HELP - Anismus? constant discomfort and pain

[azaleas]

I honestly dont know where to start i just feel i need to talk about my issues to others that may have possible gone or are going through issues similaur to mine.
Fkrst off i have not had any colon resections or bagging done, i hope it is ok that i post here, i just really need someone to talk to.

Ok so i guess ill start from the begining, a somewhat quick rundown of what has led my to ask for help.

Ever since i was a baby i have had intestinal issues mostly due to constipation, my mother "who adopted me" was told by doctor to give me prune juece and mash potatos and occassionaly use a finger to help coax stool from my rectum.
I of course dont remember any of that since i was so small. But i was lactose intolerant for a good portion of my toddler/baby life. I eventually grew out of the milk intolerence and it became one of my favorite drinks with age.
Growing up i was never really tought propper bowel habbits such as not sitting on the toilet for extended periods of time and do not strain. My method growing up was to just push really really hard, i would sweat turn red and be crying for my mom when the stool would litterally be stuck half in and out of my rectum. I was lucky when i would just have pellets here and there and would go once ever 3 to 4 days.
I continued my bowel habits like this from toilet training days to the age of 22.
It has always been my normal, i never never knew of the problems it could cause me.

At 23 i just married the love of my life and couldnt be happier. We have been together 3 years prior and well...being human we were sexually active young adults." Im so sorry for the tmi" i was very into anal intercourse throughout those 3 years and will say did it more than i should have .
In 2013 i developed a sharp pain in my rectum and when i went to use the toilet..."with my usual straining habbits" i was crying at this point and when i checked the toilet it had a fair ammount of blood in it. I was schedualed with a colorectal doctor for a colonoscopy later that week to find out i had a pretty nasty fissure develop.
Being young and stupid i just waited it out and let it heal only to later pretend it never happened, i didnt change my diet or bowel habbits so to speak.

Over the course of years i began to finnally draw attention to my bad bowel habbits and ive been picking up on just how irregular i am.
Around 2014 i began using my digit to relieve my self when impacted, i would do this with my middle finger coaxing solid hard lumps from my rectum and shortly after very soft oatmeal-like stool would flush out. (Please forgive me-i feel desgusting sharring this) i would continue this regimin 2 to 4 times a week, it gave me relief. I continued this for over a year untill one day i noticed a painfull lump on my anus....i was so scared but didnt want to tell any one due to the embarressment. I did share with my husband and he said it looks like a hemmorhoid....as sad as it is to say i didnt know what that was and i though whatever ill just wait for it to go away. I continued my regimen without second thought.
Side note-i kept the digital stool removing a secret...i was to ashaimed to share this even with my spouse.

With time the hems got worse ofcourse and i began reading up on what they were....my blood ran cold when i found out everything ive been doing has more than likely been cause of my issues. I regret so much.
Im going to make this part as short as i can...this is getting leinghty.
Long story short for tge next year2015 i have had bothinternal and external hems develop on and off. I stoped using my finger to expel stool and now delt with trying other methods of releiving stool....nothing really helped. I had lost 20 lbs over the course of 3 months, from not eating because of the pain it would bring me later. But i began to study on fiber rich foods and began drinking about 60 oz water daily as well as 20 to 30 grms of fiber daily.
I still had very hard stools followed by extreamly soft. I continued this for about 7 months and would still just get impacted and have painfull bowel movements.
Late 2015 ive been from one doctor "since early 2915 "to the next about my hems and bowel issues, i usualy get a "dont worry, just exercise more" and a tube of hydrocortisone 2.5 and sent on my way. Ive been in all honesty misserable my general surger doctor gave me a tip that if i was having issues expelling stool to use my thumb in my vagina. I took this advice and it began to help me, i still had to push though and my fiber diet i believe has been making my stools way to fast and i feel what has been causing my hard stools coukd ve just that.
2016 i have been diagnosed with IBS and put on dicyclomine 10 mg twice daily,ive lessened my fiber intake from 20/30grms to about 5 to 10 daily and water intake to 30 oz...and this has changed my stool consistancy dramaticly, i now have stools consistant to oatmeal...but one thing has not changed...why dont i feel this stool in my colon just befor it exits the rectum? Ive never really put thought into it before but over these past few years i really dont have a reflex that tells my anus to relax and expel...im still having to use my thumb and it make my vagina very sore when i have to do this two to 3 times a day due to how fast my bowels seem to move....im amazed i never noticed this...im not sure if my body has alway been this way or not. But since i started using my thumb i began to notice my rectum is full of stool 3 to 4 times daily.....and i dont even notice it, my spincter has no reflex to it.

Current day
Ive developed another external hemhoroid and for tge past 6 days have had on and off watery black diharrea, im begging to rea h the end of my rope. I went to my walk in clinic and just told all about the issues ive been having and how i dont feel to reflex to expel stool. The doctor refered my over to the gastro doc the next day and i told her all tge same. She feels it could have something to do with a muscular issue and prescribed me an antibiotic for the bowel issues plus 4 stool culture lab tests. The checked my hem and said its to far along and would be best to leave alone and that there was a small fissure next to it.....

So now i ge to the reason why im asking help...im so very very mentally and phisically drained from what ive been going through these past few years, and now my anus has reached a point where it just does not want to work...i rely on my thumb to help coax out stool from my vaginal wall wich hurts 80% of the time due to my bowels being so unpredictale.
I have a phisical therepy the gastro doc is setting up...im not sure what they are going to have me do....but im scared, to be honest.
Ive done some symptom searching and found a condition called (Anismus) and everything described sound just like what i dealing with to a tea....
Im so drained and i just want my happy life back...what i woukd give to just be somewhat normal again.
And to be honest i swear to god if i could elect to have a ostomy surgery done i would take it in a heart beat, ive read and studied as much as i can about this procedure and so much of it sounds like hell but compared to what ive been going through would be far more life giving.

I guess ill sum up my questins here.
Has anyone else heard of or dealt with Anismus?
What kind of procedures might i expect durring this phisical therepy?
What do i have to do to convince these doctore the grief im going through?

I feel so traped in my body and i just cant continue doing thing like this.
Believe it or not im sure i left out some details of info.
If you have read all this i greatly appreciete it, any kind words of wisdom are welcomed


(Notes) •
•im at a point in life where every day is a struggle, the act of eating causes my bowels to upset leading to needed defication and my only means of doing this is with my thumb.

[Lee]

HI and welcome.

Not sure if I can help butt will try. Glad to read you have a GI doc. Was also glad to read you are drinking lots of liquid. What is the GI saying could be the problem?

I do a permanent colostomy due to rectal cancer, butt I am also aware of other people getting one due to other issues like IBS. Have you talked to a Dr about this as an option.

Not sure, are you on pain meds? If yes, that can lead to constipation, especially long term pain meds.

If you feel like your Dr.(s) are ignoring you, keep finding a Dr that will listen to you. It's your life. Not all Dr.(s) are the same, some are better than others.

How old are you?

All the best,

Lee

[MissMolly]

Azaleas:
Wow . . . what a miserable lower digestive tract and pelvic floor you are experiencing.

The process of defecation requires that the rectum contract while the internal and external anal sphincters open and close at the appropriate times. It is a delicately choreographed ballet. When the proper timing and sequencing of the rectum and/or anal sphincters fails, having a bowel movement can become a complicated task that can require acrobatic stints and contorted positions to achieve.

Likely, you have some degree of dysfunction in your pelvic floor. The pelvic floor is terminology referring the sling of muscles and ligaments that suspend the rectum and bladder and uterus. It also includes the internal anal sphincter (involuntary, autonomic nervous system control) and the external anal sphincter (some degree of voluntary neuromuscular control).

You would be well severed to look for a Pelvic Floor Clinic at a major, metropolitan hospital.

A Pelvic Clinic works with nothing other than individuals with problems with defection. That is their sole work. It includes a team of gastroenterologists, gynecologists, url-gynecologists, physical therapists, psychologists, exercise physiologists, nurses, and biofeedback technologists. You will likely have a defecation study - where your rectum is filled with a barium contrast and the working of the rectum and sphincters studied via fluoroscopy in real-time.

In the meantime, invest in a "Squatty Potty."

A "Squatty Potty" is a shelf that you place your feet on when sitting on a toilet. Modern toilets are a cause of constipation because they place the body in an unnatural alignment to relieve the lower digestive tract. Squtting is a much more normal posture for defecating than is sitting on an American/European toilet. A "Squatty Potty" places the body in a more natural anatomical alignment to allow for defecation while allowing for a toilet and modern amenities. You can find a "Squatty Potty" on Amazon or other internet retail site.

Other options to ease your discomforts while you await a pelvic floor specialist would include taking a dose of Miralax or other osmotic laxative as part of your daily routine. If not Miralax, another option would be to take magnesium supplements, 500 mg magnesium citrate, to ease your defecation process. Both will pull water into your lower digestive tract + give a kinetic/muscular nudge to move things along and through and out via the anus.

You've be in agony for far to many years. It is time to face your difficulties and seek professional help through a pelvic floor specialists.

There are also discussion forums for individuals with pelvic floor dysfunction. MDJunction, I believe, has a discussion forum for pelvic floor dysfunction. Pelvic Floor dysfunction is an isolating disorder. Hours spent in the bathroom and the unease of conversing with others about the disorder lends to loneliness and despair. However, you are not alone. Look for a pelvic floor dysfunction discussion forum to find commarderie and support.
- Karen -

[midlifemom]

Azalea,
Miss Molly makes good suggestion for Squatty Potty. I didnt want to wait for shipping, but found my local Target carries them. Look around. Helped me. It doesnt sound like it will solve all your problems, but its a step in the right direction.

[DarknessEmbraced]

I'm so sorry you're having such an awful time!*hugs* I hope the physical therapy helps!*hugs* I've never used a squatty potty but it has helped many on here so it can't hurt to try it out.*hugs*