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Have had chronic anal pain for 6 years

Digestive Health | Last Active: Jun 19, 2020 | Replies (15)

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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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Replies to "I have been diagnosed with pelvic floor dysfunction and have been seeing a PT who has..."

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!!!!

@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!