This much pain and tenderness from IBS?

[AO111]

I've had a diagnosis of IBS for several years but never had much of a problem. Recently in the past 6-8 months however  I've had a dramatic decrease in appetite and weight and the more I try to eat the more abdominal discomfort I get. I've also had a aching and cramping pain in the same location in my extreme lower right abdomen. It's some what tender to the touch from the outside but from the inside (my vagina) it's worse. I found that out during a gyno visit and vaginal ultrasound. I get pain and cramping from intercourse and orgasm. I just saw the gyno 3 weeks ago and she sent me for an abdominal and pelvic ultrasound. She called today and said everything on my ultrasound looks great My regular Dr. seems to think the pain I'm experiencing in that particular spot is to do my colon being cramped or constricted in that area due to IBS. I disagree.

[AVOCADO1]

Another possibility is Pelvic Floor Dysfunction. It can cause a lot of seemingly unrelated issues and pains and it's not uncommon for patients with IBS to have it. I have been told I have it- two forms of it I've been told I have are Pelvic Floor Tension Myalgia and Outlet Obstruction. It can be diagnosed by a Physical Therapist who is specially trained in the pelvic floor and also at large clinics and universities where they have such tests as defecography (also sometimes called a proctogram). You can have both abdominal and pelvic pain- even pain down the leg like I have.

It is a difficult condtion to find treatment for. Often the large clinics and universities that do treat it use biofeedback which most insurance companies will not cover and it can be very expensive. Plus, biofeedback alone isn't very impressive in treating these conditions. There really needs to be a variety of treatments available- physical therapy, ultrasound heat therapy, possible meds and trigger point injections. Unfortunately tis isn't usually the case.

Just thought it might be worth mentioning if you haven't considered it.

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. Possible causes of the GI symptoms that may need to be considered include GI infections, inflammations, dietary causes, malsorption syndromes, GI motility issues, IBS, systemic causes such as hormonal/ endocrine imbalance, stress/ anxiety, medication side effect etc. The gynaecological issues could be related to GU infections/ inflammations, trauma, ulcers/ erosions, growths/ masses etc. I would suggest getting this evaluated by a primary care physician or a gastroenterologist for an accurate diagnosis and appropriate management. Also for the gynaecological issues such as painful intrecourse, a review with your treating gynaecologist may be sought.
Hope this is helpful.

Take care!