See my post here:
http://www.pudendalhope.info/forum/view ... =80#p34134
And don't forget to read Linda's post here:
http://www.pudendalhope.info/forum/view ... =80#p34117
HM- My opinion is that an inguinal hernia can cause referred pain to other areas than those that are inverrated by the nerves in the inguinal canal. I do not have significant rectal pain but I do have burning in the ischial tuberosities when I sit for a long time. My theory is that muscle spasms created by irritated nerves can cause pain in areas other than those inverated by those nerves. Most of my insight on this topic was gained through the experience and posts of the often banned NorthernSpy.If I do get better after all these years I will have him to thank for it. This is how he put it to me:
> I see Thunderman asked something about rectal pain and I also noticed a comment
> about this in another hernia thread, something to the effect of the rectal area being a possible
> source of referred pain in a hernia. I am wondering what you have found out about this
I am the well known "NorthernSpy" -- yes, a guy -- who's been banned from P-info many times. I was diagnosed many times with "classic" PNE -- by Renney, by Holis Potter, by Antolak, and by others.
But they were all wrong. I had an inguinal hernia -- actually 2 of them (left & right) -- got them fixed in 2007 and I'm fine now. I did an 80 mile bicycle ride this past September, and 100s of 25 and longer rides during the past few years since my hernias were repaired. Dr. Renney (a former bicyclist, and Nantes "success" story) can't say the same.
So perhaps my experience may be of interest.
> I had the impression that anal or rectal pain could not originate from the inguinal canal - no
> connection between the 3 nerves in the inguinal canal, and the rectal area. have you learned
> anything about this issue /have any thought on it?
I don't know your medical story and I have no credentials to diagnose anyone. You might have a hernia (or not) or could have one and it may not explain your symptoms.
BUT SPEAKING GENERALLY, yes, hernias can cause rectal pain for very logical reasons. I sometimes experienced extremely painful bowel movements, and experienced the "classic" PNE "golfball up the rectum" symptom. Here's why:
A hernia is a rip in the abdominal sack that allows the intestines to push through. Lots of consequences can result from that:
-- sometimes the hernia presses inward on the three nerves in the inguinal canal. In a sense it's a nerve entrapment -- intra-abdominal pressure (as examples -- from sitting, or lifting weights) presses the intestines into the nerves, irritating them. At night (any time lying down) the intestines pull back and the nerves get a chance to recover partly. This explains "classic PNE" (which is actually a classic hernia sign): pain that is mild or gone most mornings, but worse from sitting. In time the nerve irritation gets habitual -- easier to trigger, less likely to subside. It also explains why MRIs and CT scans are poor tools for diagnosing hernias (while lying down and not moving the intestines are pulled back and the hernia is almost impossible to see -- like an inner tube pushing through a slit in a car tire, and then slipping back into the tire when the air pressure is reduced -- the slit in the tire becomes invisible).
-- sometimes a bowel movement pushes the intestines deeper into the nerves. It's a matter of bad luck -- the orientation and firmness of a stool may happen to maneuver the intestines to press into the nerves. Straining to make a bowel movement is also a classic way to increase intra-abdominal pressure (aka the "Valsalva Maneuver") which can also increase nerve irritation.
-- the key about pain from hernias is -- like pain from kidney stones -- it's "referred" pain. Where the patient hurts is not where the problem is. For example, one Gastroent doc was convinced I had an anal fissure based on my symptoms. I had the "golfball" sensation, but the doctor saw nothing when he looked. Ditto tailbone, vulvar, penile, prostate, and other forms of pelvic pain -- it can all be referred from chronic irritation of the nerves in the inguinal canal. One of the three nerves there is the genital branch of the genito-femoral nerve, which may directly explain some symptoms.) -NS
(Don) I will be seeing a hernia surgeon at UCSF on May 13 and hopefully I will have more to report then.
Mild to moderate PN for 5 plus years, pain controlled by lyrica and opiates.
Nerve block (unguided) 9/10 Dr. Jerome Weiss - sciatica for 5 months but got numb in painful perineal/scrotal area - he diagnosed entrapment - but no more cortisone for me
Potter MRI 5/11 - rt STL entrapment of PN at Alcocks
Consult with Dr. Hibner Feb. 2012
Bilateral inguinal hernias diagnosed by dynamic ultrasound - surgery on 6/20/13
Feeling a little better, a few more months will tell
I proceeded to ask him if he could order a Dynamic Ultrasound and he his eyes popped out of his head.. Like he never heard of such a thing in his life! What a waste of time and a $50.00 insurance copay.