psychological problems is such a cop out! One of the GPs I saw wanted to give me anti depressants because I "seemed upset". But I wouldn't have been upset if I wasn't in so much pain!


I went through something similar. It's deeply depressing.

Another approach is possible, though. There's an interesting book by an American neurologist and professor of rehabilitation medicine, John E. Sarno, that deals with exactly this question - the book is about healing back pain, but my own belief is that much of what it says is applicable to AF as well. While Sarno doesn't deny for one moment the physical reality of the pain, he traces its origins back to a psychological and emotional basis. According to one commentary "Sarno believes that when patients think about what may be upsetting them in their unconscious, they can defeat their minds' strategy to repress these powerful emotions; when the symptoms are seen for what they are, the symptoms then serve no purpose, and they go away."

At first I was sceptical about this, but over time I've begun to wonder if there might not be something in it after all. I think if you look around on the forum you will find some posts on Sarno and his 'Tension Myositis Syndrome" (TMS).
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Just living with it
2021 Better, but still have AF
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Re: Rectal pain - no clear diagnosis

Postby brokenbottom » 04 Mar 2016, 13:26

Interesting stuff! Will certainly look into it. We've got to try to do all we can to help ourselves it seems!
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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