# Diagnosing pelvic floor isuues



## AIRPLANE (Mar 15, 2004)

Hi. This is my first post although I have visited this site many times over the past few years. I was interested in hearing from people who were diagnosed with IBS but were fairly certain that it was a structural problem with the pelvic floor yet few physicians seemed to be familiar with this type of thing- even gynecologists.My so-called IBS began back in 1984 when I was 25. It was at the end of the workday at a job that was physically demanding- I dropped something on the floor and bent over to pick it up-no, I didn't remember to bend at the knees as I was hurrying-and felt something 'snap' on the right side of my pelvis. I began to experience loud gurgling in the pelvic area, almost as though fluids were having to squeeze through a tight area. I could not be in a quiet room for very long as this noise was almost constant- especially if I was sitting. After about two weeks of this, I began to experience throbbing in the pelvis and began to have frequent, severe diarrhea, along with a very sore feeling that was pretty much 24-7. I always felt like I needed to go- this was all new to me as since early adolescence I had had primarily constipation which was bad enough to cause bleeding sometimes when I went. I also began to experience urinary urgency and passing lots of wind every few minutes.To me, it was just like my abdomen had relocated to my groin- I no longer got a "tummyache" where I used to- it was all now in my pelvis! And even though my sphincter muscles were said to be OK, I had little voluntary control for the most part although I did not quite need to wear adult diapers.It was probably 3 or 4 weeks after the original incident that I finally went to a doctor who did not bother to examine me at all. He just laughed and said 'You have IBS' and instructed the nurse to give me a copy of a bland diet with lots of fruits and vegetables. As you may have guessed this had no impact on my symptoms.Eventually I saw a gastroenterologist who pretty much made the same diagnosis BEFORE doing any testing but I was given a sigmoidoscopy, barium and colonoscopy during the next year or so. At all of my doctor visits, my pelvic pressure issues were dismissed or downplayed. It was very frustrating as the 'falling out' sensation was so unmistakable to me. But the arguments they made were that I was young and had never had children so then these problems usually would not apply to someone like me. I feel that 'usually' means 'never' in most doctor's minds.Over the next few years I was shuttled back and forth between gynecologists and gastroenterologists- each one would do their 'basic' tests-pelvic exam, more sigmoidoscopies, and when they were completed they would tell me to 'go back to the other specialist'. I would go for months, and eventually a few years in between doctor visits as I felt I was getting nowhere and was just wasting time and money.I spent lots of money on so-called miracle products and fiber.Any time I read anything about IBS solutions I would try them.Eventually a doctor at a nearby University clinic/hospital did a diagnostic laparoscopy which showed I had a golf-ball sized fibroid on my right side and an enlarged and distorted uterus and said that the uterus should come out. I decided I did not want to have a hysterectomy at this time as I had put my life on hold and was still hoping to find a solution to this problem and would possibly want to have kids when and if this came about. I'm the youngest of 3 children and my older sister could not have kids and my brother was never going to either so this upset my mother as well. I was not married or even really dated because my condition pretty much made me a recluse except for when I had to go to work which was very difficult- I could deal with the pain but the wind of course was a big issue. Once people got a whiff of me any potential dates disappeared and I couldn't have handled a relationship anyway with the degree of my symptoms.An interesting thing happened after the exploratory laparoscopy though. My pelvis was even more sore than usual for a few days but it felt as though things 'loosened up. A week later, the pressure disappeared and so did the digestive problems. I also became much less bloated and lost a lot of excess water in a few days time- I went down about 3 clothing sizes in a week. However,the relief lasted only about 10 days and then I felt everything falling and tightening up again and soon all of my symptoms came back.The water weight did stay off for quite awhile though. The doctor gave me a shot-I forget what it's called-that might help shrink the fibroid and would put me in menopause but it did not help. I asked the doctor why my symptoms temporarily improved but he had no explanation. He referred me to a gastroenterologist at the same clinic and said he was 'one of the best' but he turned out to be an arrogant lazy jerk from the time he walked in the door and rushed through a rectal exam and said he didn't see anything. When I challenged him he became extremely hostile and demeaning and the student that was with him became red-faced- I hope the student learned that this was how 'not' to be a doctor!He said the temporary improvement I'd experienced was psychological-I sure wish I had psychological problems now so I could go down a few clothing sizes in one week!I'm trying to keep this short but after 23 years it's hard to remember things. At any rate, after this I had a myomectomy for the fibroid which only worsened things. Finally in 1998 I decided to have a hysterectomy as by that time I was getting to the age where the likelihood of ever having a life where I could possibly have children was becoming pretty slim. Needless to say, the hysterectomy solved nothing. I was referred to him by 2 co-workers who thought he was good but then their problems were not the same as mine. I now think I should have cancelled at the last minute as the doctor was 6 hours late for the surgery- said he had a delivery to tend to and he seemed very rushed when he arrived. I told him before the surgery to please look around the area during surgery but I'm sure he didn't and I suppose they want to sew you back up as soon as possible. At my follow-up visit- again he was late and rushed- he asked me how I felt and I told him I felt no improvement to which he replied 'I think you feel better'! I never went back to him. After the hysterectomy it was a few years before I went to a doctor. I went to a chiropractor a couple of years ago and the adjustments helped the pressure a bit. He agreed to schedule a pelvic and abdominal MRI which no doctor would allow me to have. Unfortunately it did not show anything except for a rare tumor on an adrenal gland called a pheochromocytoma which I had removed last fall.Anyway, I'm now seeing a gynecologist who says I have a rectocele based on a pelvic exam. I just got an inflatoball pessary which is not working- it falls out during bowel movements when I need it the most- and in two weeks I'll see her again. She is the first one who will acknowledge that I have any type of pelvic floor problem so there is hope but I sure wish I hadn't had to go through a myomectomy and hysterectomy for nothing first! But as long as I had fibroids, every gynecologist blamed it on them. I know that the fact that I have had a hysterectomy is a known contributing factor to pelvic floor problems but I still say that this has been the problem all along and the hysterectomy did not help. Yes, I have tried doing Kegels for years but can barely move anything. I have read about some of the diagnosic tests available- defogram, etc.- have not yet had any but we'll see. I personally feel that these problems are not being properly diagnosed in many people but after reading some info from places like IFFGD see that maybe things are slowly improving. At the moment my biggest gripe is about appointments-i.e.- the amount of time you have to wait between visits. I think when people have chronic problems such as IBS it would be nice to have a clinic like the one I read about in a post here where you have a team approach in one place such as urinary, gastroenterologist and gynecologist- and could be scheduled for all pertinent tests/xrays in a short amount of time rather than dragging it out while the patient has to cope with the symptoms on a daily basis. As I've said to myself zillions of times over the past 23 years, 'Maybe someday'---------


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## 13599 (Mar 22, 2007)

Welcome AIRPLANE, I'am sorry to hear everything you have been though. Sounds like you have really been though the mill and more. This is a great site, you will find lots of support here.


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## SpAsMaN* (May 11, 2002)

> quote:student that was with him became red-faced-


Like that?







Sorry coudn't resist







Have you ever wonder why there is always a student when the situation is critical and WE NEED ANSWER!?


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## AIRPLANE (Mar 15, 2004)

Thanks for your replies guys. Yes, SpAsMaN, the student's face was pretty much as red as you showed! I can still remember it well even though this was back in 1990 or 1991- I remember he was wearing black horn-rimmed glasses which set the red color off pretty well.At least when I went back to the doctors who referred me they told me they had had problems with this doctor before but failed to explain why they referred me to him in the first place. Mostly I still remember the shock of encountering such a worthless piece of #### at a University teaching hospital and coming to a dead-end without him doing a single test or barely even speaking to me.


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## Jeanne D (Nov 14, 2001)

Hi AIRPLANE,Welcome to the BB.I'm sorry to hear all you've been through. This is probably the silliest suggestion you'll ever hear, but have you thought of seeing a chiropractor? I don't know that he/she could help, but if this pelvic problem is indirectly linked to your spine in some way, maybe some manipulations could provide you with some relief?I honestly don't know if that would even be possible, but I thought I'd mention it.I hope you're able to get this resolved.Hugs..Jeanne


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## AIRPLANE (Mar 15, 2004)

Actually that wasn't silly at all. I have been to a couple of chiropractors over the years. The first one I went to was shortly after my hysterectomy for a shoulder issue. It was standard procedure at his office to do an xray on new patients. He was very puzzled about an area on my right pelvis that jutted out to the right but since I'd just had surgery we couldn't do anything at the time. I quit seeing him after some issues. I went to another chiropractor a few years later but he wasn't very knowledgeable about this type of thing.I went to another one two years ago who said he felt that my right iliopsoas muscle was tight. At first the manipulations helped some but as happens so many times since this started something will help for a short time and then stop working. He was a very nice person and did schedule me for an MRI which found something on an adrenal gland. He did say I should see someone about pelvic floor issues and actually referred me to someone he knew but unfortunately they were not taking new patients.Anyway, I'm seeing a gynecologist now about a rectocele. I suspect as most literature about this says that I probably have a generalized pelvic floor weakness-that usually you have more than one problem- maybe even combined with pelvic floor tension if that is possible. Hopefully she will continue to work with me and maybe refer me for more testing if the pessary doesn't work which so far it isn't but we'll see.


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## kazzy3 (Apr 11, 2003)

It's not odd at all, a lot of people have found relief by visiting a chiropracter after all everything is connected and many have found relief for their pain and other symptoms as well.


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## ouchthathurts (May 14, 2007)

AIRPLANE said:


> Actually that wasn't silly at all. I have been to a couple of chiropractors over the years. The first one I went to was shortly after my hysterectomy for a shoulder issue. It was standard procedure at his office to do an xray on new patients. He was very puzzled about an area on my right pelvis that jutted out to the right but since I'd just had surgery we couldn't do anything at the time. I quit seeing him after some issues. I went to another chiropractor a few years later but he wasn't very knowledgeable about this type of thing.I went to another one two years ago who said he felt that my right iliopsoas muscle was tight. At first the manipulations helped some but as happens so many times since this started something will help for a short time and then stop working. He was a very nice person and did schedule me for an MRI which found something on an adrenal gland. He did say I should see someone about pelvic floor issues and actually referred me to someone he knew but unfortunately they were not taking new patients.
> 
> Anyway, I'm seeing a gynecologist now about a rectocele. I suspect as most literature about this says that I probably have a generalized pelvic floor weakness-that usually you have more than one problem- maybe even combined with pelvic floor tension if that is possible. Hopefully she will continue to work with me and maybe refer me for more testing if the pessary doesn't work which so far it isn't but we'll see.


Dear Airplane,I see a team of Doctors, some of which may have ideas that could help you. You see a GYN for rectocele. Have you considered a Rectal & Colon Surgeon for the rectocele? That is who is treating mine with great results in a short time period. Also you have pelvic floor weakness. Have you considered a women's health physical therapist? I have seen one. I went with great reservation, and the physical therapist knows what she is doing. My team of doctors all meet on the same day with me, and decide what is best.  Then other appointments are made as needed. I too have been going through this for many years, before finding this team. There is also a Urologist on the team. He talks about the "falling out" sensation which you described. Of course there is a terrific GI on the team as well. I hope some of these suggestions have been helpful. Keep looking for the best doctors and what you need.


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## AIRPLANE (Mar 15, 2004)

ouchthathurts said:


> Dear Airplane,I see a team of Doctors, some of which may have ideas that could help you. You see a GYN for rectocele. Have you considered a Rectal & Colon Surgeon for the rectocele? That is who is treating mine with great results in a short time period. Also you have pelvic floor weakness. Have you considered a women's health physical therapist? I have seen one. I went with great reservation, and the physical therapist knows what she is doing. My team of doctors all meet on the same day with me, and decide what is best. Then other appointments are made as needed. I too have been going through this for many years, before finding this team. There is also a Urologist on the team. He talks about the "falling out" sensation which you described. Of course there is a terrific GI on the team as well. I hope some of these suggestions have been helpful. Keep looking for the best doctors and what you need.


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## AIRPLANE (Mar 15, 2004)

After trying a pessary for about 3 weeks I've decided to see my regular doctor this week and tell her I want to be referred to the urogynecologist team at Mayo. She had told me she'd be willing to refer me there but wanted me to see a gynecologist first. The gynecologist is a nice doctor but I'm not convinced she is the best one to treat this. From what I've read, urogynecolgists are preferable to regular gynecologists because they deal only with pelvic floor issues- they don't deliver babies, etc. The gynecologist mentioned that she did surgery but after my poor experience with the myomectomy and vaginal hysterectomy I definitely want a more comprehensive analysis before I go under the knife again if that's what it comes to. It sounds like the Mayo clinic does have several treatments available such as physical therapy. I have wanted to go there for many years. When I was having such a hard time after the hysterectomy- especially when I was experiencing a rectovaginal fistula that nobody could find- I had asked a local doctor to refer me there but she took it personally and became hostile. When I called Mayo directly they would not take new patients unless referred.I will be seeing my regular doctor in a couple of days and am rehearsing what to say. She will probably wonder why I didn't ask the gynecologist for a referral but I kind of got the impression she felt she was competent enough to handle it so I didn't want to risk insulting her and making another doctor angry. She had wanted me to try a smaller pessary which had to be ordered but I simply don't think it will work and besides she is out of the office for a week or so and after a couple of very uncomfortable weeks with constipation and incomplete evacuation I simply don't want to wait another day! Also today I read somewhere that pessaries don't work well for women who have had hysterectomies but I thought it sounded like it was worth a try. Thanks for your reply!


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## AIRPLANE (Mar 15, 2004)

This morning I went to the Mayo site and decided to look under colon and rectal rather than urogynecology. It says that a referral is not necessary and they do deal with pelvic floor issues so think maybe I'll try them before seeing a urogynecologist. This would be great if I didn't have to go through a lot of red tape before seeing them. It says that often patients receive treatment, even surgery, within a week if necessary. I've often found the delays between tests and appointments very frustrating. Besides the endless waiting there is the issue of taking time off from work and now with fuel prices where they're at it can become even more costly.


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## AIRPLANE (Mar 15, 2004)

ouchthathurts said:


> Dear Airplane,I see a team of Doctors, some of which may have ideas that could help you. You see a GYN for rectocele. Have you considered a Rectal & Colon Surgeon for the rectocele? That is who is treating mine with great results in a short time period. Also you have pelvic floor weakness. Have you considered a women's health physical therapist? I have seen one. I went with great reservation, and the physical therapist knows what she is doing. My team of doctors all meet on the same day with me, and decide what is best. Then other appointments are made as needed. I too have been going through this for many years, before finding this team. There is also a Urologist on the team. He talks about the "falling out" sensation which you described. Of course there is a terrific GI on the team as well. I hope some of these suggestions have been helpful. Keep looking for the best doctors and what you need.


Ouch,May I ask how your rectocele is being treated? I asked to see a colon rectal person at Mayo but they said that it was only handled by the urogynecology team. I'm reluctant about surgery as I am worried about another rectovaginal fistula which nobody would admit existed. Is the physical therapy being used to treat it?


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## blee117 (Jun 10, 2007)

amen sister my story is very similiar to yours, from the moment i had problems I could tell that it felt like something was misalligned down there but doctors wont even consider that. Its ironic because I had my first baby she was 9-10 and I tore clear down to the muscle, youd think that might rearranged things, but even knowing my history the dr's were still arrogant a-hole's.. So I can understand that not having that history and being young how they would brush you off even more then they did me..my story is so long, ill try to shorten it as much as I can. Basically ive had problems with pooping and pressure down there since my first baby in jan 2005..Never had any probs before that..things got progressively worse to where I felt it was affecting my quality of life. I finnally went to my primary care who reffered me to a gyn who basically told me I had a small rectocele and he coldnt believe it was causing me that much of a problem.. I said "could it be something else since a small rectocele should cause this much pain a discomfert"? to which he replied "no".. basically calling me a wuss and crazy.. I was depressed for about a week then I thougt I know there's more to it, im not going to let that doc be right.. so I made and apt with a colorectal guy(since that is where most of my symptoms where asssociatd with), through a long process of tonz of test he diagnosed me with severe rectal prolapse, enterocel, rectocele, intussussception, yada yada... basically I was all screwed up down there. I had been doing research on my own and talked to him about multiple pelvic prolapse due to some other symptoms I had. He wouldnt even hear it he's all the problem is in your bowels and it's your only prob.So we scheduled a surgery, by this time I was severly depressed and sick all of the time..I was ready to go into surgery and so excited to be better, they had my iv in my arm and everthing and then they unexpectly found pregnancy hormomne in my blood...What the "who's the dad"?my husband said jokingly because A. i was on birth control and B. we seriously had only done it 2 in 3 months due to me being sick..I know the baby had to have been meant to be, one tough little sperm.. So colo doc said we'll have to try to get you through the preg and then do the surg.. i was in and out of the hospital with partial bowel obstructions and dehydrated, throughout pregnancy due to throwing up.. and my stupid colorectal doc was always saying "i dont know why your having such a problem, your problem is mostly by you rectum witch shouldnt be causing this." I always told him it feels like my stomach is working fine, and then there is just something pinching off or closing off my poop right before it exists, which in turn makes me so backed up that I throw up.. He never listened and my ob doc and colo doc passed me back and forth as if I was I hot coal they didnt want to touch...I got throught the pregnancy, I dont know how because the illness wore on my mind and body, and the hormones, you know you start to believe your crazy, I started to have panic attacks and cry every night, I just wanted to feel healthy and have good times with my daughter, .. I finnally just got my surgery about 3 months ago and the colo docs all "oh my gosh it was so much worse then I thought I can understand why you couldnt poop,ahhhhhhhhhhhhhhhhhhhhhhhhhhhhh.stupid guy. so since the surgery I could tell whatever was wrong was not fixed, I still had the same feelings down there, if any thing I was more obstructed and sick..also i could not pee after surgery, they sent me home with a strait cath and said oh youll probaly start peeing soon. and colo-doc says "nothing i did should have affected that"..ok so I pee fine before surgery and now I cant pee and your telling me theres not some connection?.. I really dont even care if it was something caused by surgery, it was probably not even his fault like my baldder falling or something, but at least acknowlage my pain and try to help me figure it out. Finally I got myself into a urologist faster then there stupid clinic could. I started to pee a liitle bit at a time and eventually did not have to strait cath. I still have to stand up lean forward and push really hard to pee, not normal..ne ways the urolgy tests came back mostly normal and the doc was the same as all the other ones. bring up the possibilty of pelvic prolapse and there like no that can't affect your life this severly it must be in your head..many more phone calls to the colo doc and all he ever said was take a laxative do an enema, he even told my husband a couple of times he thought it was in my head or mabye I should go to a chronic pain clinic. yada yada...finnally I went in and told him something had to be done so he did a colonoscopy..oh ya before the colonoscopy i went to the ER a couple of time for the most severe stomach pain I have ever had in my life worse then labor... the ER would call my colo to see what to do and im pretty sure he just told them i was crazy.cause all they ever did was give me pain meds to get me through the episodes. So went in for the colonoscopy and colo-guys all "im not going to sedate you I m going to let you watch the screen cause where not going very far up and I want you to see that if theres not a problem on the inside, theres one on the outside and we need to figure what that is." He was talking to me like I was a crazy person. so he goes up a little and he's like "oh, this is why we listen to the patient," my bowel was pretty much scarred off all the way from scare tissure. There was a less then a pencil size head opening....i wanted to punch him and say no ###### dumb ass...when i cant poop and ive told you its pencil thin and I take laxatives with no relief. its physiology I swear commen sense, maybe theres something in the way or maybe the thoughts in my head are making my poops spontanously shrink to pencil size..gee which one is more likly. sorry im way bitter..so he sedated me and basically stretched my bowel and said we might have to do it one more time and if that doesnt work well have to do surgery again.. im pretty sure i have multiple pelvic organ prolapse down there and if he ends up soing another surgery its not going to fix all of the problems, so now im trying to figure out who i can go to who specialize in urinary, gyno, rectal prolapse.. I cannot go through another surgery without being fixed ill go crazy and they might as well fix it all while there in there.. I wa right the whole time even though I always doubted myself and he always made me feel like ####, so far I have always ended up being right.. im almost postative there is problems beside in my intestine, i can feel it. the whole time ive been thinking the same thing as you, i needed someone who specialized in all the area's. oh plus we dont have insurece...geez I know thats long and a lot of rambling and I left out a ton but you know how it is when youve been sick for so long it all become a blurr.. just wanted to let you know that i fel your pain and we should totally change the whole medical system.....I just havent figured out how to do it yet... it's quite a big job,....I figure i need to get better first and then work on fixing the system...


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