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Suggest Treatment For Chronic Rectal Pain In The Anal Sphincter
Question: Hi.
28 Years old male. I always get healty nutritions. The only bad habit is, i drink dark black tea so much.
I actually have some depression/stress. But it is not that much. Some small work related problems.
I have chronic rectal pain in the anal sphincter, it is generally tightness sensation, but sometime it is pain. It started a month ago with a anal tenesmus without pain. After 3 days, tenesmus was complately vanished and pain started.
It is relieved when i go to bed. When i wake up at nights, or in the morning there is no sign of pain or sensation.. After i get out of the bed and walk or sit for 1-2 hours i feel some sensation in rectum which becomes sharper sometimes. When the pain is a little sharper, i stretch my buttocks, or move front and back when i am in a sitting position. It strecthes the anal sphincter and the pain temporarily goes.
During colonoscopy, the doctor said that "the rectum is too tight due to spasm. i can't even insert the tube." The diagnosis was, Grade 2 internal hemmorhoid. (Retroflexion hemorrhoidal hyperplasia) (But when i reviewed the colonoscopy recording at home i see a red small dot which i think can be anal fissure. During the tenesmus, when there was no pain yet, i had a finger test in the rectum. I think my nail can cause the tear. See the attachments please)
Bowel movements are quite normal. Once per day. No pain, No bleeding. No burning sensation. No narrowing in the stool. Stool shape is ok.
What is interesting, even in the sharpest pain period, if i start masturbation or sexual intercourse, the pain goes immediately and complately. 10-15 minutes later, it comes back.
Online research suggest that is it Levator Ani Syndrome or Proctalgia fugax. As far as i know proctalgia fugax has sharp pain, even sharper at nights. But i have no pain (not even sensation) at nights. I used Meteospasmyl by prescription. I don't think it helped me.
Regards
28 Years old male. I always get healty nutritions. The only bad habit is, i drink dark black tea so much.
I actually have some depression/stress. But it is not that much. Some small work related problems.
I have chronic rectal pain in the anal sphincter, it is generally tightness sensation, but sometime it is pain. It started a month ago with a anal tenesmus without pain. After 3 days, tenesmus was complately vanished and pain started.
It is relieved when i go to bed. When i wake up at nights, or in the morning there is no sign of pain or sensation.. After i get out of the bed and walk or sit for 1-2 hours i feel some sensation in rectum which becomes sharper sometimes. When the pain is a little sharper, i stretch my buttocks, or move front and back when i am in a sitting position. It strecthes the anal sphincter and the pain temporarily goes.
During colonoscopy, the doctor said that "the rectum is too tight due to spasm. i can't even insert the tube." The diagnosis was, Grade 2 internal hemmorhoid. (Retroflexion hemorrhoidal hyperplasia) (But when i reviewed the colonoscopy recording at home i see a red small dot which i think can be anal fissure. During the tenesmus, when there was no pain yet, i had a finger test in the rectum. I think my nail can cause the tear. See the attachments please)
Bowel movements are quite normal. Once per day. No pain, No bleeding. No burning sensation. No narrowing in the stool. Stool shape is ok.
What is interesting, even in the sharpest pain period, if i start masturbation or sexual intercourse, the pain goes immediately and complately. 10-15 minutes later, it comes back.
Online research suggest that is it Levator Ani Syndrome or Proctalgia fugax. As far as i know proctalgia fugax has sharp pain, even sharper at nights. But i have no pain (not even sensation) at nights. I used Meteospasmyl by prescription. I don't think it helped me.
Regards
Brief Answer:
The red spot is a tiny blood vessel
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Sir
Thanks for providing the screenshot. It is definitely not anal fissure. Anal fissure is a small linear ulcer at anal opening at the junction of skin and anus and is quite obviously seen during external examination. Had there been anal fissure , the bowel movements would have been quite painful and occasionaly associated with blood. Also colonoscopy would have been contra-indicated and would have been easily seen on colonoscopy examination. The red spot what you see is a small bleeding spot likley to be due to small loose vessel and is an insignificant finding.
The cause of your pain is likely to be Proctalgia fugax as previously advised by me. Young individuals have non specific spasm of of levator muscle usually associated with high resting tone of muscle and any stress leads to spasm and associated tightness.
I would suggest you the following
1. Hot Seitz bath: In a tub of lukewarm water add 1 spoon of anti-septic solution. Sit in it for 15 to 20 minutes each session atleast twice a day. The warmthness will relax the muscle
2. Meditation and yoga have been very helpful in many of my patients
3. Diverting the mind away from issue will definitely be helful
Rest be assured the problem should subside gradually.
Do get back to me if you need any further assistance, will be glad to assist you.
Do keep me updated about developments
Take Care
Best Regards
Dr Deepak
The red spot is a tiny blood vessel
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Sir
Thanks for providing the screenshot. It is definitely not anal fissure. Anal fissure is a small linear ulcer at anal opening at the junction of skin and anus and is quite obviously seen during external examination. Had there been anal fissure , the bowel movements would have been quite painful and occasionaly associated with blood. Also colonoscopy would have been contra-indicated and would have been easily seen on colonoscopy examination. The red spot what you see is a small bleeding spot likley to be due to small loose vessel and is an insignificant finding.
The cause of your pain is likely to be Proctalgia fugax as previously advised by me. Young individuals have non specific spasm of of levator muscle usually associated with high resting tone of muscle and any stress leads to spasm and associated tightness.
I would suggest you the following
1. Hot Seitz bath: In a tub of lukewarm water add 1 spoon of anti-septic solution. Sit in it for 15 to 20 minutes each session atleast twice a day. The warmthness will relax the muscle
2. Meditation and yoga have been very helpful in many of my patients
3. Diverting the mind away from issue will definitely be helful
Rest be assured the problem should subside gradually.
Do get back to me if you need any further assistance, will be glad to assist you.
Do keep me updated about developments
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi.
Thanks for detailed answers.
I have uploaded pdf file. There is a link to my colonoscopy video. Can you please review it ? Especially at 5:55.
Months ago i had tension headache and "lump in throat" feeling, both are told to be related to depression. When i was child i was urinating so frequently. Doctors said it is also brain related issue.
Would you recommend to get antidepressants or get Neurologist help?
Regards.
Thanks for detailed answers.
I have uploaded pdf file. There is a link to my colonoscopy video. Can you please review it ? Especially at 5:55.
Months ago i had tension headache and "lump in throat" feeling, both are told to be related to depression. When i was child i was urinating so frequently. Doctors said it is also brain related issue.
Would you recommend to get antidepressants or get Neurologist help?
Regards.
Brief Answer:
There is nop organic lesion in colonoscopy
Detailed Answer:
Dear Sir
Thanks for uploading the video.
I have reviewed tthe whole video. It does not show any gross abnormality. Also the area seen at 5.55 is recto-sigmoid junction which is normal looking and there is no abnormality seen.
I would suggest a routine assessment Psychiatrist. Also meditation and yoga will be very helpful in providing the much needed relief.
Take Care
Regards
Deepak
There is nop organic lesion in colonoscopy
Detailed Answer:
Dear Sir
Thanks for uploading the video.
I have reviewed tthe whole video. It does not show any gross abnormality. Also the area seen at 5.55 is recto-sigmoid junction which is normal looking and there is no abnormality seen.
I would suggest a routine assessment Psychiatrist. Also meditation and yoga will be very helpful in providing the much needed relief.
Take Care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi. Mr XXXXXXX Kaltari.
Thanks a lot for detailed answer. In last 2 days i already feel some pain relieve.
Do you recommend any diet for proctalgia fugax?
By the way, i have one more question, but if this question is out of support scope, please just ignore it. During transabdominal rectal cancer surgery, is general or regional anesthesy recomended ?
Have a nice day.
Regards
Thanks a lot for detailed answer. In last 2 days i already feel some pain relieve.
Do you recommend any diet for proctalgia fugax?
By the way, i have one more question, but if this question is out of support scope, please just ignore it. During transabdominal rectal cancer surgery, is general or regional anesthesy recomended ?
Have a nice day.
Regards
Brief Answer:
General anaesthesia is preferred anaesthesia
Detailed Answer:
Hi
Dear Mr Helix
I would suggest you the following
1. Plenty of oral fluids: 2-3 liter of water a day
2. High fibre diet: 2 servings of vegetable salad and fruits everyday
3. Avoid alcohol/carbonated / caffeinated beverages
4. Avoid junk food and food low in fibre content
During Transabdominal rectal surgery the preferred anaesthesia is General anaesthesia with Endotracheal intubation. Along with that regional block like Epidural or Spinal anaethesia can also be given along with general anaesthesia
Take Care
Best Regards
Dr Deepak
General anaesthesia is preferred anaesthesia
Detailed Answer:
Hi
Dear Mr Helix
I would suggest you the following
1. Plenty of oral fluids: 2-3 liter of water a day
2. High fibre diet: 2 servings of vegetable salad and fruits everyday
3. Avoid alcohol/carbonated / caffeinated beverages
4. Avoid junk food and food low in fibre content
During Transabdominal rectal surgery the preferred anaesthesia is General anaesthesia with Endotracheal intubation. Along with that regional block like Epidural or Spinal anaethesia can also be given along with general anaesthesia
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi. Thanks a lot for detailed answers.
My rectal pain has complately gone. i didn't do anything actually. Only tried to forget about it and it helped.
I have last question, it is safe to use "butter oil" in meals instead of vegetable oils ?
Regards.
My rectal pain has complately gone. i didn't do anything actually. Only tried to forget about it and it helped.
I have last question, it is safe to use "butter oil" in meals instead of vegetable oils ?
Regards.
Brief Answer:
Vegetable oil is preferred
Detailed Answer:
Dear Sir
That's good to know that pain has subsided.
vegetable oil is preferred as it's rich in polyunsaturated fatty acid as compared to other oil . I would recommend use of vegetable oil especially sunflower oil.
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Dr Deepak
Vegetable oil is preferred
Detailed Answer:
Dear Sir
That's good to know that pain has subsided.
vegetable oil is preferred as it's rich in polyunsaturated fatty acid as compared to other oil . I would recommend use of vegetable oil especially sunflower oil.
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Dr Deepak
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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