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Chronic constipation and pointed pain behind rectum
Hi all,
I posted in the autoimmune group earlier, but my symptoms have worsened in the digestive regard. Im (32F) with chronic constipation since 2013 when I first experienced rectal bleeding.
In the past year and a half I've gone to the ED 3 times. All three times every test came back normal even when I had gallbladder pain. I've had 2 CT scans, ultrasoumds, xrays, an endoscopy, HIDA scans, pelvic floor dysfunction testing, and colonoscopies ×2 (return in 7 years).
Recently, I've really been struggling with abdominal pain. I went to a same day clinic and she basically asked me why I was there when I frequently experienced rectal bleeding. I told her its been more than two weeks and she told me to increase fiber (this only makes my constipation worse- even in small increments).
When I went in to see an internal medicine specialist for a follow up (my PCP was booked), she told me that my bowels sound like an 80 year olds. Idk what Im supposed to do with that information.
I drink 100+ oz of water a day, when I take fiber supplements it makes the constipation way worse, I take 2 caps of miralax daily (it doesnt always help).
My biggest complaint recently is pain behind my rectum. It feels like there's someone either pushing on my rectum or it feels like there's a large marble behind it. It used to only hurt during bms but I can feel the pain constantly.
A while ago, I couldn't stop bleeding from hemorrhoids. Thankfully, I havent bled in a week or so, but short of continuing to feel full and feeling like I need a weekly dulcolax, I'm out of ideas.
I have many medical diagnoses that complicate this issue. The most likely are: endometriosis (currently managed by 5mg of norethedrone), Mast Cell Activation Syndrome, or hypothyroidism.
Other diagnoses include: Charcot-Marie-Tooth type 1c/peripheral neuropathy, Fibromyalgia, chronic fatigue, POTS/autonomic neuropathy, Ehlers-Danlos Syndrome (hEDS), pelvic floor dysfunction, anxiety, depression, adhd, ptsd, sleep apnea, low libido, nightmares, periodic leg movement disorder, chronic constipation, hemorrhoids (due to constipation), TBI x 2 in last 15 years,
If you've made it this far, my username is based on a joke I told my spouse. Doctors are told to look for horses, not zebras. Well, that must mean I'm a unicorn then with all of my different diagnoses (I still feel like I have another autoimmune disease too). Any help, advice, or recommendations are highly appreciated. I'm sick of feeling full of shit, literally.
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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?
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2 ReactionsHi @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?
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1 ReactionI'm so sorry you are having all of these issues besides constipation! That must be just awful for you. Apparently the laxatives you are using aren't helping that much. I have an old home remedy that my grandmother and mother used for constipation ever since the 1920's. I'm 80 and still use it today. It works and is natural. I hope it can help you somewhat.
Prayer also works. Just ask God for help and you will get it. I will say a prayer for you also. I wish you the best!
PML
Put a teaspoon or more if needed, of baking soda (the kind you cook with – Arm and Hammer) dissolved in a glass of water. Drink the whole glass. You may want to squeeze a little lemon juice in it to make it taste better. It tastes awful, but it works and is natural. Stay near the bathroom. It works fairly fast. By the way, this also helps get rid of gas and bloating. After it works, try and drink a lot of water to keep from being dehydrated.
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.
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1 ReactionI 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?
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2 ReactionsOh 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.
@researchmaven
I agree with the no fiber approach. Only made me worse too!
When things are real tough for me, I make what I call my prune juice cocktail which includes prune juice mixed with Milk or Magnesia. Several nights a week I take 2 stool softeners with a glass of prune juice.
Also, my gastro doc prescribes Trulance for me. This Rx med is powerful!
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1 ReactionHi bug3, Agree! Adding extra fiber is worse and has me going in the wrong direction. Wishing you well.
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.