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Bloating, Gastric Problems, Constipation, Rectal Pain

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Posted on Thu, 7 Jun 2012
Question: Hi I am a 57 year old female. Have always suffered with digestive problems i.e. bloating and gas. 2 months ago I spent a day straining through constipation and the next day developed a pain down below. The pain seems to move around and sometimes I feel certain it is rectal and other times if feels vaginal. Sometimes part of my labia feels numb. Very concerned about all this. My doctor has examined me 3 times but can't find anything or anywhere that pain is coming from. Everything else is normal, ie stools etc. Pain seems to go for a few days and then comes back. Never have it when I am lying down or in the mornings always comes back as the day progresses.
doctor
Answered by Dr. Mitaly (17 minutes later)
Hi,

Thanks for writing to us.

There could be various causes of pain in the rectal area but since you had constipation and have gastric problems so the first posibility which comes in mind could be due to:

1)The presence of vascular deformities like hemorrhoids, rectal prolapse or inflammatory bowel disease like Crohn’s disease.

2) Procatlgia fugax: It is episodic anal pain that occurs due to contraction of the anal muscles.Treatment involves warm sitz baths,over the counter pain killers like ibuprofen.

3)Levator ani syndrome: Levator ani is group of muscles that surrounds and supports the anus. Spasms of these muscles are believed to cause rectal pain and can occur frequently in women.

Some suggestions for you:
1.Certain foods, such as cauliflower, broccoli, cabbage, brussels, sprouts and legumes (beans) may worsen bloating and gassiness.

2.Dietary fiber may lessen symptoms.You should drink plenty of water, and avoid soda,alcohol which may cause gas and abdominal discomfort.

3.Eating smaller meals may lessen the incidence of pain.

4.Low fat and high carbohydrate meals such as pasta, rice, and whole grain breads may help.


If your condition does not improve then consider to get a per rectal examination and investigations like colonoscopy, nerve conduction velocity and ultrasound done to confirm the diagnosis. Kindly visit your Primary Physician and if required he might refer you to a Surgeon.

Hope this answers your query.I will be available for follow up query if any.
Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Mitaly (1 hour later)
I only had constipation for that one day and have never suffered with it before. At first I thought I had strained something when the pain appeared next day. However, I cannot understand how the pain appears to move about. Sometimes its only on left and sometimes on right. Other times it feels like a dull ache in the vagina and then another day it seems to be rectal. Its is always worse when sitting and as i said never when I am asleep or for the first few hours in the morning. I think this change of symptoms is what is confusing my GP. The pain is dull and nagging (like a toothache) and can disappear for days and then starts building up again until I have it again for 2 - 3 days and then disappears. I am very confused.
doctor
Answered by Dr. Mitaly (47 minutes later)
Hello,

Thanks for the follow up.

A detailed examination of the rectal and vaginal area could be helpful.Colonoscopy and USG scan can be considered as it would help in ruling out the cause.

It can be even due to hormonal changes since you are menopausal.

You can have Sitz bath and then observe for any changes.

Kindly discuss with your GP regarding the investigations.

Wishing you Good health!
Regards
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Above answer was peer-reviewed by : Dr. Radhika
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Answered by
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Dr. Mitaly

General & Family Physician

Practicing since :2005

Answered : 466 Questions

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Bloating, Gastric Problems, Constipation, Rectal Pain

Hi,

Thanks for writing to us.

There could be various causes of pain in the rectal area but since you had constipation and have gastric problems so the first posibility which comes in mind could be due to:

1)The presence of vascular deformities like hemorrhoids, rectal prolapse or inflammatory bowel disease like Crohn’s disease.

2) Procatlgia fugax: It is episodic anal pain that occurs due to contraction of the anal muscles.Treatment involves warm sitz baths,over the counter pain killers like ibuprofen.

3)Levator ani syndrome: Levator ani is group of muscles that surrounds and supports the anus. Spasms of these muscles are believed to cause rectal pain and can occur frequently in women.

Some suggestions for you:
1.Certain foods, such as cauliflower, broccoli, cabbage, brussels, sprouts and legumes (beans) may worsen bloating and gassiness.

2.Dietary fiber may lessen symptoms.You should drink plenty of water, and avoid soda,alcohol which may cause gas and abdominal discomfort.

3.Eating smaller meals may lessen the incidence of pain.

4.Low fat and high carbohydrate meals such as pasta, rice, and whole grain breads may help.


If your condition does not improve then consider to get a per rectal examination and investigations like colonoscopy, nerve conduction velocity and ultrasound done to confirm the diagnosis. Kindly visit your Primary Physician and if required he might refer you to a Surgeon.

Hope this answers your query.I will be available for follow up query if any.