I have pelvic dyssenergia. Does anyone else have that?

@lisalucier
Hello,
I just found this site and am so thankful I did. I have dyssynergia defacation and I am in the beginning of Bio Feedfeed. I also started taking MiraLAX once a day and I have been drinking a fresh fruit smoothie everyday for the past two months. To have any kind of a bowel movement I use dulcolax tablets (2) three times per week. I am seeing a new doctor this week who actually specializes in this area. I am really hoping if I am consistent with the MiraLAX I will have some success so I do not have to take the dulcolax. Right now my doctor at MNGI told me to use the dulcolax. I have not seen him since mid June, but then I found this new doctor I was lucky enough to get an appointment with. I have had some success with Linzess in the past.
I am so afraid I will not get this figured out. 🫤

@lisalucier
Hello,
I just found this site and am so thankful I did. I have dyssynergia defacation and I am in the beginning of Bio Feedfeed. I also started taking MiraLAX once a day and I have been drinking a fresh fruit smoothie everyday for the past two months. To have any kind of a bowel movement I use dulcolax tablets (2) three times per week. I am seeing a new doctor this week who actually specializes in this area. I am really hoping if I am consistent with the MiraLAX I will have some success so I do not have to take the dulcolax. Right now my doctor at MNGI told me to use the dulcolax. I have not seen him since mid June, but then I found this new doctor I was lucky enough to get an appointment with. I have had some success with Linzess in the past.
I am so afraid I will not get this figured out. 🫤

@bell67 - welcome to Mayo Clinic Connect. Sounds like you've been through a tough journey just to have a normal BM. I'm glad to hear you are seeing a doctor who specializes in your condition.

Fellow members in this discussion who've talked about dyssynergia defacation may have some thoughts for you about what has helped with their conditions and if they've been able to do it without bisacodyl (Ducolax). Please meet @maggie1942 @aznelson2426 @jlstjohn @ltarashuk and others here.

What makes you want to stay away from the bisacodyl (Ducolax), bell67?

@bell67
I too have suffered from pelvic dyssynergia defecation. For me, it part of a whole constellation of other factors, all of which I had formally diagnosed (pelvic dyssynergia, SIBO, acquired sucrase isomaltase enzymatic deficiency, bad internal hemorrhoids, IBS-C). Have you been tested for any of these other things? It's hard or perhaps impossible to determine what is causing what. But one big factor in the dyssynergia is that gut-brain connection. I'm glad you've found some sort of biofeedback program. I couldn't find one, but a short course of physical therapy was helpful in teaching me a few things.

In my experience, you have to go at this from multiple angles.

Here is my regimen, and now, 2 years since all this began, I am much, much better. Not "cured" but 85-90% better. In particular, the dyssynergic defecation seems to be gone:

1) Poop-stool for proper position for defecation and doing a couple of breathing things that I learned in physical therapy.

2) Miralax in late afternoon every day. It's not actually a laxative, by the way, from what I understand. It's a stool softener, which makes your stools easier to pass. Particularly important if you have internal hemorrhoids.

3) Dulcolax before bedtime only if I've gone 2 days without a poop. One thing good to learn is that there is always some poop up there and you really don't have to poop every single day. Get over the idea that you have be completely cleaned out. Might not feel great but try not to focus on it.

4) Trying to restrict pooping to once a day (for me, AM after breakfast). Because of the hemorrhoids there are some days where my rectum constantly signals me that I need to poop, especially after I eat. It's a miscommunication of gut and brain. And it's a really weird feeling, like my ass "talking" to me. If I ignore the unpleasant feelings they 95% of the time go away within an hour. In the few instances where I really did have to go (3 times in last 6 months because of a virus or something), it eventually became clear that I did have to and I went.

5) One course of antibiotics (rifaximin) for my SIBO. I think it did clear a least some of the bad gut bacteria out. I was better after that.

6) Special CSID/ASID diet. It's a real pain. But heck, I lost 20 lbs from never eating any sugar. A bit of compensation for all this woe. I was overweight.

All this takes a lot of tinkering. All I can say is I'm a lot better and can even schedule appointments in the morning now. Sometimes at night I have gas and am bloated but I try to ignore that and just go to sleep. Your digestive system goes to sleep, too, and really wakes up again in the morning. Best not to encourage it to come to life in the middle of the night!

@bell67 - welcome to Mayo Clinic Connect. Sounds like you've been through a tough journey just to have a normal BM. I'm glad to hear you are seeing a doctor who specializes in your condition.

Fellow members in this discussion who've talked about dyssynergia defacation may have some thoughts for you about what has helped with their conditions and if they've been able to do it without bisacodyl (Ducolax). Please meet @maggie1942 @aznelson2426 @jlstjohn @ltarashuk and others here.

What makes you want to stay away from the bisacodyl (Ducolax), bell67?

@bell67
I too have suffered from pelvic dyssynergia defecation. For me, it part of a whole constellation of other factors, all of which I had formally diagnosed (pelvic dyssynergia, SIBO, acquired sucrase isomaltase enzymatic deficiency, bad internal hemorrhoids, IBS-C). Have you been tested for any of these other things? It's hard or perhaps impossible to determine what is causing what. But one big factor in the dyssynergia is that gut-brain connection. I'm glad you've found some sort of biofeedback program. I couldn't find one, but a short course of physical therapy was helpful in teaching me a few things.

In my experience, you have to go at this from multiple angles.

Here is my regimen, and now, 2 years since all this began, I am much, much better. Not "cured" but 85-90% better. In particular, the dyssynergic defecation seems to be gone:

1) Poop-stool for proper position for defecation and doing a couple of breathing things that I learned in physical therapy.

2) Miralax in late afternoon every day. It's not actually a laxative, by the way, from what I understand. It's a stool softener, which makes your stools easier to pass. Particularly important if you have internal hemorrhoids.

3) Dulcolax before bedtime only if I've gone 2 days without a poop. One thing good to learn is that there is always some poop up there and you really don't have to poop every single day. Get over the idea that you have be completely cleaned out. Might not feel great but try not to focus on it.

4) Trying to restrict pooping to once a day (for me, AM after breakfast). Because of the hemorrhoids there are some days where my rectum constantly signals me that I need to poop, especially after I eat. It's a miscommunication of gut and brain. And it's a really weird feeling, like my ass "talking" to me. If I ignore the unpleasant feelings they 95% of the time go away within an hour. In the few instances where I really did have to go (3 times in last 6 months because of a virus or something), it eventually became clear that I did have to and I went.

5) One course of antibiotics (rifaximin) for my SIBO. I think it did clear a least some of the bad gut bacteria out. I was better after that.

6) Special CSID/ASID diet. It's a real pain. But heck, I lost 20 lbs from never eating any sugar. A bit of compensation for all this woe. I was overweight.

All this takes a lot of tinkering. All I can say is I'm a lot better and can even schedule appointments in the morning now. Sometimes at night I have gas and am bloated but I try to ignore that and just go to sleep. Your digestive system goes to sleep, too, and really wakes up again in the morning. Best not to encourage it to come to life in the middle of the night!

@rnewman12
There is only one GI who specializes in the deffecation issue and we are trying to locate a PT who will work with BioFeedback and one will not touch the Anus. Amazing. I am in extreme pain a lot of the time because of hemmoroids plus the stoll wantedee to pass and cannot. I have a lot of mucous. I've had a cololoocopy. We are hoping the PT I have been referred to wil do Bio Feedback. She will work with the Anorectal issue. I exercise the required exercises daily except once in a while I am in jiust too much pain. I have no life and the only time I go out is for an appointment in the afternon. Want to hear more of what everyone is doing. I take Miralax and Sun Fiber. Please excuse the grammar and misspellings I am funcially blind as the result of a series of strokes a few years ago . The defecation isue did not arise for a few years after that.

@maggie1942
Hi, Maggie. I'm so sorry you've been hit with so much. The hemorrhoids will improve if the constipation and dyssynergia improves. I was to the point of considering the surgery for the hemorrhoids which even the colorectal surgeon told me had a very difficult recovery but now things are under control enough so I won't need to do that. One thing to consider is whether lots of fiber is actually the right thing for constipation. My body can no longer process whole grains or woody vegetables like the stalks of broccoli well. There are other foods that provide bulk and fiber that are easier to digest. I also can't handle anything fermented. Sourdough bread has been a game-changer for me and now there's even a sourdough pasta (Bionaturae). Sourdough is easier to digest. And of course, drinking plenty of water helps too. But -- everyone is different. There is a lot of trial and error necessary to get anywhere. BTW, I'm menopausal and 68. Aging plays a role, too...

@rnewman12