# Levator Ani Syndrome cause of LG? Imp please read



## oceanblue141

Please look at the treatment. It looks very familiar to us. Most of LG sufferers got cured or managed symptoms by using Specific Diets, stress relief techniques, Antibiotics, Grapefruit seed extract, Oregano oil, Calcium & vit D3, L-glutamine, L- carnitine, Mg, Zn, Omega fish oil, Flax seed oil, Benzodiazepines(Valium, Klonopin, Xanax, Ativan as well as Lorazepam, Librium), Ketoconazole etc.,

Link: http://www.chronicprostatitis.com/protocol.html

(Also check causes and other treatments)

*Levator ani syndrome* is weakening of Levator ani muscles or pelvic floor dysfunction.

Symptoms include a dull ache above the Anus or higher in the rectum and a feeling of constant rectal pressure or burning. The pain may also be felt in the low pelvis or perineum.

*TREATMENT*

The following distilled wisdom has been gleaned from the experience of the site managers, the advice of prostatitis researchers and discussion among sufferers on the forum. It has made many sufferers feel close to normal again. A word of caution: do not take any of the prescription medications mentioned herein without discussing it first with your doctor!

The traditional treatment for this malady has been (and for many urologists still is) antibiotics. We frown upon the use of antibiotics after they have failed. The archives are full of men reporting negative side-effects from these drugs. Most knowledgeable urologists today will discourage the use of antibiotics if they fail to cure a patient and cultures are negative. Unfortunately, many men are temporarily helped by these drugs, for complex reasons, and this convinces them that they have an infection, sending them looking for new prescriptions again and again. In extreme cases men have taken antibiotics continuously for years without any lasting benefit.

In order to subdue symptoms you may have to change your lifestyle, diet, career, approach to life psychologically. Maybe your genes will not comfortably allow you to be the go-getter or fire-eating Type-A personality you used to be before all this started. Maybe that high-stress power career is no good for you. At first you will mourn the loss of these things, but after a few years most men adjust and feel that the sickness has taught them valuable lessons about life, fostering a calmer, philosophical approach wherein attention is paid to relaxation, both physical and mental. Other men are able to maintain high pressure lifestyles with the addition of meditation, relaxation exercises and physical therapy (as outlined in the Wise-Anderson Protocol).

With care, it is indeed possible for many sufferers to have long periods of feeling extremely well with symptoms so subdued that they are hardly noticeable.

The future looks very promising for this disease/syndrome. New treatments (releasing pelvic muscle spasms, neural stimulation, tinkering with genes, drugs which target tiny subsections of the immune system etc.) offering even more efficacious symptom control and perhaps even a total cure are looming on the horizon.

In addition to *quercetin*, it is advisable and useful to take some key supplements to bolster your immune system and subdue inflammation.


*Chondroitin Sulfate* - This substance prevents mast cells from triggering pain by releasing a myriad of nasty chemicals when provoked by nerves, allergies or any of the many other things that stimulate these cells. The longer you take it the better it works.
*Calcium with Vit D* - Adequate calcium is vital for the proper functioning of the immune system. To protect the prostate from cancer, always take Vit D3 when taking Calcium supplements. Studies have shown that calcium alone may promote prostate cancer.
*Magnesium Citrate* - Helps prevent muscle spasm and trigger points; counterbalances Calcium.
*Ester C* - Take 2g daily. Lowers histamine in blood by up to 38%. Protects against leaky gut. Natural antihistamine (1, 2)
*Selenium* - Take only once a week. Immune system support.
*Zinc Cellmins* - 30mg daily. Cycle 4 weeks on, 4 weeks off. Vital for prostate health.
*Enteric Coated Fish Oil Softgels* - Contains anti-inflammatory oils (EPA).
*Evening Primrose Oil Softgels* - Contains anti-inflammatory oils (GLA).
*Flax Seed Oil* - Contains anti-inflammatory oils (ALA). 1 tablespoon daily if possible. Drizzle on salad.

General Recommendations

*Avoid stress.* Avoid excessive sitting (pressure can be a mast cell trigger) and use a donut cushion (see page on sitting) if you have a sitting job. Avoid truck-driving, bicycling and horse riding. Avoid excessive exercising (a mast cell trigger) and fatigue, but do take gentle exercise, like walking. Avoid foods to which you react with phlegm, stomach pain, diarrhoea, flushing, headache, rash, joint pain (allergens degranulate mast cells, releasing histamine, and this may be the cause of your condition). Eat blue/red onions (full of natural quercetin) as is broccoli. Climate: a hot, dry (immune-system-friendly) climate is preferable to a cold, wet one. Researchers in northern Europe report that cold weather (a mast cell trigger and muscle spasm promoter) co-incides with flares.

*USEFUL ADJUNCTS*

The following agents help some but not all sufferers. You may wish to experiment, especially if our protocol as outlined above does not do the trick for you (listed in no particular order):


*Condoms* for intercourse and consciously relaxing during masturbatory ejaculation help many men avoid overstimulating the pelvic nerves and lead to far less post-orgasmic pain. Do not tense the pelvic muscles during ejaculation. Let your pelvis remain "limp".
*Alpha blockers* (Flomax, Hytrin, Cardura) relax smooth muscles in area. Also thought to work in as yet unexplained ways (e.g. Hytrin attenuates nociception-induced substance P upregulation).
*Antihistamines *like Vistaril (hydroxyzine) antihistamine, inhibits bladder mast cell activation by neurogenic stimuli, and has anticholinergic, anxiolytic and analgesic properties. It is useful to take Flomax concurrently to stop Vistaril's tensing (antimuscarinic) effect on bladder neck and peri-prostatic smooth muscle. Some people cannot tolerate hydroxyzine, and they may try Allegra (H1 receptor antagonist) and/or Zantac (H2 receptor antagonist).
*Neurontin* (anticonvulsant) useful for nerve pain.
[B]Elavil[/B] a mast cell protector, muscle relaxant, subdues nerve pain.
*Botox injections* (only via expert uros, currently under research) temporarily stuns nerves, allowing neural "wind up", which causes mast cell degranulation, to subside.
*Ultram* (Tramadol) a synthetic analogue of codeine. Useful in breaking the pain cycle. Supposedly non-addictive, but some men have had problems. May degranulate mast cells, like other opioids (hydrocodone, Vicodin etc), so long term or frequent use not advised.
*Calcium Glycerophosphate* takes acid out of food to help stop pain and urgency. Use a tiny pinch in water when eating acid foods that irritate the inflamed bladder and/or prostate. Very useful. The cheapest way to get this food-grade chemical is here (no affiliation or relationship to our website).
*Benzodiazepines* (Valium, Klonopin, Xanax, Ativan as well as Lorazepam, Librium) for anxiety and to help release muscular spasm. Careful with addiction.

More details of medications, including side effects, can be viewed on our medications page.

Other items rumored to help:


*Indomethacin* a NSAID, preferably as suppository
*Arthrotec* the arthritis drug (anti-inflammatory)
*Melatonin* (anti-inflammatory)
*Saw Palmetto* a traditional remedy.
*Celebrex* as needed (anti-inflammatory)
*Cernilton* (Cernitin) pollen extract, anti-inflammatory
*L-carnitine* decreases reactive oxygen species
*Grape Seed Extract*
*Viagra* - also helps with sexual symptoms, if present.
*Ketoconazole* or *Proscar* (anti-androgens)
Gentle *prostate massage* for boggy glands. Some men report flare-ups from this, probably because the most common muscle trigger points in the pelvis are located behind the prostate gland in the insertions of the levator ani muscles.
Hot shallow *baths* (*sitz* baths) - not too long, or it's enervating.
Regular Ejaculation
*Walnuts* (rich in anti-inflammatory omega-3 fatty acids; keep refrigerated).
Herbals / herbs : *tribulus terrestris, nettle root, maca root, gotu kola and marshmallow*

*IRRITANTS AND TRIGGERS*

Different people have different triggers/irritants, but here are the most common you may wish to experiment with avoiding:


*Psychological*: Stress in mice and cats triggers their bladder mast cells. Most likely this occurs in humans and other mammals too.
*Food*: Excessive amounts of high sugar foods, alcohol, spices, vinegar, caffeine, coffee, chocolate, sodium benzoate (a histamine release trigger), milk products, very acid foods (e.g. tomatoes, cranberry drinks), Nutrasweet. An exclusion diet will define your unique list of food irritants and triggers.*Wheat* (a lectin that can make mast cells more leaky and more prone to degranulate) seems to be a specific trigger for many individuals, even those who test negative for celiac disease (sprue). Their stories are available on the prostatitis newsgroup archives. Gluten can be a nerve poison in some individuals (see prostatitis forum). The issue of diet is a huge one for some men, who swear that by modifying their diets they were able to calm or eliminate the pain in their groins. These men tend to be "atopic", reacting to some foods with diarrhoea, stomach pain, phlegmy or "tight" throats, headaches, rashes, excessive sweating, depression and fatigue. If that sounds familiar, read this excellent book: Food Allergies and Food Intolerance : The Complete Guide to Their Identification and Treatment Jonathan Brostoff MD, Linda Gamlin
*Sexual Activity*: too much sex, too little sex. Find the right frequency for you. Be sure to avoid "Tantric" sexual practices, which involve grasping the penis tighly to prevent ejaculation. Some men have reported that this started their problems.
*Sitting* or pressure on the perineum. Pressure may trigger mast cells.
*Marijuana*
*Exercise*: strenuous exercise can provoke flares for some by triggering mast cells.
*Medications*: avoid those which can cause urinary retention. Be careful of decongestants and antihistamines such as Sudafed, Tavist-D, Contact, Afrin etc. Some people report problems with SSRI antidepressants (Prozac, Zoloft, Celexa, Paxil etc). Some men say their condition was caused by thermogenics (Xenadrine, Hydroxycut). Several men have reported their condition being triggered by androstenedione (see prostatitis forum), a direct hormone precursor of testosterone, which is used (abused?) to build muscles in bodybuilding. Dr Shoskes says he has seen many men report getting symptoms after taking testosterone. Some men experience bad effects from drugs like Prilosec, Lipitor, Lescol, and Aciphex. One man reported Sectral to cause symptoms.


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## Kathleen M.

But most people with LG are not complaining of the particular pain location and quality that is the main symptom of Levator Ani syndrome. I hear a lot of discussions of sensations back there but the particular it feels like I am sitting on a ball and it gets more painful the longer I sit which is the typical pain pattern doesn't seem to be what most people complain of. Not sure most leaky gasses need muscle relaxer treatments?

http://www.healthcentral.com/encyclopedia/408/373.html has the sitting on a ball reference.

And did you quote the right article, the one you quoted is mostly about chronic inflammation of the prostate, but does have a bit about levator ani problems associated with that. I don't recall most LG people complaining of prostate problems?

ETa: http://www.pelvicpainhelp.com/symptoms/levator-ani-syndrome/

so sometimes it has been called a prostate problem even though it doesn't have anything to do with the prostate.


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## oceanblue141

What I meant is LG can be related to Levator ani syndrome although the symptoms are exactly not the same, somewhere there is connection, LGers experience dull ache or constant rectal pressure, burning in rectal region which is felt sometimes(Wikipedia), sitting increases LG, Sexual activity increases LG. You must have noticed most LGers talking about incomplete evacuation, feeling of something left in rectum which can be compared to ball inside rectum, i do feel this when i am in intense stress after i got LG. Treatments of Levator ani syndrome has a lot more connection to LG success cases.

LG in the sense I mean Leaky Gas, uncontrollable constant gas coming out of anus, gas which you cannot control and can be felt most of the times, NOT skin. All the LGers who used muscle relaxers(ativan, Nardil etc.,) in correct doses have been symptom free as long as they are on it.

Yes the article talks about prostate muscle inflammation or weakness(muscle in contracted state). We can relate this to inflammation in pelvic floor muscles which might be causing LG. Just an assumption.


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## Kathleen M.

I was just thinking that anything that would make a sphincter relax might not be what is needed, but maybe I am wrong. I have to avoid most things that relax muscles because of GERD and I need that sphincter to be as tight as it can be, not relax even more than it already is.

If theanal sphinter is tight I woudln't think the gas would leak out of it. Usually it is supposed to be air tight. But I could be mistaken.

Just I've seen several people without LG on the board make (without having heard of LAS) say they have ths pain like they are sitting on a ball. Seems like I'd have seen that more in the LG community, but I could have missed it completely.


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## thickthighs1

Im with you Kathleen m,I also have GERD and need my sphincter muscles to close better than they do now...also I take a half of Xanax before I leave the house in the morning and I can STILL feel-and used to smell-LG...I don't think THAT sphincter is as tight as it used to be.Probably because I give myself enemas so much.


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## westr

oceanblue141 said:


> Other items rumored to help:
> 
> 
> Regular Ejaculation


ill try this and get back to everyone


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## oceanblue141

Since there is no diagnosis for Leaky Gas, either it must be a known disease which is causing weird symptoms in few of us instead of the regular symptoms or it should be a germ which is still not identified.

You might have heard in the this forum, "sitting makes my gas lot worse", "warm or burning sensation in anus when i sit", "feel like something is stuck in my anus". These are similar symptoms of levator ani syndrome if not exact. Disease and germs may evolve or alter, it might not show up the same symptoms in every one. I am not saying its 100% LAS, there might be chances. There are no tests to diagnose LAS, its like IBS, after all tests if nothing is found it is termed as LAS.


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## Kathleen M.

I don't assume the only symptom that is "gas" is pain. LAS is, I though, mostly about pain, but I could be wrong.

I also don't assume that medical science has found every last possible thing that can break in the body.

I don't think it is some bacteria that only makes LGers stink as many people with normal controllable gas will pass gas exactly when they decide to that stinks as bad or worse than anything anyone talks about. So being a sulfur reducing predominate person will make your gas smell much much much worse than a methane predominate person, but both are seen in the normal population. I don't thinkt here is a gas that only some weird bacteria produces that can burrow it's way out without some sort of other issue going on (and odor, even if fecal, doesn't have to come from only the intestines).

Also, I tend to think more of the original LGers who often had no sensations and nothing that ever does reduce odor of gas in the intestines nor did any medication that is for IBS or pain in the intestines ever made a difference at all to symptoms in any way. But the population of those using the term has changed over time, so now I'm not entirely sure who counts and who doesn't. Other than most people have some kind of so far unexplained odor problem. I think there may be multiple things going on, and it just doesnt' seem like severe pain is the worst complain in this population, most of the time.

Has any of the LGers complained of pain that woudl be treated with biofeedback, various electrical stimulus devices or botulinum toxin? http://www.aetna.com/cpb/medical/data/600_699/0679.html%C2


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## oceanblue141

LGers in this forum have tried almost all the IBS medicationsand antibiotics targeted on intestines with less or no relief. What i mean to say is there might be something else triggering the intestines to cause LG rather than blaming main problem is in intestines (just an assumption, not 100% sure).

Again there might be some underlying problem in LGers which is maSking its regular symptoms, but causing LG by irritating intestines and rectum. Sometimes by identifying and treating the underlying cause we can win on LG.

*Assumption:* Underlying problem/disease in LGers masking its primary symptoms but causing secondary symptoms which inturn causes LG.

*Example:* Urinary Tract Infection

*Symptoms: *


Strong urge to urinate frequently, even immediately after the bladder is emptied
Painful burning sensation when urinating
Cloudy or bloody urine, which may have a strong smell
Pain in the pelvic area or back
Discomfort, pressure, or bloating in the lower abdomen
Pelvic pain, in women; Rectal pain, in men; Pelvic pressure; 
Links[ http://www.mayoclinic.com/health/urinary-tract-infection/DS00286/DSECTION=symptoms][http://umm.edu/health/medical/reports/articles/urinary-tract-infection]

*Discussion:* Lets assume a person is having UTI and dont have any of the above symptoms except pressure in lower abdomen or pelvic pressure. Having pressure in lower abdomen might irritate Colon, Rectum and anus and can cause high mucus secretion and gas to leak out. The pressure increases when seated, more irritation and there by more gas. When there are people around, anxiety about leakage can cause extra pressure on the lower abdomen and result more LG. More pressure might also cause either Diarrhea/Constipation, mucus in stools, haemmaroids, burning sensation etc., When we consciously relax abdominal muscles, correct posture, other supplements or diet which soothes intestines and rectum can decrease LG up to certain extent.

Also if a person is cured by oregano oil, grapefruit seed extract or parsley, instead of thinking it cured SIBO, we can also assume it might have reduced or ended the Urinary tract infection, there by relief.

*Conclusion:* This is just an example relating UTI and LG. But there might be some other underlying cause.

An example where a disease causing unusual symptoms rather than the usual symptoms.

UTIs Cause Behavioral, Not Physical Symptoms in Elders "A UTI is an infection of the urinary tract, most commonly the bladder. For most people, the need to urinate frequently and/or urgently are two key symptoms of a UTI. So is a burning sensation when you go, and urine that is an off color or has an odor. Sometimes, a small amount of blood in the urine is visible. But in older adults, those symptoms are often missing. Instead, older adults may suffer from unexplained incontinence, vague fatigue or significant changes their behavior and mental status. Urinary tract infections sometimes resolve on their own, but they are easily treated with antibiotics. When left untreated, UTIs can lead to chronic Incontinence."

Source: http://www.agingcare.com/Articles/urinary-tract-infection-symptoms-151547.htm


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## desprate

Hi Oceanblue..my odor get worse after urinating i don't know y cauz i alwayz wash after passing urine sometimes with little soap..and 1 more thing after night fall(wet dream)smell get worse also.

please can u tell is it UTI infection?thax.

GOD bless us all.


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## oceanblue141

desprate said:


> Hi Oceanblue..my odor get worse after urinating i don't know y cauz i alwayz wash after passing urine sometimes with little soap..and 1 more thing after night fall(wet dream)smell get worse also.
> 
> please can u tell is it UTI infection?thax.
> 
> GOD bless us all.


Your symptoms seems to be like chronic prostatitis. You have to get diagnosed for that. Semen and urine culture and sensitivity tests are needed to check if you have any infection. Please go for a lab test asap.



pengu said:


> This is very interesting. So what do you suggest?


Many of us in this forum have done A to Z tests for gastrointestinal issues with mostly negative results. We should think in a different way and check if we have any underlying disease which is causing weird symptoms only in few section of people. May be we have high sensitivity for that disease and causing these issues.


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## oceanblue141

I have seen a GI Doc 2 months back and she prescribed me ofloxacin for a week thinking my symptoms are due to SIBO (my biopsy showed no inflammation in my duodenum). When i was on it i found 70 - 80% less LG than usual. I researched and found Ofloxacin is effective for UTI and prostatitis. I related few of my symptoms to UTI and Prostatitis like burning after ejaculation, pressure or burning sensation in my rectum when i sit.

I have given my Urine and Semen samples for culture and sensitivity testing and got my results today evening. I got positive for Klebsiella species(>10^5 cfu/ml) in Urine and E.Coli in semen. I saw Andrologist/Urologist, i told all my symptoms and he said i might be having chronic prostatitis and IBS together. He said stress is causing it, stress and anxiety can make environment of prostate or any organ convenient for bacteria to grow. I said i am anxious only because i have these symptoms. He told this is viscous cycle and we have to break it somewhere. He prescribed 30 days antibiotics- prulifloxacin and pregabalin for anti-stress and muscle relaxation.

I am not 100% sure that this is it, but i am hoping for a miracle. I will let you know if clearing my prostatitis and UTI will solve my LG.


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## Kathleen M.

Hope it works for you. And it can be a vicious cycle. The source of the stress doesn't matter. Stress is bad for you, and the physical and emotional stress from feeling less than well is just as bad for increasing symptoms as stress due to work or relationship issue, or physical stress from weather, etc.


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## carl100

oceanblue141 said:


> I have seen a GI Doc 2 months back and she prescribed me ofloxacin for a week thinking my symptoms are due to SIBO (my biopsy showed no inflammation in my duodenum). When i was on it i found 70 - 80% less LG than usual. I researched and found Ofloxacin is effective for UTI and prostatitis. I related few of my symptoms to UTI and Prostatitis like burning after ejaculation, pressure or burning sensation in my rectum when i sit.
> 
> I have given my Urine and Semen samples for culture and sensitivity testing and got my results today evening. I got positive for Klebsiella species(>10^5 cfu/ml) in Urine and E.Coli in semen. I saw Andrologist/Urologist, i told all my symptoms and he said i might be having chronic prostatitis and IBS together. He said stress is causing it, stress and anxiety can make environment of prostate or any organ convenient for bacteria to grow. I said i am anxious only because i have these symptoms. He told this is viscous cycle and we have to break it somewhere. He prescribed 30 days antibiotics- prulifloxacin and pregabalin for anti-stress and muscle relaxation.
> 
> I am not 100% sure that this is it, but i am hoping for a miracle. I will let you know if clearing my prostatitis and UTI will solve my LG.


Yeh keeping my fingers crossed for you and all of us m8!


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