# Striking:Pelvic floor dysfunction rather than IBS-C



## SpAsMaN* (May 11, 2002)

That's rigth







I've called my colo-rectal surgeon who ordered my defecography last december.He told me:You have NOT IBS but non-relaxing puborectalis aka pelvic floor dysfunction.NOW,i don't know if it's a better condition to have and if i have better chance to get rid of it.Perhaps.The thing is i don't know anybody who has been cured of PFD.Even to get a diagnosis of pelvic floor d. seems to take 5 years or more depending which doctor you see.Biofeedback is a popular treatment for this condition but again,where's the cured???I'm contemplenting(sp?) Botox injection to "unspasm" the puborectalis but then again not many people have injected.







Incomplete evacuation/strainodynia(chronic straining) being a symptoms of PFD.


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## 17985 (May 21, 2006)

Why not try the botox injection Spasman; I think it wears off over time and I know they use this with good results for other medical conditions like disabling muscle spasms. (yes, I know its good for wrinkles too) I wonder if you were to try this and it was successful if over time it would train your pelvic floor muscles not to be so tight, almost like retraining those muscles.


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## SpAsMaN* (May 11, 2002)

> quote: Why not try the botox injection Spasman;


Hi Adelaide,yeah i seriuosly think about but that's not a procedure done everywhere.I may have to pay and i'm wondering if i could have both IBS and PFD.


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## 17985 (May 21, 2006)

It would seem that one could have both PFD and Ibs, by odds alone it could happen. It also makes me wonder if PFD, which results in poor elimination, could irritate the intestines through stool retention and interference with peristalsis, thus causing ibs?


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## SpAsMaN* (May 11, 2002)

> quote:It also makes me wonder if PFD, which results in poor elimination, could irritate the intestines through stool retention and interference with peristalsis, thus causing ibs?


That's what i'm trying to figure it out for many months now.


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## 17985 (May 21, 2006)

I guess the bottom line is to improve elimination if possible to see if this clears up the intestinal irritation. If you have to pay out of pocket for the botox is the cost prohibitive? or would it be affordable enough to go ahead with it and try several injections to see if it works well?


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## 19907 (Jul 24, 2005)

I have had a similar problem. I thought I had some kind of bladder problem but my urologist told me that my irritable bladder may be caused by tense pelvic wall muscles. He also said that he sees this problem occur in many other women who seem to develop it after they have had IBS for a while. His theory is if the IBS is calmed down it won't stress out the pelvic area as much. I don't know if this information helps, but just know you're not alone.


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## SpAsMaN* (May 11, 2002)

It can cost more than one thousand $.Yeah you will probably need more than one injection.


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## 14826 (Jul 20, 2006)

I have wondered if this is my problem too - the pelvic floor dysfunction. Can't it be a result of childbirth? My problems started after I had my son. I had an emergent episiotomy (it was a bad one!) and forcep delivery - almost had to have c-section (maybe I would be normal if I had one







I never had these issues before I was pregnant. And of course I'm a runner that ran through 7 months of pregnancy and was back at it 3 weeks after. Hmmmmm....did that jarring add to the damage? Who does biofeedback by the way? I'll try anything.


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## SpAsMaN* (May 11, 2002)

First you need to be evaluated by a manometry and defecography.To be sure you don't have a rectocele to begin with.But yeah look like there is damage from the childbirth.THAT is common stuff for trained colo-rectal surgeon.Did i said TRAINED?OK,where are you located?You can PM me.


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## 13604 (Jun 30, 2006)

> quote:Originally posted by SpAsMaN*:That's rigth
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Spasman,What did the doc give you to help you after he found out about your PFD? I'm having my defecography on Wed. Here are my symptoms:I'm able to have 2 BM every morning and my stool are really soft and loose, but I only get the urge to go while I'm walking around and drinking lots of water. The urge is so strong, that I know my stool would come out if I don't run to the toilet, but after I sit on the toilet, the urge seems to go away. Most of the time I feel incomplete evacuation b/c of this. It's painful and very frustrating. What am I supposed to do? Does this sound like PFD to you?Does this ever happen to you? Or to anybody here?Blessings,Abi


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## SpAsMaN* (May 11, 2002)

Hi Abi







,Once i was diagnose,he told me to get biofeedback treatment.They really beleive on this treatment on some places.It's not a painful treatment.It's a probe who is inserted in your rectum and you tried to relearn how to evacuate,somewhat.I have not been deeply involved in this treatment du to lack of trained physiotherapist in my area.You've got a private message.


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## 13604 (Jun 30, 2006)

Hello Spasman,I already replied to your private message Thank you !Abi


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## SpAsMaN* (May 11, 2002)

I will be in my PM in one minute but i just wanted to give this link to Runningrd;>Pelvic floor injuries with childbirth:http://www.urotoday.com/264/conference_rep...ry__part_1.html


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## s_teo (Aug 14, 2006)

Hi all, I am new to this message board, even though I have been reading regularly the messages posted here. I am a C type and I have been diagnosed in 2001 and re-diagnosed in 2006 with non-relaxing puborectalis after lots of tests, including defecography, barium enema, colonoscopy etc, etc, etc.I am I would say exactly like Spasman, I use glycerin suppositories daily, dulcolax and stool softener (docusate sodium - colace)I tried botox injections (20 units)twice (first in 2003, second time 3 months ago) without any results at all. Before that (2001) Iwas given Bentyl which worked wonderfully for only 3 weeks, then I stopped and I tried again a month later, but it was less effective and finally did not work at all. I also had biofeedback for about 3 months last summer. The biofeedback helped a little, I want to do it again. I went to two colorectal surgeons to find out if there is some sort of correcting surgery, but they told me the surgery would not do any good.Thank you for listeningsteo


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## hayley3 (Aug 6, 2006)

Abigail, I have the exact same thing!!!!It feels like it's coming out while I'm standing up and the minute I sit down, the urge vanishes! Poof! It is very frustrating. I kept thinking if I didn't have to squeeze so hard to keep it from coming out, then maybe it wouldn't lock up on me.So I'm trying enzymes and herbal nerve formulas to try and affect the nerves/spasms. Since mine doesn't do it all the time, I don't think it's something's that's physically broken, but a nerve problem. Although I have considered the epidural to be the culprit.Susie


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## 22590 (Jul 18, 2006)

Hi all. I was diagnosed by PFD few weeks ago. Before that I thought that all my problems are caused by hemorrhoids. Now I know that I have both of them. I was told by the doctor that first I have to try is biofeedback and if it doesn't help, than botox injection. Tomorrow, I'm going to start biofeedback. Meanwhile the only thing which helps me is an alcohol. If I drink something like whisky, then next day I have more relacing pubo. I also found the following cite which might helphttp://www.pelvicpainhelp.com/essays.html Mike


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## SpAsMaN* (May 11, 2002)

WELL,let us know Mike60!Welcome to the board at the same time.







OK,for those with non-relaxing puborectalis,DO YOU HAVE STOOLS STUCK IN THE LOWER LEFT SIDE?That's the descending/sigmoid junction.


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## 14826 (Jul 20, 2006)

Thanks for link! Good info.Abi, I know that exact feeling. It's so frustrating and uncomfortable.Spas - Ill send an email.


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## 13604 (Jun 30, 2006)

Thank you guys for all your help and support. Hayley3, what kind of herbal nerve formulas are you trying? Can you give me some names? I already take enzymes. I also think is a nerve problem. Mike60, let us know about your bio and botox i if you get it.Spasman, when I feel incomplete evacuation, I do feel stool stuck in the lower side. I get so bloated and crampy, the worst feeling ever, right?Runningrd, it's always good to know that I'm not alone and that there are others like you that understand. Thank you!Do any of you guys eat lots of beans? That seems to help me with C. Also, having 2tsp flax seeds every morning with my cereal and lots of water helps me a lot.I have 2 more days to go for my defaecography, can't wait to know the results....Blessings,Abi


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## SpAsMaN* (May 11, 2002)

> quote: Spasman, when I feel incomplete evacuation, I do feel stool stuck in the lower side. I get so bloated and crampy, the worst feeling ever, right?


Rigth.In both side.Left side worst tho.


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## hayley3 (Aug 6, 2006)

Abigail, I'm using Stress-J by Nature's Sunshine. I took 4 the first time and it really worked and there are no laxative type herbs in it, only calming.What kind of enzymes are you using? I'm also using Pancreatin by Country Life. I've just started taking them. I did notice less bloating at first until I ate some ice cream last night. I might've waited too long to take the enzymes.I don't know what you all mean when you say it's stuck in the left or right side. When mine feels stuck, it's right at the exit.







I do have a certain pain on the right side but it doesn't feel like anything's stuck.There is alot of comfort knowing you are not alone. I was really scared at first when I thought how long can I live with my digestive system not working. Very scary.....Susie


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## 13604 (Jun 30, 2006)

Hayley3,Thank you for the info. Is the Stress-J you are taking helping you daily? How long have you been taking it? I have been looking in to it. Where did you buy it?I'm taking Mega-Zyme by Enzymatic, but I don't really know if they are working. I'm still bloated must of the time. I might have to try Pancreatic ones. My issue is incomplete evacuation and when that happens I can feel the stool stuck in the left and right at the exit. The point is that I know is there wanting to come out but won't relax. Like I said before, I can only get it to relax as I'm walking and drinking lots of water.Thank you for your words. My strong faith in God keeps me going and expecting better days. Blessings,Abi


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## 22590 (Jul 18, 2006)

Hi everybody. Yesteday I had first biofeedback session. I was given just few exercises for everyday training. That's all! When I asked about probe, the doctor said that this will be at the next session (two weeks later). So, I'm a little bit dissapointed and sceptical.To the question of SpAsMaN. When I have an incomplete evacuation (every day for last two months) I also feel stool stuck in the left lower part. Sometimes I also feel bloating in the right side. Does anybody knows how dangerous it is to have incomplete evacuation every day? Can it go for years? Good health to everybody, Mike


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## Kathleen M. (Nov 16, 1999)

I don't think incomplete evacuation has any danger as long as stuff keeps moving out regularly. Doesn't matter if it is all of it every day just as long as everything keeps progressing to the outlet to get eliminated fairly soon.When you don't have a BM at all for over a week then people start to worry about impactions and that can end up being a medical emergency if you are obstructed. But pooing something out tomarrow rather than today is not a health risk.Also incomplete evacuation is sometimes more a feel like I still need to go than actually need to go thing for some people. The people that do anything and everything for hours on end and never had another BM may be fighting a battle that cannot be won because it is the body sending the wrong signals about something that isn't there.K.


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## hayley3 (Aug 6, 2006)

Abigail,Are you taking the Megazyme by Enzymatic Therapy? I'm just trying to compare the different enzymes. The Megazymes by Enzymatic Therapy say to take them before the meal and the Country Life say to take them after the meal. I thought that was interesting.I take the Stress-J if I can't go or if I feel like I'm stressed. I've went thru one bottle so far and I'm on the second. Yesterday because I hadn't went to the bathroom the day before, I took some before I went to bed and this morning I went to the bathroom twice. However, I am taking 2 of my enzymes EVERY time I eat a meal. I just started taking the enzymes, a week or so ago. Also, I completely eliminated caffeine 2 months ago just to see if that helped, but it didn't. At least I'm off of caffeine now, except for my 1 cup of tea in the morning. I feel like I've tried everything.Susie


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## SpAsMaN* (May 11, 2002)

MAN,S-teo,check your private message!!!There should be a green flag flashing at you above the post.


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## s_teo (Aug 14, 2006)

> Originally posted by SpAsMaN*:That's rigth
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## SpAsMaN* (May 11, 2002)

The scientist way to find out if the non-relaxing puborectalis is a real disease is to compare with normal people.Do some of the normal people have the muscle spasms and have no symptom?


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## hayley3 (Aug 6, 2006)

I'm starting to think this is like a neuromuscular disorder. In my case I have trouble swallowing and I read somewhere that peristalsis starts with the swallow. Also, I notice that there is a lot of people who have anxiety with this. I know that I have weird butterflies in my stomach alot which is really a new occurrence with me. I'm grateful that that's all I have though.I also remember reading a study that eliminates the endocrine theory in relation to IBS, but I don't think one study is enough to discount it completely.I also read that Chronic Fatigue Syndrome is now considered an adrenal gland malfunction.So then I started reading up on Endocrine disrupters and that's pretty scary. And the fact that it is not a simple solution (if it's the actual cause) is a little daunting.Anyway, I think the neuromuscular theory is a good one, because there's a nervous system in the stomach. And that could be why the calming herbs work. But it's still either inflammation causing the endocrine system to get out of balance or could be something else???I think about this a lot and I'm sure you all do too.Susie


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## 13604 (Jun 30, 2006)

Hello Hayley3,I went to the Nature's Sunshine website to order the Stress-J , but it won't let me. Do I have to be a member to be able to order it?Can you help me about this please? I really want to try it that.I do take Megazyme by Enzymatic right before my meals. I'm also starting taking Beano together with the enzymes. I hope is ok to take both of them together. Do you think?Can't wait to know my test results on Tuesday. Having pains, cramps and spasms since after my defecography on Wed. Still pooping all that barium out of me, hated it :-(Thank you much!Blessings,Abi


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## hayley3 (Aug 6, 2006)

Hi Abigail,I got mine at the following link. They were alot cheaper here than the first place I bought them.http://www.theherbsplace.com/You don't have to be a member either.I don't really understand the enzymes potency labels, but it looks like the Megazyme and the Country Life are about the same, but the Megazyme has extra enzymes. I may give that one a try just because it has the Chymotrypsin. I can't remember why that's good, but it is. I hope the Stress-J work for you. I've been doing fairly good lately. I've got my fingers crossed that it stays like this.







I feel for you. I actually cringed when you said you were still pooping out the barium and cramping. Uggggghhhh. I can still remember my barium enema, just like it was yesterday.







I'll be curious to hear your tests results too. I don't know much about defecography. Susie


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## hayley3 (Aug 6, 2006)

This is the actual link to the capsules.http://www.theherbsplace.com/Stress___J__f...___J_p_260.html


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## hayley3 (Aug 6, 2006)

Has anyone else tried elevating their feet? I read that if you raise your feet up when you're on the toilet, it relaxes the pelvic floor muscles. Just thought I'd pass that on. P.S. I didn't realize that the Stress-J was specifically for colitis. The clerk just handed it to me at the store and I tried it.I actually had a stool this morning that was in one piece, wasn't flat, and floated!!!!!! That's a miracle for me! Susie


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## SpAsMaN* (May 11, 2002)

OK check this out what Spasman has found for you.BALLOON EXPULSION test is the way to go to know if you able to expell or NOT!!! http://www.ncbi.nlm.nih.gov/entrez/query.f...5&dopt=Abstract


> quote: 1: Dis Colon Rectum. 1992 Nov;35(11):1019-25. Related Articles, Links Balloon expulsion test facilitates diagnosis of pelvic floor outlet obstruction due to nonrelaxing puborectalis muscle.Fleshman JW, Dreznik Z, Cohen E, Fry RD, Kodner IJ.Jewish Hospital of St. Louis, Washington University School of Medicine, Missouri 63110.We compared balloon expulsion, defecography, colonic transit times, anal manometry, and electromyography in 21 patients with severe constipation. Defecography demonstrated nonrelaxation of the sphincter during straining in all patients. Only 12 patients were unable to expel a balloon. Colonic transit was normal (five) or showed rectosigmoid delay (seven). All 12 patients were offered biofeedback. The nine patients able to expel a balloon had normal colonic transit (six) or colonic inertia (two). Rectosigmoid delay was due to severe intussusception in one patient. Anal manometry and pudendal nerve latencies revealed no difference between those who could and those who could not expel a balloon. Balloon expulsion seems to be a more reliable way to diagnose pelvic floor outlet obstruction due to nonrelaxation of the puborectalis muscle. Nonrelaxation of the sphincter on defecography should be correlated with balloon expulsion and colonic transit studies.


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## SpAsMaN* (May 11, 2002)

S_teo,you said the Botox has been unsucessful for your constipation.Have you been tested with the balloon expulsion?If not,there is a good possibility that you have been misdiagnosed with non-relaxing puborectalis.Especially if your rectum is always empty!


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## annie7 (Aug 16, 2002)

Susie--thanks for the info on raising the feet while on the toilet--that's something to try. how high should I raise them? should i raise them by myself or support them by using something like a footstool or a chair--does it matter?? and congrats on your success this morning--it's a wonderful feeling when it happens, isn't it..


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## 13604 (Jun 30, 2006)

Spasman, did I do the defeco and the anal manometry for nothing? If the tests come out negative for PFD , should I ask my doc to also do the balloon test? I'm so tired of all this painful testing







Also, if my rectum is empty, but I still feel like I have to go, what's my problem then?? So confused right now







HELP !Susie, thank you for the link and info. Is the Stress-J supposed to change the way your stool comes out?? I thought it was just for stress and nerves?? I been elevating my feet on the toilet for a little while now, but I don't noticed any changes. If you do, let us know.Blessings,Abi


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## SpAsMaN* (May 11, 2002)

Well it depend of your doctor plan.Defecography can show prolapse organ which the balloon expulsion test cannot shows.


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## 13604 (Jun 30, 2006)

Spasman, I don't know what you mean. Do you mean that I need all of the tests regardless of my tests results? Havenâ€™t had good days since my defeco last Tuesday







Thank you for your great replies always.


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## hayley3 (Aug 6, 2006)

Annie,I think it said to elevate your feet 6 inches. I tried a footstool and it seemed too high. I am lucky that I have a half bath with a vanity door frame to prop my feet on. I'm not sure it helps but I'm not sure it doesn't. Abigail,When I bought the Stress-J I couldn't poop. The clerk at the store handed it to me and said I looked stressed and it might help. I took 4 of those pills when I got home and I went alot and I thought I had found nirvana. I have in the past eliminated eating junk food, sodas, smoking, etc. I try to eat as natural as I can.I've tried fish oil, liver cleanses, fasting, etc. Anyway, when I went to find the link so that you could order them, I actually read what it said about the capsules. I thought it was just for Stress/tension, but it's says it's actually for colitis too. My colon or rectum or whatever, spasms (or doesnt' relax enough) so that my stool is either flat or in little round pellets, so when I have a regular BM it is cause for celebration!







But then sometimes I would sit down on the toilet and it seemed like the door can't open at all and it pops it right back up in the colon and I lose the urge to go at all. Just like we talked about earlier.Susie


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## 13604 (Jun 30, 2006)

Susie, Thanks again for the info. I already ordered it, I hope it helps me.My stool is usually flat(like mashed potatoes) with lots of undigested food in it. I wonder if that's normal for IBS-C people







Blessings,Abi


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## annie7 (Aug 16, 2002)

thanks, Susie for your reply. elevating the feet is certainly worth a try and it doesn't cost any money or have side effects either!


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## hayley3 (Aug 6, 2006)

Abi,Mashed potatoes would be diarrhea, no???Susie


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## 13604 (Jun 30, 2006)

Susie, I didn't think so. I thought the stool had to be somewhat watery to be D. Maybe I'm wrong, not sure







I'm going to post that question or maybe spasman or somebody else here can tell us. Blessings,Abi


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## s_teo (Aug 14, 2006)

To Spasman:Yes, I did the balloon expulsion test in I think 2002 and I failed to expel the balloon. I also I did a defecografy in 2003 and another one in March 2006. I was expecting some type of anormality like intussusception or something like rectocele, but nothig abnormal, except this non-relaxing puborectalis.If the rectum is empty, what would that mean?s_teo


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## SpAsMaN* (May 11, 2002)

S_teo,you have been a hard worker and still...Well i have a question to answer your question:When did you start straining and becoming a bad evacuator?I mean,did you got it from years of colonic constipation?


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## SpAsMaN* (May 11, 2002)

S_teo,have you done the segmental Sitz marker with 3 x-rays???http://www.konsyl.com/products/sitzmarks.htm


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## 19287 (May 16, 2005)

My problem started about 30 years ago when I felt some pain and discomfort on the left side of my colon. I noticed that about 30 minutes after a meal I had this paradoxical contraction on my gut, instead of going to bathroom I was completely tight as if somebody made a knot around my bowel. I was very bloated because of this. However after 2 or more hours this situation disappeared and I was able to function more or less normal. I went to several doctors, they told me "you are healthy, go home, eat vegetables, everything is fine". In 1989 I had a barium enema(in Montreal at Sacre Coeur hospital) and I was told I was OK then I moved to Toronto where in 1995 I went to a hospital (I think it was Saint Joseph hospital, downtown Toronto, west side, close to QEW) where I had first colonoscopy. The doctor told me very angry that I was OK and that everything was in my head. Then I moved to southern California and in 2001 I went to UCLA medical center where I did the expulsion balloon test (which I failed) and I learned about gut-brain connection. They put me on a short biofeedback therapy (3 sessions) which had zero effect.After that I went to a gastroenterologist in Long Beach (I learned about him from this board - Dr William Snape) who gave me Bentyl. As I said before, Bentyl worked wonderfully for about 3 weeks and then started to be less and less effective. I explained about the "knot" on my bowel and he sent me for a defecography that showed nothing abnormal. Then I asked him that I would like to be seen by a colorectal surgeon and he sent me to USC medical center where in 2003 I had a second defecography that showed this time strangulation - the puborectalis muscle. The surgeon suggested trying botox. I was injected with botox but the effect was minimal, if any. Finally the surgeon told me that surgery was not indicated, the partial division of the puborectalis muscle was tried before in different places and the results were not good. Then he put me on biofeedback therapy, which I did for 3 months. I had some improvement during the treatment and I can say now that I am a little better than before but not much. Meanwhile I started taking flaxseed that I grind at home twice a day and that helps a little too.Anyway this year I went to another colorectal surgeon (good one, very good reputation) and he asked me for a 3rd defecography. This time I asked him to explain what was found and he showed me that on the X-ray films the puborectalis muscle is the culprit. I requested him to try botox once again and one more time no results. Also he said that surgery is not a good option and he recommends biofeedback therapy. This is my story in short version. I can tell you that I went to more than 40 doctors all these years. It looks that I run out of options.s_teo


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## s_teo (Aug 14, 2006)

Yes I did the sitzmark test with 3 Xray in 3 consecutive days. That was in 2001 at UCLA medical center.s_teo


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## s_teo (Aug 14, 2006)

Initially I joined the group with the name "steo", but I had to re -register because I changed the email address. Right now I am "s_teo"To Spasman:I told you that I had 2 defecography, but actually I had 3. I forgot the first one.s_teo


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## SpAsMaN* (May 11, 2002)

Did you have any Sitz markers stuck in the colon somewhere?Impressive investigation.


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## s_teo (Aug 14, 2006)

No, I did not have any sitzmarkers left in the colon. s_teo


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## SpAsMaN* (May 11, 2002)

Look like we have a recto/sigmoid motility disorder.It always bring me back to this interesting research,once the sigmoid motility is restored,IBS symptoms *"*disapears*"*:COLONIC PACING IN THE TREATMENT OF PATIENTS WITH IRRITABLE BOWEL SYNDROME:http://www.bioscience.org/2003/v8/b/989/pdf.pdf


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## SpAsMaN* (May 11, 2002)

Constipation test:http://www.medscape.com/viewarticle/501075_4


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## 22590 (Jul 18, 2006)

Hi everybody. Yesterday I visited my GI doctorand discussed my problems. He said that it could be that I have both PFD and IBS. He also said that the only way to cure my IBS is to resolve first PFD. He gave me a prescription for a kind of spasmolitic pills to calm my colon (colotal). Yesterday in the evening it worked. Meanwhile, I'm continuing my exercises for biofeedback. I don't know whether it works, but it doesn't harm anyway. I don't feel improvement in my BM. Everyday I have to go MANY times by small portions. Good health to everbodyP.S. I also failed in balloon test.


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## SpAsMaN* (May 11, 2002)

Wow Mike you are SOOO welcome here.We have common symptoms.I also have many fragmented BM.ALWAYS incomplete evacuation.I'm rising the possibility of another rectal sphincter(much higher in the rectum):*Rectosigmoid junction: anatomical, histological, and radiological studies with special reference to a sphincteric function:*http://www.ncbi.nlm.nih.gov/entrez/query.f...3&dopt=Abstract


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## 14554 (Aug 24, 2006)

I just found this website tonight after my doctor scheduled me for my first Botox injection next week. What you have just said sounds like me!! Had my third baby 15 months ago after which at 6 week postspardum (when I began running again!!) I developed Pelvic Floor Dysfunction. Of course, at the the time I had NO idea why I was having such pain and it took me 4 months to find a GREAT doctor to find my problem and PROPERLY diagnose me with PFD. Her name is Dr. Susan Kellogg-Spadt and she is with the Pelvic Floor and Sexual Health Institute at Graduate Hospital in Philadelphia, PA. She is amazing and takes a VERY aggressive approach to getting better. To answer your question, YES your problem is definitely related to childbirth. Please email me if I can answer any questions for you. It sure sucks, huh?? But you CAN get better - and hopefully I will begin running again soon!!


> quote:Originally posted by runningrd:I have wondered if this is my problem too - the pelvic floor dysfunction. Can't it be a result of childbirth? My problems started after I had my son. I had an emergent episiotomy (it was a bad one!) and forcep delivery - almost had to have c-section (maybe I would be normal if I had one
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## teach (Oct 20, 2001)

I would LOVE to hear from anyone who has tried biofeedback. I was dx. with a rectal Prolpase and one of the main symptoms is incontinence. They say part is due to a weak pelvic floor. Will the biofeedback push the prolpase back up.. I know it may help the incontinence. How does it work? Do you have to prep each time and how many times do you have to go. I have soooo many questions!!!!


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## 22590 (Jul 18, 2006)

Hi everybody,To SpAsMaN: I looked at the abstract of the paper, but didn't understand too much. It could be that there exists another sphincter, but this knowledge doesn't make my life easier. About biofeedback. I got three exercises to do everyday. They are very easy, but I'm not a good student. So, I do only one, and it seems to me that I'm doing a little better. So, here is the exercise (for those who want to try). You have to sit down on a hard flat chair close to its edge. Your back should be straight. Then you have to contract the sphincter 10 times and then to relax it for 20 seconds. This should be done in three series per day, each series is 20 times of contraction-relaxation. Good health to everybody


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## SpAsMaN* (May 11, 2002)

Mike60,i guess the debate is still on regarding the rectosigmoid junction and his influence pelvic floor dysfunction but it is very interesting to learn how the RSJ works.http://www.ncbi.nlm.nih.gov/entrez/query.f...term=O'Beirne+J[PS][/URL]1: Dis Colon Rectum. 1986 Aug;29(8):525-31. Links Rectosigmoid sphincter of O'Beirne.Ballantyne GH.In the early 19th century, James O'Beirne proposed that a physiologically important sphincter existed at the rectosigmoid junction. Interest in the rectosigmoid junction had been stirred by a common affliction of the time: spasmodic constriction of the rectum. It was believed that many patients suffered from chronic constipation because of rectosigmoid spasms. O'Beirne proposed that a sphincter at the rectosigmoid junction governed the passage of stool from the sigmoid into the rectum. Further, he maintained that spasmodic constriction of the rectum resulted from dysfunction of this rectosigmoid sphincter. His views, however, conflicted with those of such contemporaries as Houston, who emphasized the role of rectal valves in producing spasmodic constriction. Anatomic studies in the early 20th century found at least a rudimentary sphincter at the rectosigmoid junction in 40 percent of the normal population. Motility studies in the last 35 years have demonstrated unique intraluminal pressure patterns as well as the propagation of retroperistaltic waves in this area. The rectosigmoid in patients with constipation shows an increased activity, as if this area is causing a physiologic obstruction to the passage of stool into the rectum. In contrast, the rectosigmoid in patients with diarrhea demonstrates markedly decreased activity, thereby providing unobstructed access of the feces to the rectum. These studies support O'Beirne's hypothesis that a sphincter governs the passage of stool from the sigmoid colon into the rectum.Personal Name As Subject:


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## 22590 (Jul 18, 2006)

If there is a sphincter (in the rectosigmoid), then it should be seen during colonoscopy, shouldn't it?


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## SpAsMaN* (May 11, 2002)

Yeah it could.You know what Mike60,i have the cassette video of my defecography.I look at it dozen of time.One thing finally strike me is that there is like a stricture formed in the recto-sigmoid area.When the barium cleared out after the first evacuation,it reveal high in the rectum a shrink with a stricture appearance.







I never got any clue from it so far or any explanation from experts.


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## annie7 (Aug 16, 2002)

thanks, Spasman, for posting that article about the sphincter at the rectosigmoid junction. that confirms what I've always felt is happening--it seems like I can feel something just snap shut in that area and it won't let any more poo out even though the poo is there so it just backs up causing distention, discomfort and pain. I try to use small enemas and/or glycerin suppositories to make that spasm open up and sometimes they work and sometimes they don't.


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## byte (Feb 15, 2004)

> quote:Originally posted by s_teo:If the rectum is empty, what would that mean?s_teo


this thread is quite interesting! i myself am curious to the answer of this question.you see, when i did my colonoscopy 2 years ago, despite following the pre-op procedure to the letter, i still felt unevacuated. but sure enough, the colonoscopy went normal, and the images showed a clear colon. when i told me GP about this puzzlement, he just said it could be because of one of two things:1. because i have ibs and cant evacuate properly, my colon has stretched due to the stools and would need time to shrink back to normal.2. because of the ibs, my colon is never-endingly spasming, making me feel like im unevacuated.however, this didnt sit well with me because i dont seem to be experiencing what many others on this board seem to be. i dont bloat, i dont have gas, i dont have pains or cramps. i dont have trigger food. i eat a balanced diet with lots of fibre and i exercise a lot. in fact, i actually have daily BMs with solid big stools (sometimes twice a day). admittedly, coffee and alcohol make it easier to go. but i just never feel fully evacuated - EVER! there is definately stool in there.perhaps you could shed some light on the matter? i would love to hear any opinions you have and any help you could offer. id really appreciate anything really.


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## hayley3 (Aug 6, 2006)

Hey Annie,I feel the same thing. I can feel it shut, whatever IT is. I think the stress herbs are helping.Of course, I'm now doing the milk thistle again. So far, so good.Susie


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## 22590 (Jul 18, 2006)

I did a colonoscopy a month ago and I wasn't completely evacuted! The doctor showed me inevacuted stool in my colon. Nevertheless he wrote "normal colonoscopy". I also don't feel complete evacuation for more than 3 months. I suppose that this feeling will follow me till the end of my life Good health to everybody


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## SpAsMaN* (May 11, 2002)

Sherylsa,HOW WAS the Botox injection this week?


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## SpAsMaN* (May 11, 2002)

S_teo,do you have pelvic discomfort?Like stools stuck on the pubic bone that irritate the area?Please lemme know.


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## I'll B Snookered (Apr 9, 2004)

Hey Spasman and others,I also have nonrelaxing puborectalis (inability to expel balloon) and incomplete evacuations. I don't know anything about a rectoanal sphincter, but I think what y'all might feel closing off the rectum is the puborectalis muscle. Do a google search to see where this and the other pelvic floor muscles lie. For me it is definitely that muscle, though my IEs are in center and not on the left or right.Check out the thread on squatting again. It is not enough to just raise your feet. I have posted an interesting study and my own experience. In short, it greatly helps me with IE by increasing the anorectal angle.For any of those who had anorectal manometry, do you also have blunted sensation? On my report, it says, "He had first rectal sensation at 180cc and maximal tolerable volume of 320cc, which is severely blunted."For anyone who does have blunted sensation, I found an interesting procedure called the Secca procedure. It is for moderate fecal incontinence (which I have), but there is an interesting statement in the final report by Dr. Efron regarding the procedure: "The only change in anorectal physiology results was a significant reductino in the initial and maximum tolerable rectal volumes." http://www.surgicaltechnology.com/0-STI-XI...%20treatment%22Obviously, if you really are constipated, this is not an option, and it isn't going to do anything for spasming. However, if you are like me and incomplete evacuations and maybe a little fecal/gas incontince occur, it might be helpful. Just throwing it out there.For me, I am going for:Biofeedback -> Secca -> ColostomyI haven't read anything good about pelvic floor repair surgeries.


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## 15757 (Sep 13, 2006)

> quote:Originally posted by SpAsMaN*:S_teo,do you have pelvic discomfort?Like stools stuck on the pubic bone that irritate the area?Please lemme know.


I have constanct lower back problems that seem to be getting worse. YOU?


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## SpAsMaN* (May 11, 2002)

Welcome Cjj







Oh yeah if i walk too quickly my lower vertebrae hurt.I had 2-3 back blockage in the last year.Now i watch out.


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## s_teo (Aug 14, 2006)

To Spasman and Cjj:Yes, I do have pelvic discomfort. I can say that I almost always I have some degree of discomfort, sometimes really bad. The sphincter area becomes very irritated, sometimes blood comes out with stool. I also have pain in the left side of my tummy, lower portion of the colon, the sigmoid. When I am in this situation I am not able to work. But most of the time I can prevent this by using glycerin suppositories or dulcolax 5 mg.s_teo


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## SpAsMaN* (May 11, 2002)

Wow S_theo.You're like me.The pressure stuck in the lower descending colon is disgusting.


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