I know the prevailing advice for constipation has always been more fiber and water, but what I have been reading lately says stop with the fiber intake when you are constipated because it make it worse (just adding more bulk to an already bulked up system) then start again after resolving the constipation and start small. If you are doing fiber in this case I think I would add a stool softener to it. Fiber is not a stool softener, just added bulk.
Also, wondering if your pelvic floor dysfunction could be part of the cause.
please note I am not a doctor, just doing some wondering with you.
have you had a PET scan?

Hi @medicalunicorn, I’m glad you started this discussion in the Digestive Health group as well. Something you wrote really caught my attention… your description of feeling like there is a “large marble” behind your rectum.

I also deal with chronic constipation and pelvic floor issues, and I’ve struggled to describe a pressure sensation that at times has felt almost like a rock sitting near my tailbone. I don’t know that what I experience has the same cause as yours, but your description immediately resonated with me.

You’ve already had a considerable amount of testing, so I can understand why another normal test or being told simply to add fiber would be frustrating, especially when you already know fiber makes things worse for you. The fact that the pain has changed from occurring with bowel movements to being there constantly seems important to tell your doctor, particularly with the recent bleeding.

When you had pelvic floor dysfunction testing, did they identify what type of dysfunction you have or recommend pelvic floor physical therapy? And has anyone specifically evaluated this newer rectal pressure/pain since it became constant?

Hi MedicalUnicorn,

Could you have a redundant colon? That could either be a contributory source or "the" source of constipation. A gastro MD should see a redundant colon during a colonoscopy. There are ways to eat to reduce its constipating impact. Sometimes gas gets trapped too. Certain floor stretches and just walking can iron that out.

If not that, as miralax/metamusil and such do not work for me (I have a severely redundant colon), I rely on slippery elm powder (inner bark), magnesium citrate, kiwi, rhubarb, spinach, chia powder (or seed), cooked vegetables, food-source fiber with every meal and avoiding whatever foods seem to constipate me, as well as Colace stool softener as needed . Water, of course, as it seems to absorb into my body more slowly than other drinks. Exercise, stretching. Stimulant laxatives work, but are harsh. Someday I may need them though.

Keep trying things new things. Anxiety and stress should not be ignored either.

I hadvanal cancer diagnosed in late 2023. I had radiation treatment with only 2 rounds of chemo. The 23 apprx days of daily targeted radiation resulted in similar results you ate having. In the last two years, it has improved due to me and not from the contradictory treatment/products suggested. Yes, it a pain, but you know your routine and you may need to make adjustments accordingly. My colorectal surgeon not to add fiber. Also, how come countries where the people drink very little water do not the kind of digestive and colon issues?

Oh my goodness, medicalunicorn, all these health difficulties and challenges thrown your way and through out it all you’ve kept ayour chin up. I wish you well and am sending good health prayers to you.
Have you tried the Mayo Clinic, John Hopkins or Cleveland Clinic for 2nd opinions? My sister went to Mayo in Jacksonville, Florida for 2nd opinion. She said there was a team of specialists dedicated to her. The Mayo & CC are both great, but John Hopkins is gold. With your many health conditions, JH would most certainly want to help you.
Please let us know if you’re able to find relief.

Sorry for the typos.
Hang in there. Keep at it and never ever give up or give in. Reach out any time.
I'm just starting my first year re-check for cancer and hoping I'm still .all clear.
The bowels, mostly function but do admit there are times, I have to get to the bathroom promptly. And of course little, or a lot, it hurts in the rectum no matter what. I went through the diarrhea aspect for quite a long time so know how awful that is. I had to have repeat sigamographies and sometimes I could go through with them because of the pain or either because of the backup. Some days, I continue to wear my pink "diapers" just in case.
As far as pain externally, the sole product that provides instant relief is a product made in Sweden by Stryker called StrataXRT, but haven't been able to find it carried by the pharmacies here in the area. My radiation oncologist provided a sample and it was soothing. Of course that won't help internal pain I don't think.

Try Mary Ruth’s digestive enzymes before meals. It was a game changer for me.

@medicalunicorn, I merged your two discussions into one thread that appears in both the Autoimmune Diseases and Digestive Health group. This way you will have the benefit of connecting with members of both groups and only have to go to one place to connect with others.