Severe Pounding Headache During Bowel Movement

[mt_100]

I have had a problem for some time now and am now very worried.

Background:
I have had this on and off for quite some time, over a year.

I'm a 33 man and at the time it started I was 194 pounds and had cholesterol of 216. I admit I was out of shape. One thing to note is my tolerance for pain is very high.

I was tested for everything, CAT scans, bowel X-rays, scoped from one end to the other. Tried fiber, lots of fiber, Nothing. I gave up on answers about the time the symptoms subsided.

Since then, I shaped up. I am now 165 pounds, cholesterol of 136 and can run 4 miles a day. At no time during the workouts or other strenuous activity do I experience this issue or other issue.

Symptoms actually went away for quite a while, several months in fact, but are now back as of this last week and worse. I now can tell when I need to have a BM because it starts very mildly.

During the BM, without straining at all, it starts. It will start on the back of my neck as a small soreness or stiffness and very quickly I will feel my heartbeat in my neck. Within seconds the pounding in my head starts on the left side and goes up to the top and down the bottom. With each heartbeat there is excruciating searing pounding pain. A pain that feel like someone hooked a bicycle pump to the left side of my neck and is pushing pressure very hard into my head. Each heartbeat is torture and afterward it slowly subsides over a few hours until only a stiff sore neck remains. However this last time the dull headache lasted into the next day.

The pain is so severe I have blacked out once however I fight not to. I am not straining, pushing, or doing anything. Most of the time I am trying to relax. This happens with hard or soft movements and diarrhea. I would consider this pain to be a 8-9 out of 10. (A motorcycle accident with broken bones was a 6 to me for comparison sake)

I have tried to identify changes or habits that may have changed or repeated and so far cannot find something. I am truly worried that I will have a stroke or brain aneurysm during a bowel movement to the extent that I call my wife on the phone.

Can someone help? No doctors around here are able to.

[selmaS]

Hi...not to give u one more thing to look at, but, strain headaches are typical with chiari malformation and so r the bowel issues u describe.

A Brain MRI and a cervical spine MRI can help rule this out, but it is a possibility as well...

There r sooooooo many conditions that have overlapping symptoms it can get frustrating and take a while to get a dx....if ur PCP is a good one he will keep looking until u have an answer.

U may want to try Miralax after discussing it with ur dr to see if that may help u go on a reg basis and eliminate the strain.

Best of luck
"selma"

[mt_100]

Typically my bowel movements are either one of two types.

1. Severe diarrhea where there is absolutely no solid matter. Typically this happens after a period of a week or more of no movements and happens very, very suddenly. Typically the only warning sign is an extreme stomach noise, rumble, gurgle seconds before.

2. Very soft ribbon like flat stool that is very difficult to pass. These can be in excess of 18" long and are 1/2" wide and flat.

I have had a colonoscopy, CAT scan (3), and nothing was found. I actually have another doctors appointment today with a new doctor to discuss this. Although the sharp painful headaches during bowel movements are gone I have had a lingering headache similar to the sharp ones only very dull for three weeks now.

[Dr Santos]

Hi,
Can you elaborate on these bowel movements? Do you have diarrhea every time you move your bowels?  I was focusing on the headaches and did not realize that there is also a possible gastrointestinal issue. The nerves that control the anal sphincters or the nerves that sense stool in the rectum may have a problem.  Another differential would be pelvic floor dysfunction or abnormalities of the pelvic floor muscles and nerves can lead to impaired ability to sense stool in the rectum. Either way, it is best that you have this evaluated further for proper management. Talk to your doctor about this. A referral to a gastroenterologist may also help.

[mt_100]

Thank you for asking, I am doing better. My doctor put me on medication to lower my blood pressure. Although my blood pressure wasn't high at all, very normal, he thought that the inter abdominal pressure was causing the headaches and lowering my blood pressure may help.
For now the headaches are gone which addresses one of the issues I was having. I still feel as though there is something physically wrong with my bowels or something in there. I can go for a week without a BM and gain 10 pounds during that time. I feel pressure and backed up to the point where I cannot even eat anymore.
Fiber, probiotics, and stool softeners do not help. I just can't go and don't usually even have the urge to. Then suddenly without warning it will happen, and very fast, diarrhea. What is odd is it will happen after I do something like jump up and down for 30 seconds with the nephews or bend over to pick something up. Running on the treadmill sometimes does it but not usually.
I almost feel as if there is a pocket or something inside me that collects waste and doesn't let it out until I shift to the right position and cause it to empty. I have told all this to my doctor and both (I have a new one) think I am crazy. Yet no one can explain why I will gain 10 pounds and get a large stomach and then empty out all of a sudden.

[Dr Santos]

How is your wife? I'm sorry to hear what you've been through for the past few days.  Uncommon exertional headaches associated with bowel movement do require a careful work-up to exclude potentially serious underlying problems.
In its classification system, the International Headache Society (IHS) includes exertional headaches in the group of headaches unassociated with a structural lesion. Do keep us posted with the MRI and MRA results. Best regards.

[Dr Santos]

Hi,
How are you?  Have you tried taking preventive medicines before taking a bowel movement? This is usually done in exertional vascular  type of headache. However, as mentioned by newbidder, additional tests such as MRI and MRA will rule out any vessel problems. Talk to your doctor about this. Take care and do keep us posted.