Rectal Discomfort - No relief from doctors

My wife's twin sister has been going through quite an ordeal the last 9 months and she recently had a Laparotomy two weeks ago, but it hasn't provided any comfort and her symptoms appear as they were prior to the procedure.  Her symptoms are: Tenesmus, Rectal fullness, and Constant and Urgent need to deficate.

Occasionally, she gets gas gets stuck in the rectum, but always
has difficulty deficating and requires much straining

She has been to many gastroenterologist and treated for rectal spasms many many times. She is said to have IBS, but the symptoms don't appear as so.  She has been treated for Endometriosis by gynocologists and has had the following procedures: Laparascopy, Laparotomy, Sigmoidoscopy (2),
Colonoscopy (1), Rectal Exams (Many), and Biopsie of samples from the rectum.  

My wife has done much research on her sister's issues, but so far, nothing has provided relief to anyone.  We're at the point now where it seems we are running out of options.  

Is there anything that is being overlooked?  Should she consider non-conventional means of treatment (e.g. accupunture).  Can you help?

Thanks.

[Kevin Pho, MD]

I would suggest a referral to a colo-rectal surgeon.  There has been quite the number of tests performed already.  The various endoscopies would make the possibility of cancer less likely.  

Other tests to consider would be defecography.  This is a test where barium is used in the assessment of the anorectal structures, including the anorectal angle, which are obtained at rest and during expulsion of the barium mixture.

Anorectal manometry can also be considered to evaluate the tone and function of the anal sphincter muscle, which can cause the symptoms.

Consideration of treatment (i.e. acupuncture) should be made once there is a diagnosis.

Discussion of these further tests can be made with a specialist or your personal physician.  

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.

Thanks,
Kevin, M.D.

[surgeon]

I'd suggest a consultation with a colo-rectal specialist surgeon