Digestive Disorders / Gastroenterology Expert Forum
Strain in the Rectal Area
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Strain in the Rectal Area

2 years ago I was a healthy male of 59 walking 6-10 miles a day up 1500 feet.  While working out at a gym doing crunches I noticed weakness in the lower abdominal muscles.  2 days later I urinated and defecated blood.

My doctor had me get a colonoscopy where a harmless polyp was removed and I was diagnosed with hemorrhids.  Suppositories were recommended.

Over the next few weeks severe pain occured with each bowel movement.  Off to another doctor who diagnosed a fissure.  Recommendation: exercise and nitroglycerine or else an operation.  I was told the exercise I did had nothing to do with the fissure.  The procedure to see the fissure was exceptionally painful as the anus at that time felt bruised

I used ice to control swelling and Nupricainal to control the spasm the fissure slowly disappeared.  As the pain disappeared intense itching began and for a while I felt as if I had 'pimples' around the rectal area and even coming out of the rectum.  Over several weeks the 'pimples' disappeared, but not the itching which has gone on now for about 2 months.  The itching oftentimes awakens me at night and the only way to stop it is with ice.  With time I've noticed the itching comes on if I do any exercise that aggravates the back.  It can be exacerbated when sleeping if I roll from flat on the back to the fetal position (I assume I'm stretching the rectal area).

However, I still have no strength in the lower back when bending over about 5 degrees to 10 degrees.  I also have what feels like severe tendonitis in the hips.  If I try and walk quickly up hill, stair master, or slow sit ups the rectum and lower back becomes irritated.  I have had an x-ray for the lower spine which showed some arthritis (old news) but no apparent nerve damage.  I still have a mild spasm afer every bowel movement that generally last only 1-2 minutes.  If I have to vacate more than once per day the spasm will last longer.  The area of pain in the hips appears to 'migrate' with time to other areas.

Yesterday I tried to do some new rehabilitation exercises for the hips and while I was successful at the time.  An irritation in the lower abdoman slowly formed.  The rectum began to feel a burning sensation and later I had recatal bleeding lots of itching and stiffness in the back.

It appears as if there is a connection between the rectum and other muscles which had been strained 2 years ago and that when the connection is again strained, depending on the severity, I get itching in the weakened area, a spasm develops in the rectum, and some sort of nerve damage radiates out to the hips.   These symptoms were masked by the fissure and associated spasm for the past 1.5 years.

What do you think?
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Surgeon has kindly answered your question in his comments below and I agree with his assessment.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
1 Comment
It sounds as if there is a persisting fissure, or possible a fistula (a tract from inside the anus to the nearly skin). The itching could be from local contamination either from pus or tiny leakage of stool. It might be that seeing a surgeon (general surgeon or colo-rectal surgeon) would be useful. I'd also say that something going on internally has not been fully ruled out; likewise, nothing you have said explains urinating blood: if that was not specifically looked into at the time (perhaps it was and you didn't mention it?) neither hemorrhoids nor polyp would have had anything to do with it. So the possibility exists that there's a process going on that is either separate, or if related would imply inflammation or even tumor involving the bladder and rectum. Not likely. But a loose end, potentially.
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