Anal pain, Help!?!?!

[Ihurt]

I have been dealing with gut issues for 5 yrs now. My intestinal issues started with just having awful pain and crampiness in my intestines. I did Not have any bowel changes at all the time. My GI doc dx me with IBS. Finally after 2 years he decided to do testing. He held off on testing because I have other health issues that would definitely be aggravated with testing and such. I had an MRE of small bowel 4 years ago and it was normal as well as blood work and stool tests. I continued to have symptoms so three years ago I got a colonoscopy which also was normal. GI said IBS. I seemed to kind of keep things at bay with watching my diet and eating as healthy as I could. Last year in July was taking a medication for my other health issue( IC of bladder) and the med was called Uribel. It contains like 6 different ingredients, one being a salicylate which I believe is a form of NSAID. I was only taking a tiny dose of it daily and sometimes not everyday even. One day I woke up and had some diarrhea.I thought maybe the drug was the culprit so I stopped taking it. Well for like 6 months I could not get back to having a normal poop. I was only going once a day still, but it would be in pieces or very very soft. I asked my primary care doc to to a fecal Calportectin test and that was elevated( 348.5) where it should have been 160 or under according to the ref range at the lab. I brought this to the attention of my GI doc and he was not at all concerned and dismissed it saying it was likely the IBS. He stated that calprotectin levels can elevate slightly with some people who have IBS. He also said other things could cause it to rise. He then said since my colonoscopy has been completely normal two years previous, he was sure it was just IBS.

Fast forward to about a month ago. I went through a terribly stressful period( still am actually). Well I noticed a small hard lump under the skin on my labia. It did not hurt at all and I did not even concern myself with it as I had something like this in the past and it just disappeared by itself. I figured it was a hair follicle or gland. After two and three weeks the lump got bigger. I then started putting hot compresses on it to bring it to a head. It finally started leaking a little stuff but not enough. I broke down and went to a dermatologist to have it lanced and drained( I was afraid to lance it myself). She said it was an abscess, likely from infected hair follicle or oil gland. Pathology came back saying there was e-coli bacteria in it. She said due to the location being near vagina and close to anal area this is not uncommon. Anyhow, it seems healed up now which is three weeks later but sometimes I still feel some phantom pain in that area. There is no longer any lump under there though. Not sure if this is connected to my gut issues or just an isolated thing.

Last week my intestines started acting up. I got a bout of loose stool, not water, but pudding like consistency. I still so far am only going once a day, but I am noticing pain and irritation in my anal area, like inside. I do have some hemorrhoids that I Have had for a long time that will act up somewhat from time to time, but usually it is mild and just goes away. I was at my primary care doc and she gave me a script for this hemorrhoid cream which is basically a 2% cortisone cream. I have been using it for two days and feel not difference at all. It feels like at times I get throbbing pain in there( not constantly though), but it always feels irritated inside. Like achy feeling. Sorry if this is TMI, but also it feels tight inside. How do I know this, well after I have a Bowel movement I have to bottle wash and shower per my urologists suggestion. I have Interstitial Cystitis and am Very prone to UTI's so I have to keep extra clean down there in order to prevent UTI's. Well when I soap up the area down there I soap all around the opening of that area to make sure it is clean. It feels more tight in that area. Could it be swollen? The outside of the anus looks okay, not redness or anything. Oh also, last week I got this horrible pain, like a charlie horse in the rectum. It was so painful! It lasted for like 10 minutes but them went away. I think that may have been that Fugax thing where you can get like an anal spasm or something that can be very painful. When I have a BM it does not hurt at all per-say, but it feels more irritated inside after I go.

I have an appointment with my GI May 13th which is two weeks away. I also had my primary care doc give me an order for fecal calprotectin level to have it redone and should get those results any day now so I can also bring that with me when I see my GI doc. My C- reactive Protein was normal. I want my GI doc to look in there. Will he be able to look just inside the anal area to see if something is there?

What could this be? I don't think IBS can cause anal pain, at least I have never heard of it. I also don't think hemorrhoids would cause the achy irritated feeling either and besides, I have been using the cream and still feel the same. Any ideas what could be going on here? I am so fed up and confused and worried.

 

[ronroush7]

I don't know for sure but I would think the doctor should be able to look in the anal area. It may be a good idea that the gp gave you an order for another fecal calprotectin. Keep pressing until you get an answer. I hope you feel better soon.

 

[Ihurt]

Thanks ronroush! I am still waiting for the results of the Calprotectin test. It was primary care who ordered it for me because I asked her to. She ordered the one i had last year that was elevated as well. My GI doc seemed unconcerned about it, he claims they are not reliable at all. It has been a week since I dropped of the calprotetcin test so I am not sure what is taking so long. I called the lab and they say it is a culture so it is still pending. Then if it is elevated not sure if it will matter as my GI doc may not even be concerned about it. I do not want to look for another GI at this point because it would take too long to get in to see one being a new patient. I need help now, not in 2 months so I have to stick with this guy for now. It is just all very frustrating.

I don't know for sure but I would think the doctor should be able to look in the anal area. It may be a good idea that the gp gave you an order for another fecal calprotectin. Keep pressing until you get an answer. I hope you feel better soon.

 

[ronroush7]

It seems like most people take stock in the fecal calprotectin. I am sorry you are having a rough time.

 

[Ihurt]

Thank you so much for the support!!

It seems like most people take stock in the fecal calprotectin. I am sorry you are having a rough time.

 

[Cat-a-Tonic]

Ihurt, the doctor should be able to do an anuscopy. It's like a little clear plastic scope thing that they insert just into the anus so that they can see if there's anything like a hemorrhoid, fissure, abscess, etc. I've had them done several times - no prep needed and no sedation either, it's just a quick little procedure. It's not comfortable but it's not horrible either. I've had nonstop recurrent bleeding painful hemorrhoids (all internal) over the past year, so I definitely understand how painful and annoying anal issues can be! I hope you can get things figured out easily and that the treatment is nothing that exacerbates your bladder issues. Good luck!

 

[Ihurt]

Thanks Cat! I called my GI doc' office to see if I can get in any earlier than my appt. which is May13th. Really annoying because it usually takes the nurse 2 days to get back to me! Then she has to contact the doctor and give him the message and then get back to me again. The whole process can take over a week! It is a joke!

Can internal hemorrhoids cause discomfort? Everything I read says not usually. I do have some external ones, but they do not look to bad just from my looking at the outside. I wonder if there are ones that are just inside where I cannot see that could be swollen and causing discomfort.

Would symptoms be different with an abscess, fissure or hemorhoid? What would be the differences?

Ihurt, the doctor should be able to do an anuscopy. It's like a little clear plastic scope thing that they insert just into the anus so that they can see if there's anything like a hemorrhoid, fissure, abscess, etc. I've had them done several times - no prep needed and no sedation either, it's just a quick little procedure. It's not comfortable but it's not horrible either. I've had nonstop recurrent bleeding painful hemorrhoids (all internal) over the past year, so I definitely understand how painful and annoying anal issues can be! I hope you can get things figured out easily and that the treatment is nothing that exacerbates your bladder issues. Good luck!

 

[Cat-a-Tonic]

I had read that as well, that internal hemmies usually aren't painful. My experience though is that sometimes they can be terribly painful! Sort of similar to how you described, my pain can be throbbing and sometimes it feels like there's something in my rectum that I need to poo out, but I can't poo it out because it's a hemorrhoid (it sometimes feels like there's a marble in there!). My hemmies also tend to bleed a ton, to the point that I developed a severe iron deficiency and had to have iron infusions at the hospital. They don't always bleed, but they usually do.

I have never had an abscess so I don't know how that would compare in terms of pain or symptoms. I have had mild fissures in the past, those feel sort of like a papercut on the anus. It's sort of a sharp, stinging pain and can bleed although mine never bled much (my hemmies can fill the toilet bowl with blood, but my fissues only ever left a few drops of blood on the TP and that was it).

If you can't stand the wait until your appointment, you could always try going to an urgent care clinic. I have had at least one anuscope done in urgent care in the past (I was bleeding a ton that time, to the point that I actually got dizzy & light-headed, so I figured I'd better get checked out ASAP than wait for my doctor).

If you've got external hemmies then my guess would be that you've got internal ones too. You didn't mention blood but your other symptoms sound similar to mine. For mine, I do steroid suppositories which help somewhat (mine seem to heal but then come back a few weeks later). I also tried having my internal hemmies banded, but that didn't really work (the hemmies that were banded died and fell off, but within 3 weeks I developed new hemmies already). Creams don't work so well for internal hemmies. I'm presuming they'll probably give you a suppository to take if you do have hemmies, that seems to be pretty standard.

 

[ronroush7]

Thank you so much for the support!!

You are welcome.[emoji2]

 

[Ihurt]

Hey Cat,

Wow, sorry you have went through all that. I have not had any bleeding that I see so far. I do also have that feeling you said you felt, like there is something in there. I feel worse after sitting for some time, like it aggravates it or something.

Ugh, I talked to my GI's nurse, she called me back. I explained to her what I was feeling. She said to just keep using the 2.5% cortisone cream my primary care prescribed me! She said it would take 5 days at least to start working. She said she would send the message to my GI about my symptoms and see what he says. She then said to just make sure you wipe with wet wipes instead of toilet paper. I use moistened toilet paper ( I cannot use wet wipes, the chemicals in them irritate my skin). She said try not to rub just blot. Um, no way, I cannot do that, I have to wipe somewhat to get every last bit of stool off in order to prevent UTI's which I am super prone to getting. I am as gentle as I can be though. It takes me literally almost a roll of paper to get clean as my poops seem super messy( sorry if TMI). I then even soap up the area very well and shower afterwards. It sucks I have to be so anal( no pun intended) about staying clean down there, but it has helped reduce the number of UTI's I get. It is important I do not get another one because at this point I am resistant to most of the antibiotics that treat them and the ones I am not resistant to, well I have severe adverse reactions and cannot take them. It is so scary.

I pray I do not have Crohns because I have no clue how I would even treat it since I become allergic to All medications I take. It is so crazy. I have an allergist and an infectious disease doctor. My allergist said it is not a good place to be in. My infectious disease doctor said I am to under no uncertain terms take ANY antibiotics unless I am dying basically due to all the resistances I have. She said obviously if I get a UTI I have to treat it but to try and do all I can to prevent them( which I am doing the best to my ability). I have no idea what I am going to do if I have IBD/Crohn's. It has to be treated with medication and my body just wont accept it.

Have you been dx with Crohn's?

I had read that as well, that internal hemmies usually aren't painful. My experience though is that sometimes they can be terribly painful! Sort of similar to how you described, my pain can be throbbing and sometimes it feels like there's something in my rectum that I need to poo out, but I can't poo it out because it's a hemorrhoid (it sometimes feels like there's a marble in there!). My hemmies also tend to bleed a ton, to the point that I developed a severe iron deficiency and had to have iron infusions at the hospital. They don't always bleed, but they usually do.

I have never had an abscess so I don't know how that would compare in terms of pain or symptoms. I have had mild fissures in the past, those feel sort of like a papercut on the anus. It's sort of a sharp, stinging pain and can bleed although mine never bled much (my hemmies can fill the toilet bowl with blood, but my fissues only ever left a few drops of blood on the TP and that was it).

If you can't stand the wait until your appointment, you could always try going to an urgent care clinic. I have had at least one anuscope done in urgent care in the past (I was bleeding a ton that time, to the point that I actually got dizzy & light-headed, so I figured I'd better get checked out ASAP than wait for my doctor).

If you've got external hemmies then my guess would be that you've got internal ones too. You didn't mention blood but your other symptoms sound similar to mine. For mine, I do steroid suppositories which help somewhat (mine seem to heal but then come back a few weeks later). I also tried having my internal hemmies banded, but that didn't really work (the hemmies that were banded died and fell off, but within 3 weeks I developed new hemmies already). Creams don't work so well for internal hemmies. I'm presuming they'll probably give you a suppository to take if you do have hemmies, that seems to be pretty standard.

 

[Cat-a-Tonic]

Officially no, I am still technically undiagnosed. Unofficially, my GI and GP feel that it must be some type of IBD (my symptoms fit and I respond well to IBD meds and we've ruled out most other likely suspects) but they aren't sure which type of IBD (likely either Crohn's or microscopic colitis). My bleeding though is always from hemorrhoids, I think my IBD is actually in remission and it's just the recurrent hemmies that are giving me issues these days.

Yeah, sitting for a while seems to aggravate my hemmie issues as well. I was just recently in Japan and I walked around a lot (like 8 to 10 miles per day) and I felt great the whole time. I think it was a combination of the walking and the Japanese foods that I was eating, I just felt really well. But then I came home and the jet lag triggered some d, and my hemmies and bleeding came right back (diarrhea usually triggers me to get a new hemmie). Ugh. At any rate, try to walk around as much as you can, because that does seem to help.

As far as cleaning yourself back there - have you looked into getting a bidet attachment for your toilet? I have a basic one and it wasn't expensive at all. It sprays clean, fresh water to clean me back there, so I feel much cleaner and use much less TP. I'm prone to UTIs as well so I know how important it is to be clean back there. My bidet attachment is very similar to this one (mine is a few years old so they don't sell the exact same one I have anymore, but mine is the same features and was a similar price and same brand as this one):
http://www.amazon.com/Luxe-Bidet-Ne...TF8&qid=1461937152&sr=8-3&keywords=luxe+bidet

 

[Ihurt]

Wow, well at least it sounds like your GI and GP are in your corner and trying to help you, that makes a difference. I have a pretty nice GP and my GI doc is also the kindest guy ever, but I feel he kind of just fluffs me off sometimes. It sucks when you have other health issues because doctors then kind of just want to wave off any new issues and blame them on your other health conditions it seems and you end up getting ignored.

That sounds wonderful, your trip to Japan! Must of been nice to get away like that to a whole different place. I can see why you probably felt better over there eating their food. I do not think they use GMO's or loads of chemicals in their crops and foods like they do over here in the States. I have been trying to not sit for too long of periods. It is hard when my guy starts cramping though and now my period is due and that causes me insane cramping. I honestly think I am the only woman who is wishing menopause would hurry up and come!!!

Thanks for the link on the Bidet. I am so paranoid about getting UTI's. My urologist is the one who told me I had to make sure I wiped every speck of poop away from the area and to wash in the shower immediately after every BM in order to prevent UTI's. She said it is the only way. She told me it only takes a tiny amount of stool to contain enough bacteria to make it's way to the urethra and into the bladder. My poops are always so messy too, I mean literally I use almost a roll of toilet paper every time I go!! I will admit though since I started being so anal about keeping super clean after I go to the toilet I have not gotten as many UTI's. I try not to wipe more so touch and blot the area and all around with moistened tissue. It truly is a pain in the butt having to go through all that but it is better than getting a UTI. For me my biggest issue is that my e-coli which is what my UTI's are usually caused by is resistant to most of the antibiotics out there and the ones it is not resistant to I cannot take due to severe reactions I had to them in the past. That makes it very worrisome.

Thanks again for the tips. I am sorry your Hemmies are acting up again, ugh the crap we have to put up with. I always envy it when I see completely healthy people just living their life with no illness and just care free. I miss being healthy .

Officially no, I am still technically undiagnosed. Unofficially, my GI and GP feel that it must be some type of IBD (my symptoms fit and I respond well to IBD meds and we've ruled out most other likely suspects) but they aren't sure which type of IBD (likely either Crohn's or microscopic colitis). My bleeding though is always from hemorrhoids, I think my IBD is actually in remission and it's just the recurrent hemmies that are giving me issues these days.

Yeah, sitting for a while seems to aggravate my hemmie issues as well. I was just recently in Japan and I walked around a lot (like 8 to 10 miles per day) and I felt great the whole time. I think it was a combination of the walking and the Japanese foods that I was eating, I just felt really well. But then I came home and the jet lag triggered some d, and my hemmies and bleeding came right back (diarrhea usually triggers me to get a new hemmie). Ugh. At any rate, try to walk around as much as you can, because that does seem to help.

As far as cleaning yourself back there - have you looked into getting a bidet attachment for your toilet? I have a basic one and it wasn't expensive at all. It sprays clean, fresh water to clean me back there, so I feel much cleaner and use much less TP. I'm prone to UTIs as well so I know how important it is to be clean back there. My bidet attachment is very similar to this one (mine is a few years old so they don't sell the exact same one I have anymore, but mine is the same features and was a similar price and same brand as this one):
http://www.amazon.com/Luxe-Bidet-Ne...TF8&qid=1461937152&sr=8-3&keywords=luxe+bidet

 

[Bgatto]

I have had Crohn's disease for 16 years is mostly found within my rectum and anal area. I have actually found an over-the-counter ointment called "Dr. Butler's hemorrhoid and fissure ointment bio enhanced with organic herbs, minerals, and amino acids. As far as active ingredients this contains 4% lidocaine, awesome, and hydrochloride .25%. Lidocaine at 4% is very potent and will numb the area, and hydrochloride is a vasoconstrictor that will reduce swelling. This is better than anything I've ever received from the doctor as prescription.

 

[Ihurt]

Thanks, I will have to try this. I am guessing I can get it at any pharmacy?

I have had Crohn's disease for 16 years is mostly found within my rectum and anal area. I have actually found an over-the-counter ointment called "Dr. Butler's hemorrhoid and fissure ointment bio enhanced with organic herbs, minerals, and amino acids. As far as active ingredients this contains 4% lidocaine, awesome, and hydrochloride .25%. Lidocaine at 4% is very potent and will numb the area, and hydrochloride is a vasoconstrictor that will reduce swelling. This is better than anything I've ever received from the doctor as prescription.

 

[Cat-a-Tonic]

Ihurt, yeah, Japan was wonderful. I was really nervous about going so far away from home and not knowing what my guts might do, and I don't speak Japanese so there was also the language barrier to deal with. But fortunately my guts were great, Japanese food is really easy on me and my guts agreed with everything I ate. It was really nice. Too bad it didn't last! But I am trying to incorporate more Japanese foods (fish, rice, noodles, seaweed, etc) into my everyday diet now that I'm back home. Hopefully that will help me not bleed so much. I'm trying to walk more too, because I walked so much in Japan and I felt really well. More walking + better diet will hopefully = Cat feeling consistently better.

 

[Ihurt]

That is great! I hope by you incorporating more rice, fish, noodles and seaweed to your diet will do the trick to helping you feel better. And yes, I agree, walking is good for the body and a great form of exercise!

 

[fernando3]

An update on what I use:

After each bowel movement I use Cottonelle wet wipes, they are very gentle on the tissues

For a stronger wipe I also use Tucks but they contains Witch Hazel which may irritate the condition

After recommendations from this forum I also use Calmoseptine (buy at Amazon) which is stronger than Prax but contains menthol which eventually irritates it.

If you are a woman, to avoid UTIs, wipe from front to back ALWAYS, I prefer Cottonelle (I am not a woman ! but I have heard this advice multiple times).