Rectal discomfort

Digestive health
1

I'm a 22 year-old male who has been suffering from rectal discomfort for the past 7 years, to the extent that it has greatly impacted my quality of life. 

How it got started: I used to have a pretty bad habit of using perhaps excessive force when wiping. I'm right-handed, so naturally this meant that the left side of my rectum often bore the brunt of my forceful wiping techniques. The details are a little hazy, but from what I remember, one day, I wiped too hard and felt as though something on the left side of the anus had snapped or popped, or perhaps had become displaced. Ever since then, the left side of my anus has been uncomfortable. I should note that this happened at a time when I was suffering from quite a bit of anxiety, which was probably a contributing factor.

Symptoms: The discomfort seems to vary in its quality and severity, but is always located on the left side of my anus. At times, it will feel as though something is missing, as though the skin on the left side of the anus was lose or untethered, or simply abrasive/raw/irritating. There can also be a sense of topographical unevenness with respect to the right side of the anus (which has never caused me any problems, event though my physical therapists have told me that it is also tight). It feels like an infection, but antibiotics have done nothing to alleviate the discomfort and I can pinpoint a clear physical event at which it began, so I doubt it really is one. I will also sometimes feel movement on the left side of the rectum, which might be muscle spasms. I have seen a physical therapist, who told me that the muscles on the left side of the anus were tense and curled up.

I do feel occasional relief after urination. The feeling is that of fluid being retained and somehow pushing or swelling against the muscles. This relief vanishes when the fluid is pushed out (by say, sitting down).

I have seen a urologist who prescribed antibiotics for prostatitis, but they offered no relief to my discomfort. I have also attempted physical therapy, to no avail.

Any idea on what this could be or how I can solve it?

 

2

If you have seen a urologist he would have done an anal exam to determine if an internal hemorrhoid is there correct?

3

See your urologist again.

4

I have. No hemorrhoids were found.

5

Anal fissures can be a huge problem. Unfortunately, you can reinjure yourself every time you wipe. There is also glands that could be swollen that gives you the feeling that fluid release helps. I worked in urology for sixteen years. There are so many possibilities. Go see them again they are missing something.

6

Huh, really interesting. I've seen a few urologists and they haven't found anything besides a "soft" prostate. I have an appointment with a colorectal surgeon next week. Could you list some of the possibilities that you're thinking of? Thanks! This actually sounds like it has potential.

7

Although I should mention that for me, it's fluid retention that seems to alleviate some of the discomfort, not fluid release.

8

Proctalgia fulgax, levitor ani symptoms. Lamens terms spasms of the anus. But, there are other areas to look at as well. One, do you have diarrhea or constipation? IBS can transform into multiple symptoms. Unfortunately without an H& P it's difficult to determine. I would love to help but don't really know enough about your symptoms.

9

Hi honhonhon

How are your bowel movements..do you have pain when having a bowel movement?

10

I usually don't have any pain during bowel movements, although on some days I will have them at unusually elevated frequencies.

11

I do possibly have IBS. I just got access to my physical therapist's notes--I don't know if this will be helpful in any way. She found a significant spasm of L>R puborectalis muscle, a moderate spasm of the L & R obturator internus, and possible slight "palpable asymmetry of the coccyx, positioned in slight flexion and R downward rotation." I've also had a kidney stone in the past, as well as a period about four years ago where it was difficult to empty my bladder.