Severe rectal pain

[TamiMitchell]

My son has struggled with severe rectal pain for almost 3 years.  We have taken him to several drs. and specialists and they are not finding out what is wrong with him.  He has been to Dr. Peaster, Bartlesville, OK , urologist and Dr. Roeder, GI spec. in Topeka, KS.  Nothing is showing up with all the procedures.

Last week we had to take him to the emergency room due to the problem.  Blood work indicated Myco. Plas Pneumonia, and elevated liver enzymes.  We have him scheduled to see a Dr. next week and Roeder in two weeks, but we are very frustrated about the quality of his life.  His pain seems to flare up from anything to no activity to physical work.  He is 20 years old and healthy except for this and it is dragging both him and the family down emotionally.  We are desparate for suggestions you might have.  At this point we are willing to consider anything to find out what is wrong with him.  I can send you the long list of details of all the procedures, timelines...a chart of what he has done to try to discover what is wrong.

Please help us.

[TamiMitchell]

The GI Spec. ruled out Crohn's and decided to just treat the symptoms.  Colonoscopy showed healthy bowel, no hem. or fissures.  I just read about proctalgia fugax, and the only thing that doen't match too well is the length of pain.  It can last several hours, and then just disappear.  The pain is dibilatating to my son.  He has adjusted his diet somewhat but flares up unexpectedly.  I will quiz him about the proctalgia fugax symtoms tonight to see how well it matches his problem.

The pain is so severe, you can just look at him when he has had a bad day and see it in his expressions.

[Kevin Pho, MD]

Various reasons can cause rectal pain, including an anal fissure, hemorroids, or a condition known as proctalgia fugax.

I agree with seeing a GI specialist, but also, a general surgery referral can be made to exclude an anal fissure.

The cause of proctalgia fugax is unclear, but can cause prolonged episodes of rectal pain.  Surprisingly, treatment with the asthma medication albuterol has been shown to help in some cases.  Also, options including a pudendal nerve block, as well as medications like clonidine, botulinum toxin injections, and nitroglycerin, can help in select cases.

These options should be discussed with your son's personal physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd