Health Organization for Pudendal Education

Hi all. I have always thought my 'problem' was fairly unique. Now I have found this place I know there are other likes me. I am not sure all of the symptoms fit though. I am wondering if I have a combination of problems, perhaps PN with IBS, (although I have been diagnosed with levator ani).

It would help me greatly, if anybody could give me feedback on BM's and if they share similar experiences. Sorry if this is very candid.

My symptoms are largely drive by my BM's. When I wake up in the morning I feel almost normal. Then after the first BM of the day, problems begin.

BM's involve me sitting there for 30 minutes. I will initially pass some stool, then feel nothing but know I need to pass more. Suddenly - sometimes through straining, sometimes not - something will clear and I will pass more stool. This happens 3-4 times then I feel kind of empty. Stools are usually pretty soft and get softer towards the end of the BM.

Afterwards I will have a pain/sensation/numbness inside my rectum. Principally on the back wall about 6cm up. Shortly afterwards I will have a pressure as well, like I need to go again. If I try, sometimes I pass more small stool, sometimes I cannot. The pressure to go again slowly builds over the next two-three hours, along with a lot of gurgling, movement and what feels like twitching/spasms inside my rectum.

An obvious solution may be to delay BM's as long as possible. This has a major drawback though: when I do then come to pass stool it becomes very difficult. The stool has hardened and is even more difficult to pass.

My days can also be very different. Sometimes in the 2-3 movements I have, I will pass very little stool. Sometimes an amount that seems way out of proportion to what I have eaten because the volume is too high. BM's within days can also vary. I can be straining, passing small hard stools.... then two hours later I will pass a large amount of stool.

My specialist tells me that my pelvic floor is dysfunctional. It doesn't release, so nothing is getting through efficiently. This may be correct. What I don't understand though is the variance in stool volume and the gurgling according to what I eat.

I have been told on another thread that IBS often affects PN sufferers. Has this been your experience?

Thanks in advance. J

J, I think I'm the one who told you IBS is common in PN sufferers. The reason I said that is because I've been moderating the PN forum for over 6 years and I have seen this complaint often. In fact we had a whole thread on the subject on our old forum with many people posting but unfortunately, we don't have access to that thread anymore.

In the past I experienced many IBS-type symptoms, some of them similar to yours so I understand how annoying this can be. It was so bad, often I was uncomfortable being in public. I can't say for sure how my IBS problems were related to PNE. I just know that since decompression surgery and with some changes in diet and using magnesium citrate tablets I am pretty much cured of the problem and being in public is no longer a problem.

Some of the PNE docs feel that levator ani syndrome or chronic spasm of the levator muscle with inability to relax that muscle is caused by pudendal neuropathy.

Hi Violet - thanks for the reply.

That is very interesting. What exactly is magnesium citrate, and can I ask how it helps? Do you take it in tablet form?

Thanks, J

Magnesium citrate is a laxative but it is more mild than senna and yes, I take it in tablet form. I don't experience any cramps with it. Some people prefer miralax but mag citrate works well for me and my physician said it's OK to take long-term. My oriental medicine doc recommended it when I was doing acupuncture and it has made a huge improvement in my quality of life. I suppose there is always the risk of hypermagnesemia if you were to way overdose on it. The goal is to keep your stools the consistency of applesauce. I've been taking about 400 mg twice a day for 5-6 years with absolutely no problems.

So, you said sometimes your stools are soft but then they are hard. This is very typical of IBS and is what I experienced. You can have some soft stools but have a lot of hard stool trapped higher up in the bowel. The soft stool and gas leaks out around the hard stool. Now that I take magnesium citrate it keeps things moving through so I don't have all of that awful gas and gurgling like I used to and no hard stools.

I also eat a lot of raw fruits and veggies. I munch on veggie sticks while I type at the computer so I don't have to think about how bad they taste. And I make large green salads topped with stuff like flax oil, olive oil, strawberries, blueberries, and cashews to make them taste better. It's really a lifestyle change but it makes you feel so much better.

And BTW, if anyone is grossed out by this discussion, it's your own fault for continuing to read.