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I am wondering if anyone else has experienced these symptoms.  Mine started back at the end of December and have changed little.  I have a scope due next week but I'm looking for any information from others with any similar experience to carry in with me to my appointment.  I have had pouchitis in the past so I know all about the 20 to 30 visits to the bathroom with little or no success but this is a bit different.  It started with the main symptom of pain and tenderness around the rectal area to the point is was painful to sit.  I was at work and couldn't wait to get home to sit in the tub.  To try and pass anything required a lot of straining and the soreness down below felt as though I might damage something or push out something I shouldn't so I did not force it.  I had a prescription of cortenema which I jumped on right away when I got home.  Even inserting that felt painful (no burning) and trying to get a good flow for the enema was difficult as it felt like something was "plugging" the route. I really had to take my time... in the past for inflammation for pouchitis I was able to squirt the enema in with no restriction.  I also started a course of cipro/flagyl which I had to stop 4 days in due to neuropathy, and since then I have been on Rifaximin, which I don't thing is doing very much.  

I still have the same symptoms along with soreness in the lower back (especially at night in bed) and my legs ache from time to time.  I think at times a bit of a fever as I get chills time to time.  The GOOD thing is that I am not running to the washroom all the time.  In fact my BMs are down to about 4 a day.  I'm on the paleo diet for the last couple months.  Been very religious in what goes in my pie hole... no grains, no sugar, no dairy, no caffeine, very low on the carbs.  I'm not starving myself but I can tell the diet has brought my cravings way down in fact I have lost weight (I am definitely eating less at mealtime but feel nourished).  I'm 6' and 3 months ago weighed around 203... today I'm 185 back to my marathon running days weight.  

Although I'm thankful for less trips to the can, when I do have a need to go, it is very hard to get anything out.  I give it time... sometimes I will sit for 15 minutes and  strain too much but there still is that pain around the rectal/anus area.  Some will pass... then a few minutes later a bit more... then if is works out okay finally what feels like the rest comes followed by some gas which generally tells me I'm done and I feel relief.  In the night I am only getting up once and sometimes not at all.  And I feel as though I'm eating enough that even in my healthy j pouch days, I would be going twice as much.  

Also, no blood in stools... just when I feel full like I need to go, this soreness and a need to strain.  I am thinking there has to be some inflammation somewhere downline.  I thought perhaps I am suffering from cuffitis but after reading the symptoms, I'm not so sure.  I am thinking today, I might start back on the cortenema to see if I get results.  I have been off them for 2 weeks but I know the pain of going was much less severe when I was on them... but I can't live on them.

And one other thing, as I have my scope coming up, if there is a restriction down below, what can I expect from the examination?  I'm feeling uncomfortable with the thoughts of the scope being done when things are not passing... can damage be done during this?

Thanks all,

Mark

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Mark,

I have not experienced this, however, have experienced the tenismus (straining to go and feeling like need to go) as well as fissures. Back in May I had 3 at one time. Sure you don't have fissures? So sorry you're going through this. Sending prayers your way for your upcoming procedure, for strength, as well as hopefully to find some answers.

JenB

Mark, I have the same exact issue currently. I've seen multiple specialists and have had a pouchoscopy and they agree it's tenismus. Basically, you anal sphincter is spasming and the more you try to use the bathroom the worse it gets. I find that exercise or other bodily strain can worsen it. A short course of cipro helps Bc it decreases frequency but what I've found to help is nifedipine/lidocaine cream four times per day (calcium channel inhibitors prevent the sphincter muscle from flexing so essentially it relaxes you down there) in addition to ilex paste for the bleeding of the skin from chronic wiping of the area.

If you butt starts to get sore or pain starts to radiate down your leg as this progresses, then I've had success with a Botox injection of the anal sphincter. They use a very small amount. If you do this I'd recommend wearing pads at night though because you might experience some accidents at first.

Thanks J Moons for that.  After reading your post, I have been reading about tenesmus online and that might be my issue.  The closest thing I have to help might be the cortenema, as they list it as one of the treatments for it and I will take the rest of this info with me for my scope.  I have not heard of this before... hopefully it can be identified and treated successfully so I can get back to work.  

Thanks

Mark

Tenesmus (that's the spelling) is really a complex symptom pointing to a number of possible causes. Some folks have mentioned fissures, and the often-accompanying spasms can act as you describe. Another possibility that comes to mind is a stricture, which is much easier to diagnose during pouchoscopy. It's good that you have an appointment and examination coming up. 

Hey y'all,

I though about it, and I think that my doc used Canasa suppositories for the tenesmus. Also wanted to let you know that Desitin, Balneol cleansing lotion, and RectiCare (Lidocaine 5%) anorectal cream(relieves pain/itching/burning) are VERY helpful when you're going a lot. J Moons, I also had the botox (or some sort of) injections in the anus (not painful- although you think it would be) and it helped. I no longer have any leakage. I did for a while after, but it corrected itself somehow. The injections were to correct this, but it took a couple of years until it completely subsided. Mark, hope this is helpful.

JenB

Thanks Jen... I have written all this down to give to Dr. tomorrow for my examination.  All helpful information.  Praying it's something simple.  As I said it does not have the pouchitis feel to it this time... frequency or need to go to the bathroom is way down.  I remember my pouchitis being 30 visits sometimes in a day with little or no relief but thankfully nothing like this.  Just when the need to go is there, it's tough without straining and patience to get much result.  If anything the cortememas are giving some relief and "opening" a passageway a little. 

Mark

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