Health Organization for Pudendal Education

Hi Folks
I know that combo supps (used rectally) used as therapy for rectal pain.
Does anyone use them with success and if so what combos and what strength?

My doc rxed one but admitted he wasn't sure exactly what to rx for me,, and got some advice from the compounding pharmacy. I assume I got a standard amount ( with a pretty small amount of 4 differet meds.
they want me to give it a chance and try it a few times to see if it offers some relief.

I was wondering if it turns out that the amounts of the various drugs are too low to offer pain relief, do they go up on the amountsts ( Tweaking it etc)

I have been using hyrdro-morphone supps for about 2 years...They no longer help much, but seem to now be constipating.
so we are trying the new combo suppository combination route.
Any info you folks can offer on this type of supps would be appreciated.
An ex; would be Baclofen, Amitryptyline, and one or two other elements
Thx!
Kathy

Hi Kathy
Dr Hibner prescribed the usual baclofen/Valium combo but it wasn't helping my severe rectal pain so my doctor increased the Valium to 10 mg and left the baclofen at 4 mg. I am not sure if you have tried this combo yet? This combo does help with the pain and I use the supp's twice a day. I'm still on narcotics as well.........

Take care......

Lara

Thx Lara,
I willl ask my doc to try this combo. He really needs advice as he did not know what to try.
NI don't think Ive tried them together as a supp and not at that higher level...Do they interfere with bladder emtpying at all?
I have tried both supps separately but at too low levels to help too much.I remember the valium helped a little
Thx so much!
Kathy

I use just 10 mg of Valium. I use it vaginally and just the actually pill, twice a day. The local compounding pharmacy tried two different bases but they all gave me yeast infections so Dr. Carrillo had me just use the pill, no problem since. I rarely get rectal spasms anymore since he increased the dose to 10 mg. I still feel like I have a vice grip in my rectum and PT cannot tell the different in my pelvic floor hypertonicity but it has done something to help as those crippling rectal spasms rarely happen now.

The IC forum has some good advice on different compounding agents.

Hi Kathy
This combination does NOT interfere with bladder emptying at all. My pain management has said that only if you add a narcotic or opioid to the mixture will it cause issues.... I also have problems with bladder hesitancy especially with oral meds so I have to be careful. I use the Valium/baclofen twice a day and I find I get relief (within 15 minutes of inserting it) for the terrible rectal pain.

Take care.... Hope you are doing well.

Lara

Hi Lara,
Thx for the info regarding the valium combo and your bladder. I have issues as you described.. some times with opiods but mostly with tricyclic-anti-depressants and/or anti-cholinergics like over -active bladder meds. Its good to hear the combo you tried did not affect your bladder. I have tolerated baclofen well before and also tried a half pill of valium and tolerated it as well.
Im pretty sure the elavil in my combo med was the problem.
Im so glad this combo helps your rectal pain. That must be an incredible relief. I am hoping my doctor will try this combo.
If you don't mind saying is your pain a constant type of pain or a spasm? Mine is a constant throbbing type.

Thx again LaraMarie for your suggestion.
Hope you are doing well!
Kathy

Hi NYT
Thx for your reply. I will check out the IC network for more supp combos ideas if necessary
I also like the idea of valium as combo or pill, as a couple years back I inserted a half pill rectally and it helped me at a social event which required some some sitting. If I had used the whole pill as my obygyn doc suggested I prbly would have done even better.

BTW there is a compounding drug store call McGuffs (in Orange County, California) whose name I got from one of the pelvic pain support groups ..The compounding pharmacist deals with these issues often and comes up with combos to help patients.

Thx and glad the valium helped you.
Kathy

Hi Kathy
My rectal pain has changed a lot since surgery and is now an annoying foreign body type feeling. It used to be broken glass and it worsens after sitting and using the restroom. I can't sit at all now without having incredible pain. I bought a Roho cushion last month and that seemed to worsen the pain. I only sit when I am in the car and that brings on a lot of rectal discomfort. Are you able to drive? What type of cushion do you use?

Lara

Hi Lara,
I am so sorry your are having this pain. Its very hard to deal with. It sounds like since the muscle relaxant supp helps a bit ,there is a muscular component to it
I hope that your meds help you with your daily function as much as possible. I find that getting out of the house and doing things always helps with the pain, tho events requiring sitting and/or lots of standing can be hard..They are worth it tho.
I replied and answered your questions in a longer private msg.
Thx again for the supp. suggestion
Best regards
Kathy

Hi Lara,
I finally have received the supp combo that you use.

I am so nervous to try it..based on my experiences with meds before

I am still using my hydro morphone rectal sups which help very little but are better than nothnig..
They seem to also relax the areas at times and help me to empty bladder

At other times they make it harder to empty...I think a lot has to do with whats going on in my pelvic floor at a particular moment.

I wonder is it okay to try the new supopsitory the same day I used the dilaudid ones.. I could use relief as I had an active yesterday.

My doc tho he wants to help admits that he knows very little about meds for pudendal pain and will just keep trying and hoping for the best (God-willing)
Thx for any info about the supps.
Your issue and reactions to meds seem similar to mine tho I know we are different
Warm regards,
Kathy