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Possible Levator Ani syndrome/ PNE?

About 2 months ago I used a vibrator anally (on my own).  It was new and clean.  And, as they say, seemed like a good idea at the time - how wrong I was.  It was pretty painful and I guess I was rather agressive with it.  Anyhow, the next day I had a feeling of tightness in my rectum and a sensation of fullness.  There was no bleeding or mucous.

Since then I still have the same symptoms.  I'm very constipated (I was constipated prior to this also), but I have a pretty much constant feeling of rectal tightness, rectal pressure and a feeling like I have something in my rectum.  This is sometimes accompanied by a irregular low grade, dull rectal ache (that's often made worse if I sit down on certain chairs).

I went to my doctor (a gastro specialist).  He said it was IBS and recomended a better diet.  The constipation/soft stools remained.  I then had a sigmoidoscopy and was told everything looked fine.

The relatively constant discomfort, while not life threatening or painfull, still is making my life a misery.  I can't sleep at night with the worry that I've permanently damaged myself.  I was so, so stupid.  I don't even have health insurance.  I think I may have damaged nerves through trauma from the vibrator.  I've read about Levator Ani syndrome and PNE and think I may have something like that.  Though my symptoms are low grade and constant.  Can you help?
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233190 tn?1278553401
Levator ani is a disease of exclusion and the diagnosis is normally made clinically.  Further evaluation to rule out other causes would include a lower endoscopy such as a sigmoidoscopy or colonoscopy.  Nerve damage may be possible as well.  

A referral to a gastroenterologist and/or neurologist can be considered to look for other GI or neurological diseases respectively.

In terms of treatment, there are only small studies that have been done.  This can include topical nitroglycerin, medications like clonidine, as well as injection of botulinum toxin.

These options can be discussed with your personal physician, or in conjunction with a specialist.

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.
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