Health Organization for Pudendal Education

The one symptom I get that's most distressing is an IBS-like flare up- a sudden abdominal cramp, followed by 1-2 explosive diarrhea bowel movements about 5-10 mins later, sometimes followed by rectal spasms and pain for up to a few hours. Sometimes afterwards I even have like "spasm bowel movements" as I call them, where it feels like I have to go but nothing comes out but a tiny amount of foamy-like stuff. It does not appear to be related to sitting, foods I eat, stress levels or... anything really. Tried probiotics which had no effect. It all seems to be random.

Looking back, I've had it since I was teenager, but it only occurred a few times a year- I'd think I had a "stomach virus" and would take something like Pepto-Bismal or Imodium. The symptoms would go away rapidly, leading me to think the medicine worked, but then I realized later on that it resolved in the same amount of time even if I didn't take any medicine. After a fall on my tailbone 3 years ago (which started the other PN symptoms I get) these IBS-like flares became more frequent- now occurring anywhere from once a week to once a month.

I read a lot about pelvic pain patients also having IBS, but what is the connection? Is it Central Sensitization/Mindbody? Muscle spasms? Seems mostly any IBS symptoms reported are constipation or straining, but I've never really seen anyone listing abdominal cramping or diarrhea. I'd say it was unrelated to my PN but this problem clearly got way worse after my fall.

As usual, no two practitioners could ever agree or give me an adequate explanation. Gastroenterologist did not know what it could be but said IBS was the closest thing he could think of. I had a spine surgeon say there's no way an injury to the sacrum or tailbone can cause these kinds of bowel issues either. One pelvic PT told me that tight pelvic muscles in the area can spasm around the colon and cause it (although she did not find a tight pelvic floor at the time). Another pelvic PT told me its the other way around- that intestinal issues can irritate the pelvic floor muscles and nerves.

Any insight would be appreciated!

Jason,
I m new to the forum and suffer from PN symptoms. I am no expert and can only give you advice. I am not sure if PN can cause IB, but it sounds like you have had IB and it's gotten worse. You may have two issues occurring at the same time. Your IB may have gotten worse over the years and then you had the accident that injured your tailbone, which resulted in a PN injury.

I do think it is possible for PN to cause IB like symptoms due to the muscles and nerves. If you look at how the Pudendal nerve wraps all over the pelvis I wouldn't be surprised if it isn't causing some of the issues you describe.

I learned very quickly to advocate for myself when talking to treating providers. You should also do some research and write down all the questions for the PN doctor and Gastroenterologist.

Wishing you all the best,
Hope

Hi Jason,

You can have diarrhea but still be constipated and have intestinal back-up. The diarrhea can leak around the hard stool trapped in the bowel. I don't know if that's what's going on with you -- just that it can happen. An x-ray can tell you if you have stool backed up in the colon. There are so many things it could be but really you need a physician who will do a good work-up to rule out what could be going on -- rule out things like diverticulitis, colitis, stool sample for parasites, etc. I agree with HopeItWorks that you have to advocate for yourself until you find answers that make sense.

There have been numerous PN patients who posted that they have IBS-type symptoms. So, I think it is possible there is some relationship to PN but I can't really tell you what the mechanism would be. I've known PN patients who had such bad spasms after BM's they had to get in a warm tub of water to calm down the spasms after their BM's.

Often with PN -- there is more than one thing going on and the symptoms from one problem are exacerbated by the PN and the other way around. Physcians are trained to focus on their area of expertise, so you may need more than one type of provider to help you figure this out, and you have to get your providers to look at the big picture and not focus on just one little thing.

Violet

Hi Jason,

I am thinking outside of the box here... Have you researched h pylori ? I had H. pylori several years ago and had similar symptoms as you. When signs or symptoms do occur with H. pylori infection, they may include:
An ache or burning pain in your abdomen.
Abdominal pain that's worse when your stomach is empty.
Nausea.
Loss of appetite.
Frequent burping.
Bloating.
Unintentional weight loss.
Diarrhea.

H. pylori are spiral-shaped bacteria that grow in the digestive tract and have a tendency to attack the stomach lining. H. pylori infections are usually harmless, but they’re responsible for the majority of ulcers in the stomach and small intestine.

H. pylori is a common type of bacteria that usually infects the stomach. They may be present in more than half of all people in the world, according to the Mayo Clinic. The “H” in the name is short for Helicobacter. “Helico” means spiral. The bacteria are spiral shaped.

H. pylori normally infect your stomach during childhood. While infections with this strain of bacteria typically don’t cause symptoms, they can lead to diseases in some people, including peptic ulcers, and an inflammatory condition inside your stomach known as gastritis.

H. pylori are adapted to live in the harsh, acidic environment of the stomach. These bacteria can change the environment around them and reduce its acidity so they can survive. The shape of H. pylori allows them to penetrate your stomach lining, where they’re protected by mucus and your body’s immune cells are not able to reach them. The bacteria can interfere with your immune response and ensure that they’re not destroyed. This can lead to stomach problems.

It’s still not known exactly how H. pylori infections spread. The bacteria have coexisted with humans for many thousands of years. The infections are thought to spread from one person’s mouth to another. They may also be transferred from feces to the mouth. This can happen when a person does not wash their hands thoroughly after using the bathroom. H. pylori can also spread through contact with contaminated water or food.

The bacteria are believed to cause stomach problems when they penetrate the stomach’s mucous lining and generate substances that neutralize stomach acids. This makes the stomach cells more vulnerable to the harsh acids. Stomach acid and H. pylori together irritate the stomach lining and may cause sores or peptic ulcers in your stomach or duodenum, which is the first part of your small intestine.

H. pylori is diagnosed via a blood test and the treatment is antibiotics. After I finished the antibiotics I was fine and have had no more stomach issues.

Wishing You Pain Free Days,
Hope