Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

165 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest the type of specialist to consult for endometriosis

Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

default
Posted on Thu, 14 Aug 2014 in Brain and Spine
Question: Hi. I'm a 39-year old woman of healthy weight with fairly serious degenerative disc disease in my lower back (being monitored by a neurosurgeon, but no surgery as of yet). I also suffer from constipation-prevalent IBS. I've had near-constant pain in my lower back for years, but lately I've had severe, sharp pain in my tailbone. It is noticeably worse when I'm constipated. I have suffered from mild rectal prolapse on and off for a few years, have endometriosis, and have had twins, all of which make bowel movements slow and difficult. I use a stool softener/laxative recommended by my GI doc, and I have a diet rich in fiber. I've also had 4 separate laparoscopic procedures to remove endometriosis, some of which was growing near my rectum. I guess I'm just wondering which of my doctors I should be seeing first, lol! The pain is extremely severe when standing up or bending, and it's gone from occasional bouts to being constant. It's impacting my daily activities. Advice? I feel like a walking train-wreck!
doctor
Answered by Dr. Shafi Ullah Khan 4 hours later
Brief Answer:
Needs management

Detailed Answer:
Thank you for asking
You would be surprised to know that endometriosis is most of the time presented with a correlated bowel IBS symptoms due to predispositions still to be researched.
Degenerative disc disease has also a role in your constipation etc as nerves arise from that place and pain there can compromise function down here in rectum etc.
So first seek a gynecologist and get a management for endometriosis.50 % of bowel symptoms will resolve.you are young and might be needing babies so discuss some conservative options apart from pharmacotherapy like pre sacral neurectomies, LUNA laptop comic uterine nerve ablation etc.
Then comes the degenerative disc disease.seek a rheumatologist and a physiotherapist in this regard for the conservative management and exercises to help the pain and if need be one mild interventional procedures and surgery if necessary losing weight and avoiding lifting heavy weights would be advised.
Then comes ibs.that for you are already on diet and lifestyle modifications

Dietary measures may include the following:
Fiber supplementation may improve symptoms of constipation and diarrhea
Polycarbophil compounds (eg, Citrucel, FiberCon) may produce less flatulence than psyllium compounds (eg, Metamucil)
Judicious water intake is recommended in patients who predominantly experience constipation
Caffeine avoidance may limit anxiety and symptom exacerbation
Legume avoidance may decrease abdominal bloating
Lactose and/or fructose should be limited or avoided in patients with these contributing disorders
Although evidence is mixed regarding long-term improvement in GI symptoms with successful treatment of psychiatric comorbidities, the XXXXXXX College of Gastroenterology has concluded the following:
Psychological interventions, cognitive-behavioral therapy, dynamic psychotherapy, and hypnotherapy are more effective than placebo
Relaxation therapy is no more effective than usual care
Pharmacologic agents used for management of symptoms in IBS include the following:
Anticholinergics (eg, dicyclomine, hyoscyamine)
Antidiarrheals (eg, diphenoxylate, loperamide)
Tricyclic antidepressants (eg, imipramine, amitriptyline)
Prokinetics
Bulk-forming laxatives
Serotonin receptor antagonists (eg, alosetron)
Chloride channel activators (eg, lubiprostone)
Guanylate cyclase C (GC-C) agonists (eg, linaclotide)
Antispasmodics (eg, peppermint oil, pinaverium, trimebutine, cimetropium/dicyclomine).
I hope it helps. Take good care of yourself and don't forget to close the discussion please.
May the odds be ever in your favour.
Regards XXXXXXX


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Treatment/Therapy ,  
Medical Topics

Recent questions on  Sharp pain

doctor1 MD

Hello Sir/Mam, My self XXXXXXX XXXX and i m 29 yrs old.I m accountant by profession.from last 1 yr i m suffering from Sinus problem.I DAILY FEEL PAIN IN MY FOREHEAD IN MORNING NEAR 11-12 AM. AND IT IS NOT SHARP PAIN .I FEEL PAIN IN MY FOREHEAD AND...

doctor1 MD

I HAVE BEEN HAVING SEVERE CRAMPS/SHARP PAINS IN MY PELVIS FOR THE LAST 2 DAYS. IT IS SPORADIC BUT VERY UNCOMFORTABLE WHEN IT OCCURS. I CANT PINPOINT ANYTHING THAT I HAVE EATEN OR DONE THAT WOULD CONTRIBUTE TO THE ISSUE. I HAVE ALSO EXPERIENCED A...

doctor1 MD

My 17 year old daughter has sharp pain on her left side of her abdomen and has thrown up twice. She doesn't have a fever , I'm just curious what this could be; the pain woke her up

doctor1 MD

Two days ago I started getting occasional sharp pain inside my right ear and occasional shooting pains in my head, also on the right side. My head feels a little tender in that spot. I also noticed some small, painless lumps on my jaw line under my right ear. I have no idea if they re related to the other symptoms. Any ideas what this could be?

doctor1 MD

My period is now 16 days late, and it is very regular...I use a menstruation tracker. I have been feeling sick to my stomach, getting headaches, severe backaches, and feeling dizzy. I did take a pregnancy test, but it was negative, so I wasn't too worried because I am on the pill (although there were probably a few times where I forgot to take it and then doubled up the next night). Suddenly today, I started getting severe sharp pains in my lower abdomen (mostly on the left side, but radiating to both sides) and severe pains in my upper abdomen, like I was going to throw up...I feel weak and started to have bright red bleeding, although it isn't heavy. all day today before the pain, I was having brown discharge that had stringy clots in it. I am debating on visiting the ER and wanted to ask your opinion.