Rectal Pain

[camdavis38]

Hello everyone, I am a new member and contributor. I was diagnosed with pelvic floor dysfunction and pudendal neuralgia five years ago. Perhaps the most painful symptom that I am currently experiencing is searing, burning pain in my rectum. I have a very difficult time having a bowel moment (it feels as if I am passing a sharp diamond). The searing pain comes and goes with no warning. I cannot sit for more than 10 minutes without searing burning pain and can no longer drive a car because of it.

My question is this: I know that proctalgia fugax(stabbing pain or sensation) is a secondary condition related to prudendal neuralgia. I'm starting to suspect that I'm experiencing secondary pathology due to the pudendal nerve being compressed for five years now. I can detect hard places in the tissue of my rectum that is extremely painful. I have tried applying pressure like a trigger point, but he pain is often simply too great. I have even tried the vibrating pelvic wand which leaves me in more pain than before. I am now considering that I may have a fistula or hemorrhoids from not being able to defecate properly for the last five years. I'm in the process of finding a good proctologist in the DFW area to evaluate what is going on inside my rectum. It literally feels as if there is a heated electrical wire turned up to 11 in my rectum. It also burns from the outside all the way inside constantly. This seems to be an increasing symptom after the last five years.

Has anyone ever seen a proctologist as a result of the secondary pathologies of pudendal neuralgia and if so did you find or learn anything that could be helpful to myself or the rest of the forum? At this point, I am using preparation H and with hazel pads. I also have compounded suppositories that contain baclofen, gabapentin, and valium, but they do not help with the pain.

Thanks for any input and I am glad to have found a forum to share this challenging condition with others who understand.

[Violet M]

Hi Cam,

I only know of one proctologist listed on our website who treats pudendal neuralgia but I don't know of any in the DFW area. Here is a copy of his listing.
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Dr. K. Steven Wiley, MD, board certified colorectal surgeon and Dr. David M. McGee, DPT, PhD, physical therapist and neurophysiologist run Ohio Valley Colon & Rectal Surgery, an anorectal physiology lab which treats all types of pelvic pain syndrome, including but not limited to levator ani syndrome, proctalgia fugax, coccydynia, pudendal neuralgia, and traumatic induced pain syndrome. Treatment options range from conservative therapy to aggressive surgical intervention.

We perform pelvic floor electromyography, pudendal nerve motor latency testing, sensory and motor nerve evaluation, and anorectal manometry.

Treatment for pain syndromes ranges from myofascial releasing of hypertonic muscles, to electric stimulation, iontophoresis of medication, and injections under anesthesia.

David M. McGee, DPT, PhD, BCB PMD
Director, Anorectal Physiology Lab
Ohio Valley Colon & Rectal Surgery
76 Sixteenth St., Suite 100
Wheeling, WV 26003
304-238-0212 ext. 108
Fax 304-238-0215
_________________________________________________________________________________________________________________

I remember one pudendal neuralgia patient who had primarily rectal pain and she found nitroglycerin suppositories to be helpful.
https://www.mayoclinic.org/drugs-supple ... g-20075252
Might be worth trying until you can figure out what's going on for sure. Anusol suppositories help some people. But I think it's important to see a specialist so you know for sure what's going on before medicating yourself.

One thing to keep in mind is that the inferior rectal nerve can come off of the main trunk of the pudendal nerve above the area of the ischial spine or in the Alcock's canal so a typical nerve block at the ischial spine won't necessarily tell you whether your inferior rectal branch is affected. So that might be something you want to ask your doctor about.

Violet