I wrote a while back that my symptoms are similar and I’ve had the manometry and scope. Diagnosis? My pain and spot bleeding are from pelvic floor dysfunction. I’ve been in therapy about 6 sessions now and I “get it.” The biofeedback software shows you how your muscles are working with —or against—when emptying your pouch. I’m seeing improvement but it’s a slow process. Lots of breathing and stretching exercises but worth it when that awful pain lessens. Are you aware of how much you are currently straining? During my worst days, I used to let that spasm strain push and push—all because I thought I’d feel relief at the end. However relief would never come, just pain that could last for days with inflammation, leakage, urgency and other symptoms that are similar to cuffitis. If not cuffitis, it’s probably pelvic floor dysfunction.