Need help with severe Rectal Pain

[lwarre]

My mother 60 yrs old has had severe RECTAL PAIN for 2 years since a colon resection.  She describes it as a burning fireball that is very severe all day from when she wakes up until sleep.  She also has MS, abdominal surgery, and dystonia, but she can handle those and is under control.  We have been to 5 GI's and one Pain doctor.  They keep giving her narcotics which seem to be killing her.  They have only tried one nerve block.  She is about 85 lbs right now.  She cant eat much and has trouble with bowel movement. Her stomach is like a small bowling ball. We live in Arkansas but will travel if someone somewhere could help.   She has handled everything and still can...she is a fighter!  I know there is an answer for this, I just dont know where.  If someone could just help relieve her of this pain and get her off some of the medications.  EndoDan, Darvoset, Cancer Medication, etc.  These are the only relief so far, but we must find something else.
1) Please advise on how to help this pain?
2) Who to see, where to go, or what to try?
She has had colonoscopies, rectal inspections, and
1 nerve block. They say they cant find anything wrong.

Thank you!

[ligaya]

A related discussion, Persistent Rectal Pain was started.

[lwarre]

Thank you all for your help!  I believe my mother now has PNE.
I found a previous comment to go to www.tipna.org and read about it...It sounds identical.  The burning pain coming on after the surgery makes complete sense that it is pudendal nerver issue.  She has always said it was so fierce nothing but treating that nerve would work.  The link above has given some hope and the advice from your has site really helped narrow it down.  It is not Protactagia or whatever they have been telling her...you're right, I just dont think our local doctors know about PNE.  Hopefully we can go to Mayo to have the 2 nerve blocks tried.  Maybe someone else closer can do it. She just moved and will be seeing a new pain doctor soon.  Again, Thanks for all your help!!

[Kevin Pho, MD]

Difficult to say without examination.

An anal fissure should be something that needs to be ruled out.  This is normally described as a tearing rectal pain that is worsened with bowel movements.  

Treatment can be considered with topical nitrates, oral calcium channel blockers, or injection of botulinum toxin.  If these options are not helpful, there are surgical therapies available.

A referral to a colorectal surgeon should be considered to evaluate for this possibility.  

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.
Medical Weblog:
kevinmd_b

[yoshi]

older women past menopause do experience pain in the anus area,applying hormone replacement cream help.
Have you tried any OTC soothing cream??
How is her BM??have you ruled out yeast/bacterial infection??

[TJV]

Proctalgia Fugax is a fleeting pain  that doesn't last long, not a pain  that is continuous from morning until night. .  Also there are no tests, it's a diagnosis of exclusion.  

[yoshi]

try plain yogurt with live culture and see if it helps-either apply it in the area or eating it.
please no Dannon yogurt,get the good expensive one from the health food store.
I bet you anything after all these surgeries and in and out of hospital,her flora has been altered and you said her abdomin is like a hard ball??

[Sarah Connors]

In my opinion try to rule out Proctalgia Fugax.