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Forum Name: Gastroenterology Topics

Question: Stabbing Anal Pain, help...


 tcirn - Sat Jan 10, 2009 11:39 am

Hello,

I'm a registered nurse and I am writing concerning my husband. He has had 3 to 5 of that I call episodes. Let me explain more in detail... The first time it happened was the worst. He awoke at 03:00 (am) got up with pain (described as a stabbing pain diectly at is anus. He in turn tryed to have a bowel movement, woke me up stating "something does not feel right." I went to the bathroom with him, he sat down on the toilet and was talking to me about this pain he was having the next thing he was slumped down, and head leaning back, with a dazed looked, eyes open fixed like he was looking right through me, would not respond to voice. This lasted about 35 seconds, he was cool, clammy, pale (lips had no color) and asking me what just happened. I would say this looked like a vagel response, possible straining on the toilet. I assisted him to bed, where is BP was 122/62 (sitting up), Heart rate 78, and Blood sugar was 116. He stated the pain was gone. He then stated he felt very sleeply and just had to close his eyes, just like a siezure patient would react after a seizure. (very lethargic, cool/clammy to touch, and he was not white as a ghost any longer. Since the first episode it was probable 4-5 weeks later, another one arose, I instructed him to walk and see it would help his bowels to move, and relieve the pain, after 45 min to an hour, his bowels moved a little and he was better. The next time it happened he state that physical activity seem to help last time, and he walked the floor again, and it got better. At this time, I realized the the last time I remember this happening he had ate Chinese meal for dinner. He had Chinese again last night, and it happened again last night, he strange ideas for physical activity, and he had an off the wall for an activity...(sex). This seem to relieve the pain for a few minutes (10-15 minutes), and then he was up and down to the bathroom, could not sleep, and walking the floor again (able to pass gas, and small amt. of stool / also, no blood has ever been noticed). I have only found that walking is the only thing to work, where he is up moving and not straining on the toliet (if that was has caused the pass-out), however with all the episodes, he has stated while walking that he still feels "funny" at times. What is causing this direct pain, he states "this pain is at the muscle at my butt hole, and no where else." During each episode BP,HR, and Blood sugur are WNL. History of patient; 30 y/o male, wt: 260 lbs. and 6'3" tall, no medical problems, no diagnosis. Has regular bowel movements avg. 2 per day, that are soft, formed and without difficulty to pass. Takes a Multi-vitamin daily, non-smoker, drinks beer socially (avg. 2-3 [bottles of beer] in a 7 day week). Has had ECHO (normal), cardiac stress test (normal), tilt table test (normal), labs (WNL; excluding borderline elevate chlosterol levels). He has a moderate activity level, due to his job as a equipment operate places him sitting alot of the day. Any information would help, thank you for your time, any other information or question feel free to ask.
 docflash - Sat Jan 10, 2009 11:33 pm

from the sounds of the tests you listed (if they were done for this problem) he's already seen his doctor. it'd be important to make sure the doc did anoscopy, at the least, to be sure he doesn't have anything local going on, like a fissure, etc.

your description of what happened does sound vasovagal. but please be sure that his doc (or a doc he's been sent to) has physically examined the inside of the rectum and perhaps the sigmoid.

this reminds me of an old saying in medical school, regarding the DRE (digital rectal exam:

"if you don't put your finger in it, you put your foot in it."

good luck.
 tcirn - Thu Jan 15, 2009 3:50 pm

thank you for your response, he saw is FNP, which referred him to a cardiologist and a doctor to possible do a scope, but that doctor did not seem interested when situation expained, and suggested taking fiber supp. however he has regular BM's, and that if that does not help then return.... yet this only seem to happen if he has Chinese food for dinner, How would something he is eating cause these symptoms? This is confusing and he has not had another episode since he had Chinese food last week.

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