Chronic Pelvic and Rectal Pain

[Rebs]

I am 32 year old female who 3 years ago following a small amount of blood and mucous had a colonoscopy and was diagnosed with mild Proctitis and Gastritis.

The time thereafter I developed chronic pelvic and rectal pain which I still have to this day.  I have tried Pentasa and Solofalk both of which didn't agree with me and also Predfoam for 1 month which also didn't appear to do anything.

I have consulted with numerous doctors who don't really seem to think that it should be affecting me so much..however they are not the one who has chronic pain on a daily basis.  I have had a CT, MRI and a Laporoscopy which all were normal and now I don't know where to turn.

I have mucous on my stool as well as on it's own but my bowel movements are only one a day.  My stools generally are of a greenish colour and I often get pain in my right side (gallbladder area) however I have had an ultrasound which doesn't appear to have shown any gallstones.  My Gastritis has also never resolved.

I sometimes get pain in my right hand side above my hip but no inflammation was ever found. After my Proctitis I have also developed some symptons of IBS.  I eat a very healthy diet and have been taking VSL Probiotics for 20 days.

My questions are this:

Could all this pain stem from my Proctitis and is it ever likely to spread?
Could the right sided pain be IBS?
What course of treatment would you recommend?

Thank you so much for reading this rather lengthy posting and I look forward to any assistance and advice you may be able to offer me.

Kind Regards
Joanne

[chawol]

Try biofeedback. It can help. A pelvic floor Physical therapist is the one to contact. Do a goggle search for the American Physical Therapy ***. and call them or E mail them as to a practioner. I had Pelvic pain and dysfuction and Biofeedback helped.

[Empreinte]

READ WHAT I WROTE TO LINDA ABOUT HER SISTER - SHE PUT HER POST AS RUQ AND FEVERS SOMEWHERE IN THE MIDDLE HERE.

EMPREINTE~

[Empreinte]

This has been going on for howwwwwwww long?  You mention the word pain more than few times and pain is a strong indicator that something is wrong.  Gastritis that has never been resolved is sinful.  You need, in my opinion, a whole new set of Doc's or even better yet, get out of town to be diagnosed.  I say this from personal experience.  I know what Chronic Pelvic and Rectal pain feel like and in this day and age no one should have to live with that and at present I am. Oh, I will get myself fixed for sure but once again trouble with the Doc's, as usual.  I've tried my City, went to a Major 'Clinic' out of my State, which I would not recommend to anyone but I refuse to give up.  Why are you on Pentasa?  That is typically for IBD patients - which I am.  I have Crohn's Disease.  I have had many surgeries, too many, and some were not necessary as we found out much too late.
For the rectal problems, for the time being - try Sitz Baths and at least 4 to 6 times a day at minimum of 20 to 30 minutes.  Also, get your Pharmacy to order you Brite Lite A & D Ointment and use it continually.  For the Pelvic Pain try Ice Packs for any inflammation that may be going on or a Heating Pad - which ever one makes you feel better.  Proctofoam does help and so does Rowasa Enema's. Valium, in low doseage helps immensely with rectal pain as half of that could be spasms.  IF none of your Doc's will go along with that -
convince them to AT LEAST let you try them.  That's how I have to work 'through' the Doctor b.s. and especially when one says one thing and another says something else.  Get them to give you
something for pain and Suppositories.  I use Lidoderm Patch's right now and that helps some and I'm on Norco and Panlor DC plus Neurotin.  Even if it's Tylenol 3 but get something -
Do not suffer in pain.  Tell them "What if this is nerve pain"? and see what they say. I plan to keep working on what 'THEY SAY'
is NOW my problem and that is a possible 'upcoming' Rectal Prolapse, massive adhesions (I agree with that one) and Severe Pelvic Floor Dysfunction due to all the surgeries that I had to go through - 8 of them in the same incision.  I refuse to do the treatment outline for PFD as I believe, and I should know after 20 some years now, that their
description of what I have and my description of what I KNOW what I am going through don't match one bit.  Going to try another out of state Hospital and give that a whirl.  This has been going on with me for over a year now and the pain has been hideous especially when I have to poop.  I don't hold back on my terminology anymore.  Too old - don't care.  I'm 48 and have been through enough and have had enough of these pompous 'WHITE
COATS' who think it's all in your head or 'it can't be that bad' - UNTIL..............they finally figure it out.
Best of it to you and don't give up - You are a Woman and 32 -
Trust me - The Doctor's (most of them) always take that into
consideration to the point where I've been asked if I was a happy person, did I have marriage problems, do I love life and on and on.  I told them I wasn't here for a damn psych evaluation-That I was in their Office for Medical treatment - especially being a Crohn's patient.  
I despise seeing Doctors and only go when I can't take it anymore.  In otherwords - not a twinge of pain - outrageous pain is what makes me or my husband dragging me out the door to go.
Keep up with us and let us know how it goes - I'm not a Doc, ya know.  Just my 2 cents and maybe some of it will help a bit.
Also curious - Are you seeing a Colo-rectal Surgeon?  They do everything as well as Gastro Docs and sometimes even better.
Make some calls and find out what's up in your City and you can call the Medical Referral in your area - Call info and ask for#

Empreinte~

[Kevin Pho, MD]

To answer your questions:
1) It is possible that the pain can be caused by the proctitis.  You can consider obtaining a stool lactoferrin test if there is some diarrhea to perhaps determine whether there is an inflammatory cause.  It is possible for the inflammation to spread - depending on the cause.

2) IBS is a possible cause for the right-sided pain.  Other considerations would be problems with the appendix or Crohn's disease.  The CT scan and a possible small-bowel series can all be considered for evaluation of these conditions.

3) Treatment would be dependent on the cause.  You can consider a transvaginal ultrasound to evaluate to ovaries or the small-bowel series.  If proctitis continues to be the diagnosis, you can consider immunomodulator therapy like 5-MP and azathioprine for further evaluation.

These options can be discussed with 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.

Kevin, M.D.
http://www.straightfromthedoc.com