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Suggest treatment for severe back pain and constipation

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Posted on Tue, 16 Aug 2016
Question: Hello, i am 33, female non smoker, and very, very occasional drinker. I eat reasonably healthy and used to be moderate to very active, now i am mildly active. I used to be a collegiate competitive rower. I have had lower back pain for about a year and have been doing chiropractic and massage and foam rolling, stretching. It sure feels muscular/skeletal. But, i have also been constipated and using glisorine suppositories for a few months now (maybe once a week) today when pooped, there was a substantial amount of blood in the toilet. I do tend to have constipation from time to time, but not so consistently. The stools weren't dark or containing blood, but i was dripping out blood for a good couple minutes. I am curious if there might be a correlation between my back pain? Is this worth going in to the dr for? Also, on the lower vaginal wall (the wall shared with the colon) there is a small oblong fleshy feeling lump - about half of a golf ball size. Is that a normal anatomical thing? I don't even know where to start with my dr, so i thought i'd start here. Hello? The prompts lead me to believe this was an online chat with a doctor?
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Answered by Dr. Bonnie Berger-Durnbaugh (2 hours later)
Brief Answer:
Need to go in to be seen for this.

Detailed Answer:
Hello and welcome,

It is an online chat, but sometimes we don't get to all of the questions quickly (depending on number of doctors on the site at a time and the number of questions).

I definitely think you should go in to be examined because of the fresh bleeding. The bleeding may be from a a small rectal tear or anal fissure that happened when you tried to defecate, particularly if the BM was not soft. It can also be an irritation of a hemorrhoidal vein. But it can be from a polyp or growth too, so that should be checked out.

I also think the lump between the vagina and rectum needs to be examined - starting with a bimanual exam with two fingers in the vagina and one in the rectum. This will give the doctor an idea of what it might be. It could be an internal hemorrhoid or a cervical polyp (usually benign).

Constipation can definitely cause low back pain, and vice versa. Having low back pain chronically can cause constipation.

Some people are more prone to constipation in spite of a good diet and activity level. Have you tried a fiber supplement such as Metamucil or Citrucel? If you do, go up on it very slowly so your body gets used to it without a lot of gas.

So... I think you should go in to be seen and the bleeding and lump evaluate.

I would be grateful if you let me know how you are doing after you have been evaluated.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (16 minutes later)
Thank you very much! I do use psyllium husk fiber, but not as regularly as i should. I do eat a lot of fruit and veggies, real oatmeal with chia seeds and fruit for breakfast nearly every morning, so usually i'm fine. But one night of pizza for dinner and i know i should have some extra fiber. Maybe a change to Citrucel to see if that is better.

I will call and make an appointment today. These are just the embarrassing type of appointments that are hard to make! Especially if there is nothing wrong aside from maybe needing more fiber. But your response gave me the little courage that I needed to trust myself and make an appointment. I will let you know how it goes. Who knows when the next appointment will be available. I would like to see my regular doctor. But if any more bleeding occurs, or any sort of discomfort, i will just go to the walk-in instead of waiting.

Thanks again!
Gail
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (3 hours later)
Brief Answer:
Nothing to be embarrassed about.

Detailed Answer:
Please don't be embarrassed by this issue. It actually happens fairly often to people, and anyway, by the time a person is done with medical school and residency, nothing phases them anymore. So nothing to be embarrassed about!

Yes do go in to an urgent care or ER if there is a lot of bleeding, and otherwise your own doctor.

Best regards,
Bonnie Berger-Durnbaugh, MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3138 Questions

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Suggest treatment for severe back pain and constipation

Brief Answer: Need to go in to be seen for this. Detailed Answer: Hello and welcome, It is an online chat, but sometimes we don't get to all of the questions quickly (depending on number of doctors on the site at a time and the number of questions). I definitely think you should go in to be examined because of the fresh bleeding. The bleeding may be from a a small rectal tear or anal fissure that happened when you tried to defecate, particularly if the BM was not soft. It can also be an irritation of a hemorrhoidal vein. But it can be from a polyp or growth too, so that should be checked out. I also think the lump between the vagina and rectum needs to be examined - starting with a bimanual exam with two fingers in the vagina and one in the rectum. This will give the doctor an idea of what it might be. It could be an internal hemorrhoid or a cervical polyp (usually benign). Constipation can definitely cause low back pain, and vice versa. Having low back pain chronically can cause constipation. Some people are more prone to constipation in spite of a good diet and activity level. Have you tried a fiber supplement such as Metamucil or Citrucel? If you do, go up on it very slowly so your body gets used to it without a lot of gas. So... I think you should go in to be seen and the bleeding and lump evaluate. I would be grateful if you let me know how you are doing after you have been evaluated.