Have had chronic anal pain for 6 years

Posted by pomegranite14 @pomegranite14, Aug 10, 2015

Very quick summary:

- 20 yr old

- have had chronic anal pain for 6 years

- been to many many doctors and had first been told there was no evidence of anything on my rectum. the next doctor said it was a hemorrhoid (telling me to eat more fiber and drink more water). the next, a thrombosed hemorrhoid. even one doctor said it was an inflamed varicose vein. then I went to see another doctor when the pain did not go away after years and years of this, and I was told it was an anal fissure. I then had the botox injection to heal the fissure (during which the doctor found 4) and because the area was numbed for days afterwards, I could not feel how hard I was straining to go to the bathroom and I developed a new hemorrhoid.

Today I am certain that same hemorrhoid turned into a skin tag which I have had for months now. The same doctor who performed the botox injection suggested I could have crohns because of all the fissures I had before. I did some research and think I could have perianal crohns. Most of my symptoms match up. I also have had very bad heartburn for years as well as constipation which I wonder could be a symptom as well. I take stool softeners everyday and have tried everything, (I am gluten-free and vegan for years) but still every time I go to the bathroom I am in excruciating pain.

I spend my summer in Colorado in the mountains and I think the altitude makes the pain worse. I recently ended up in the emergency room (my second visit just for fissure/hemorrhoid pain) because the pain after going to the bathroom was just too bad. They gave me a prescription for the pain killer norco to take after I go to the bathroom because the pain is too horrendous. That helps but constipates you which is even worse for fissures/hemorrhoids/skin tags. I do not know what to do, after I go I cannot move for hours, the pain lasts for as long as 14 hours.

I have tried everything, and have had chronic pain for 6 years now and just want to figure out a diagnoses. Every doctor has told me something different, I know crohns is difficult to diagnose, but I feel like this could be it.

Can anyone help me figure out what this is and if it does indeed sound like perianal crohns? I cant take it anymore

Thank you!!!

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@colleenyoung

Hi Yoanne,
Normally, I would recommend that you post questions related to a neurological condition to the Brain & Nervous System group. But in this case, you posted correctly to the Heart group since you suspect a correlation to your heart medical history.

Your questions definitely are beyond my medical knowledge or experience. I did a quick search and found a couple of mentions of a possible correlation between scintillating scotoma and cardiovascular issues. See
- https://www.reviewofoptometry.com/article/visual-aura--and-scotomas-what-do-they-indicate
- http://www.healthnadvise.com/health-blog/scintillating-scotoma-causes-and-symptoms

I'm also tagging @johnwburns on this conversation to see if he has experience or references to add.
I believe this is worth further investigation with your medical team.

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Try emu oil on and around the rectum. This is amazing. Also add prunes to your diet every day--lots sod prunes! I bet you will be amazing at the results.

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Can you have chrons and the doctors telling you that you have ibs? I’m in so much pain I can’t live with it anymore and no help from anyone. They actually told me, last visit, they do not know what’s wrong and cannot help me. That is what the dr at the Health Dept of palm beach said to me.

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Did you ever find out what it was ? I have same pain

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I was just treated with Anal Botox injections. The pains spasms have been horrific. I ama t day 4 post op and now have large hemmoroids. Is this common

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@harper2018

I was just treated with Anal Botox injections. The pains spasms have been horrific. I ama t day 4 post op and now have large hemmoroids. Is this common

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I'm tagging @richman54660 to join this discussion.

@harper2018, what did you have the anal botox injections for? Were you having the spasms before or after botox treatment?

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@harper2018 @pomegranite14 Sorry to hear about your pain. That area is highly innervated. I know I could sense pelvic floor tension and had pains in those areas, which can be disconcerting. Some things to try (I think these helped me):
-Pelvic floor exercises (Kegels for anus) and general exercise like Pilates, etc., that strengthens pelvic floor. It may take time and relief may come incidentally from strengthening and flexing the pelvic floor and your core (the psoas “Hip flexors” are the biggest part of the core). Pilates is one of the best types of exercise for this. I use a reformer but floor and core ball exercises might help a lot.
-If you can find a pelvic floor physical therapist specialist go see one or read about pelvic floor rehab as pelvic floor issues can cause that pain, too.
- a supplement called rutin. Often used for hemorrhoids by some docs (NHS, I think), while others seem oblivious and don’t know about it. I’d suggest a low dose (you can buy 50 mg tabs on Amazon) and titrate your way up. Beware don’t overdo as it makes the poo thicker (I.e pastier - may reduce mucus). This creates some difficulty going.... Which creates straining.... However, avoid straining as that can exacerbate the pain. However, the veins will be stronger, too, so a tiny strain would be OK (add stool softener and insoluble fiber along with a little rutin). However, rutin seems to heal the hemorrhoid at the right dose. Read people’s reviews. Some also claim diosmin / hesperidin can also help vessels heal, but these may increase pain sensation, too. Swanson has a nice mixture of this. Rutin is generally a sure bet, however. It’ll stop the bleeders. You can find those on Amazon.
-for dietary fiber, not only use insoluble fiber, consider using heathers tummy fiber which is an soluble fiber (soluble is found in Peak performance organic greens, too, a supplement powder I take at one meal; I use Heathers at two other meals - 1 teaspoon only). Soluble tends to glue the poo all together and may smooth out any bowel issues. Also, find the right balance too much fiber can cause issues as it is a FODMAP. I do have some mild IBS-D myself and I slow with small doses of Imodium, but that’s me. Almost no one has much soluble fiber, unless your taking a soluble fiber supplement. Insoluble fiber is all around in veggies and in your powders,etc.

There are some things to try. Proper exercise and smoothing out the bathroom habits (often via diet, too) can go a long way in some cases of pain down there. Good luck!

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@colleenyoung

I'm tagging @richman54660 to join this discussion.

@harper2018, what did you have the anal botox injections for? Were you having the spasms before or after botox treatment?

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I have been diagnosed with pelvic floor dysfunction and have been seeing a PT who has been worked with me but only on my vagina. I had a rectal abscess in April, the dr. Felt it could have been caused by a chronic fissure. He didn’t see a fissure but said the anal sphincter was in spasms. Botox was recommended to stop the spasms and to treat what he believed was a fissure that he didn’t see on exam. After the Botox I was told the fissure was totally healed but there were rectal spasms. I was and am in extreme pain immediate following surgery with multiple lumps and bumps around my rectum with bleeding. Saw the PA yesterday and was told that I have multiple fissures and sentinel piles not hemmoroids. I did not have this before surgery and she is saying I must have had an event, straining that caused this. I don’t recall any such event and they deny it is the Botox. I am extremely depressed and feeling so hopeless. Not sure I can continue a life like this. This is all worse that before the surgery.

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@harper2018

I have been diagnosed with pelvic floor dysfunction and have been seeing a PT who has been worked with me but only on my vagina. I had a rectal abscess in April, the dr. Felt it could have been caused by a chronic fissure. He didn’t see a fissure but said the anal sphincter was in spasms. Botox was recommended to stop the spasms and to treat what he believed was a fissure that he didn’t see on exam. After the Botox I was told the fissure was totally healed but there were rectal spasms. I was and am in extreme pain immediate following surgery with multiple lumps and bumps around my rectum with bleeding. Saw the PA yesterday and was told that I have multiple fissures and sentinel piles not hemmoroids. I did not have this before surgery and she is saying I must have had an event, straining that caused this. I don’t recall any such event and they deny it is the Botox. I am extremely depressed and feeling so hopeless. Not sure I can continue a life like this. This is all worse that before the surgery.

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Wow. You need an excellent gastro doc. What area are you in? Take control of getting the best referral you can for a second opinion then get help!!!!

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@harper2018

I have been diagnosed with pelvic floor dysfunction and have been seeing a PT who has been worked with me but only on my vagina. I had a rectal abscess in April, the dr. Felt it could have been caused by a chronic fissure. He didn’t see a fissure but said the anal sphincter was in spasms. Botox was recommended to stop the spasms and to treat what he believed was a fissure that he didn’t see on exam. After the Botox I was told the fissure was totally healed but there were rectal spasms. I was and am in extreme pain immediate following surgery with multiple lumps and bumps around my rectum with bleeding. Saw the PA yesterday and was told that I have multiple fissures and sentinel piles not hemmoroids. I did not have this before surgery and she is saying I must have had an event, straining that caused this. I don’t recall any such event and they deny it is the Botox. I am extremely depressed and feeling so hopeless. Not sure I can continue a life like this. This is all worse that before the surgery.

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@harper2018 I might recommend something unconventional. I have lower lumbar DDD and that makes for pain sensitivity to those area you're talking about. I think you should really try the enzymes nattokinase, serrapeptidase and lumbrokinase. You'll want to add them slowly and also keep doing exercises that keep you moving and strengthen the pelvic floor (I personally love TRX suspension work and Pilates reformer). You can heal and the tissue can remodel. You can also boost your consumption of flavinoids in general + extra vitamin C spaced out to assist with healing. I believe the enzymes will be the miracle workers including gettting rid of bumps / cysts / etc.. I'm going to post a review I wrote for a book by Dr. Greg Fors re: "why we hurt and how we heal". In that review, I've summarized everything that I do along with a review of the book. Beware: the enzymes might be counterindicated if you are on blood thinning medications (warfarin, etc.). Also, about 10% of people are irritated by these (gastrointestinal irritation). Otherwise, you should be OK. There are affordable versions of nattokinase and Serrapeptidase out there. Here goes with the review and protocol.
Dr. Fors book. Why we hurt. How we heal. Sorry, this is a long post:

I've had some chronic myofascial pain in glutes and legs and I've found essentially the "cure" on my own. In the meanwhile I'd read other books such as "A headache in the pelvis". That book talks about the problem but doesn't specifically give you the cures (only some "cures"). However, Dr. Fors book is the go to book with practical tips and suggestions. His own story "case study" could practically have been my story with sitting pain and muscular tension. In his book Dr. Fors talks about oxidative stress on tissues, etc. For a person who's interested perhaps you could read it all. However, you can skip some and just go to the practical parts and use that information instead. I personally believe it is poorer circulation and poorer tissue remodeling as we age that causes these issues like myofascial tension and pain (including neuropathic pain). Apparently, I had some fibrosis / extra clotting going on as I got older (i.e. 58-ish). I believe the fibrosis in tissues / veins was causing poorer circulation and stiffness. While speculative, it may be deposits of fibrin (the blood clotting protein) that causes issues when deposited in veins, arteries and tissues and that tends to recruit cells of the immune system (granulocytes) and, hence, you also get "inflammation" (there is your low-grade autoimmunity tie in; these are my opinions; not something Dr. Fors mentioned). I believe this was true in my case. Supplements may alter and reduce this process. Read below for specific suggestions - many of which were mentioned in Dr. Fors book (I added 2 supplements to my regimen as a result of Dr. Fors' suggestions).

I do believe the supplements are the key to promote healing and proper tissue remodeling / regeneration which may go awry as we age and don't heal properly without the correct supplementation. Said differently, as you age you may need to supplement your diet with various plant substances and minerals, etc., for best health. His book is worth the price of that information alone which he details in a chapter on supplements / nutrition - but he doesn't mention adding a little hemp seed oil, etc. (I'm just writing this off the top of my head - there is a lot in this book - maybe he did mention healthy fats). As you take supplements, do check your blood pressure as these can vary it.

For me, proper supplementation (I added on a couple of Dr. Fors' suggestions, along with stretching and exercise) have largely "cured" my tension and pain in the lower back and glutes. I have lower lumbar degenerative disc disease (which is most likely a “perpetuating factor” for myofascial pain) but all my pain comes from muscular tension and pain - which can be controlled without NSAID's and without antidepressants for me (although for a time, I did use some nortryptline for nerve pain). Honestly, if you cure your gut health (Dr. Fors has a whole chapter on that) and take the right supplements, your myofascial tension and pain may go away on its own without needing to do a bunch of trigger point work (possibly; that is what happened to me - but he has a whole chapter on trigger point removal and has invented a tool you can buy separately for trigger point work - instead of using the usual balls and rollers for this). As one other reviewer said, until the root problem is cured the trigger points might simply come back - they did for me, too, at one time.

He has whole chapters about each topic. Especially, adding various supplements such as Flavinoids and flavolignins can really help you heal. Some of the supplements Dr. Fors mentioned such as ginger extract to calm digestion and Milk thistle extract (source of flavinoids) is one of many you can take (silymarin, the active ingredient in milk thistle extract, is a bunch of flavolignins, I believe; I also take diosmin / hesperidin and some quercetin (stay below 500 mg or so daily); these are all flavinoids, I believe / resveratrol; ORAC energy greens (full of plant stuff and - you guessed it flavinoids) and extra vitamin C (staying below 2000 mg daily) and a tblsp of hemp seed oil, and turmeric.

The regimen I use along with stretching and exercise reversed or is cutting down on my sitting pain / neuropathic pain in the legs and glutes (i.e. less "sciatica") and reduced fibrosis in the muscles/veins, etc. I also supplemented with enzymes nattokinase / serrapeptidase and lumbrokinase, too, taken between meals to help with possible fibrin (or other amyloid type deposits) in veins / tissues. These are counter-indicated if you have clotting disorders or about 10% of people simply don't tolerate these in the gut. These have never bothered me and helped tremendously. Unfortunately, Dr. Fors did not mention those supplements that might reduce depositions of proteins in veins / tissues and are thought to be anti-inflammatory. However, these might still be considered “alternative medicine” in the west despite being used in Asia for years. Regardless, you might cure your issues with the right supplements alone, without those enzymes. I found milk thistle extract, recommended by Dr. Fors, was a good addition to the above substances as a source of flavinoids. Yes, cut down on added sugars, too, as Dr. Fors (and everyone else in the universe talks about). I had tried some of the other supplements he mentioned (like devils claw - but found it increased my blood pressure). Many others actually lowered my blood pressure!

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@marlailene111

Wow. You need an excellent gastro doc. What area are you in? Take control of getting the best referral you can for a second opinion then get help!!!!

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@marlailene111 @harper2018 This is just my opinion. The problem is: pelvic floor dysfunction and also the spasms of muscles are classic signs of myofascial pain. Stretching, exercise, supplements and some particular treatments of the pelvic floor are more likely to be fruitful than other approaches (There is a lot less invasive treatments than Botox injections, I think, moving forward). A lot of the pain and dysfuction may go away with changing diet and exercise (this takes time).
Hence, the long detailed post I made recently about Dr. Fors book and some info about supplements I've used may help a lot. A lot of that is done by you and a good pelvic floor therapist will also help greatly, I think.

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