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Dr. Andrew Rynne

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Exp 50 years

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Suggest treatment for knee and back pain

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Dr. Salah Saad Shoman

Internal Medicine Specialist

Practicing since :2004

Answered : 2118 Questions

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Posted on Sat, 4 Mar 2017 in Medicines and Side Effects
Question: Hi, I'm looking for incite into a situation that occurred over the summer. I had a get together for my birthday back in August 2016. One of my girlfriends who was there decided to drink (even though she hasn't drank since November 2015). She chose to drank liquor and ended up falling. The way she fell was her leg went in between wooden deck and an out of ground pool, basically straddling the deck. The deck is also elevated to the pool. We helped her up and all she complained of was knee pain. She eventually became sick and began vomitting and dry heaving for a little while. I and a male friend of mine were in the room taking care of her at the same time and then took rotations until she fell asleep. She did complain of stomach pain before she finally went to sleep.

So, November 2016 I am approached by this girl who says she was sexually assaulted at my party. She says she doesn't remember anything after the fall but she sustained anal injuries and since my male friend was seen in the room with her by himself (just sitting in the floor playing on his phone) she thinks he has done this. This girl has a 20 years history of anorexia and bulimia. She also has abused laxatives for periods of time. She has also turned exercise into an addiction when she attempts to eat properly. She said she suffered internal anal trauma, Hemorrhoids internal/external and loss control of her bowel movements. She said she went to the doctor I believe the Tuesday after, but only took a screen shot of the final diagnosis and won't let me see the medical papers. She even stayed for a couple hours after she woke up in the morning and spoke to me on Monday never mentioning these injuries.

My questions are, could the injuries have been sustained from this staddle fall/ straddle injury. Could the abuse to her body over the last couple of years left her more susceptible to these injuries after a fall with trauma. Could the blunt force to that area cause internal anal injury and loss of anal sphincter control? If the detail about the fall was left out or not described as a straddle fall could she have been misdiagnosed. She also said she woke up in the middle of that evening with a sharp pain in her back... Could this fall have caused this as well? Please my friends life is destroyed. (She never filed a police report) thank you for your help.
doctor
Answered by Dr. Salah Saad Shoman 32 minutes later
Brief Answer:
not likely to be caused by the fall

Detailed Answer:
Dear reardonk.. The blunt force to this area will not cause an internal anal injury. The only way the injury could have caused these damages is that a part of the wodden deck was sharp enough to pierce her clothes and get in direct forceful contact with her anus( get inside of her anus) , which is unlikely to have happened.
sexual anal abuse can lead to internal anal injuries and damage to the anal sphincter that leads to incontenence that can be either temporary or permenant according to the extent of damage .
If she claims that she was sexually assisted, the right thing to do is to take a swap from her anus for a foresenic laboratory to analyze. but this was supposed to be done right after the claimed assault. if you're male friend was the doer his DNA would have appeared in the test.
The back pain could be due to the fall or could be due to vigorous sexual activity.
I hope you find this helpful.
Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Salah Saad Shoman 24 minutes later
Couldnt the laxative abuse have caused incontinence and the hemorroids?
doctor
Answered by Dr. Salah Saad Shoman 52 minutes later
Brief Answer:
No..

Detailed Answer:
Dear Reardonk, No it is not possible for laxative abuse to cause incontenence and hemorrhoids. on the other hand , severe constipation can cause hemorrhoids and incontenence . I hope you find this helpful.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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