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Diarrhea,rectum pressure,painful bowel movement

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Internal Medicine Specialist
Practicing since : 1998
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I am a 24 year old white female. 118 lbs and 5ft tall. I have been diagnosed with IBS-D. I sometimes have this terrible pulsating and throbbing pressure in my rectum or in the sphincter and I am not sure what causes it other than stress on my body from constant diarrhea. It is not incredibly painful but just uncomfortable. I do have a lot of pain with bowel movements lately though.. What could this be? I don't currently have insurance so I don't have a doctor to see but I don't know if this is something serious that I need to have checked out, or if this is common for IBS. I have researched this online and have not found much information on it. Can you help me?
Posted Wed, 18 Apr 2012 in Digestion and Bowels
Answered by Dr. Jasvinder Singh 2 hours later

Thanks for posting your query.

The first possibility for your symptoms is of course IBS (due to contraction of the anal muscles.Treatment involves warm sitz baths,over the counter pain killers like ibuprofen and botox shots in severe cases.

2)     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.

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

You will need to checkout whether you have lactose intolerance, if such food causes diarrhea you will have to stop it.

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, which may cause gas and abdominal discomfort.

3.Eating smaller meals may lessen the incidence of cramping and diarrhea.

4.Low fat and high carbohydrate meals such as pasta, rice, and whole grain breads may help IBS symptoms . If you have celiac disease you can get gluten free flours.

If your condition does not improve i then suggest you to get a per rectal examination and investigations like colonoscopy, nerve conduction velocity and ultrasound done to confirm the diagnosis. You need to consult a surgeon for the physical examination.

Hope this answers your query.

If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Diarrhea,rectum pressure,painful bowel movement 20 hours later
Thank you for the answers. I appreciate your advice.
I know that I am not lactose intolerant but even so, I try to limit the amount of dairy I eat.
I try to eat fiber all the time because I was told that I need to increase fiber in my diet. But it seems like fiber actually worsens my symptoms! Are there certain fiber foods I should eat and certain ones to avoid? It seems like any time I eat any type of salads or raw veges it gets worse. If I do have any of the first two types of disorders you described, is a sitz bath and ibuprofen all that can be done for it? Thanks for all your help.
Answered by Dr. Jasvinder Singh 16 hours later

Thanks for writing back.

You can start with making some lifestyle changes. Alterations in diet, like gradual addition of whole grain breads, XXXXXXX leafy vegetables & fruits can ease your symptoms. Avoid taking cabbage, cauliflower, broccoli, beans and lentils, caffeinated drinks (tea, coffee) aerated drinks, fried and spicy foods.

Also drink plenty of fluids and water and try to stop smoking or alcohol if there is history of intake of any such substance. Also start doing daily exercises, brisk walks, XXXXXXX breathing exercises which help in preventing constipation.

Regarding proctalgia fugax and levator ani syndrome, discomfort may be relieved by walking or pelvic tightening exercises similar to Kegel exercises. Other treatments include massage of the muscle, warm baths, muscle relaxant medications, botox injections, NSAID painkillers and low dose diazepam at bedtime.

You can discuss these treatment options with your doctor and then start with the best one for you.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
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