menstrual-time pain from the phantom anus

PoopReport of the Year AwardComment Quality Moderatorj 1000+ pointsk 500+ pointsl 100+ pointsm 1+ points - Newb

Big Sister Asks:

Dear Motherload,

This is a serious question. My youngest sister has Crohn's disease and has had an ileostomy. Her rectum has been removed and all is stitched closed down there. Every month at her menstrual ovulation time, she is miserable. She only has one remaining overy, but her remaining GI tract is in chaos.

The symptom I am writing about, however, has the MDs stymied. She gets a pain in the area where her rectum used to reside and feels the need to bear down continuously. She has to sit up, on a stool or hard chair, and push for days on end. She can't sleep. She has tried nerve pain pills, narcotics, muscle relaxers... nothing helps much.

We are trying to get her menstrual cycle stopped to see if the pain will go away. It is proving to be a stubborn task -- depo-provera shot and provera pills are not completely stopping her cycle. She wants a hysterectomy. Any suggestions?
Please, any help would be appreciated.

Dear Big Sister,

Phantom pains from a missing anus are not uncommon among ileostomates, but I would be more inclined to believe that your sister is suffering from proctitis. The National Digestive Diseases Information Clearinghouse (NDDIC) has this to say about proctitis:

"Proctitis is inflammation of the lining of the rectum, called the rectal mucosa. Proctitis can be short term (acute) or long term (chronic). Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Sexually transmitted diseases like gonorrhea, herpes, and chlamydia may also cause proctitis. Inflammation of the rectal mucosa may be related to ulcerative colitis or Crohn's disease, autoimmune conditions that cause inflammation in the colon or small intestine. Other causes include rectal injury, bacterial infection, allergies, and malfunction of the nerves in the rectum.

The most common symptom is a frequent or continuous sensation or urge to have a bowel movement. Other symptoms include constipation, a feeling of rectal fullness, left-sided abdominal pain, passage of mucus through the rectum, rectal bleeding, and anorectal pain.

Physicians diagnose proctitis by looking inside the rectum with a proctoscope or a sigmoidoscope. A biopsy (a tiny piece of tissue from the rectum) may be removed and tested for diseases or infections. A stool sample may also reveal infecting bacteria. If the physician suspects Crohn's disease or ulcerative colitis, colonoscopy or barium enema x rays may be used to examine areas of the intestine.

Treatment depends on the cause of proctitis. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the inflammation is caused by Crohn's disease or ulcerative colitis, the physician may recommend the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications."

After reading several forums on the topic, it seems to be quite common for people to have this complication even when the rectum has been surgically closed. Your sister may just be more prone to the symptoms during her ovulation time just as most women do experience increased activity and sensitivity of the lower digestive system each month.

Thanks for asking Motherload!

Motherload is a Certified Nurse Assistant as well as an IBS sufferer, which means she knows a lot about poop. Got a question for her? Ask it here.

8 Comments on "menstrual-time pain from the phantom anus"

Bilgepump's picture
Comment Quality Moderatorh 3000+ points

Nice job, and welcome back, MOM!!!


The proper order is kiss me, then go smell the other dog or cat's butt. I cannot stress this enough.

"One of the founding members of the Front Page Hyena Pack, and runs as its alpha male when the urge strikes him, which is often." Daphne (one perceptive chick)

Leaky Bowel King's picture
l 100+ points

Wow, I couldn't imagine having to feel like having to shit when there's no possible way to shit. That sucks. And my mom had Crohns and it almost killed her, but luckily she got to keep her whole digesive tract. Crohn's disease is a bad thing that's for certain.

ChiefThunderbutt's picture
PoopReport of the Year AwardComment Content ModeratorComment Quality Moderatorf 5000+ points

Big Sister...Your little sister has my heart felt sympathy, I hope the doctors are able to help her soon. Glad you made it through the ice storm OK Motherload. welcome back.
Eat chilies and feel the burn!!

If I had two faces do you think I'd be wearing this one?

Blind Mullet's picture
k 500+ points

(Can I call you BS?)
I, too, am an ostomate, but I had a colostomy to get rid of bowel cancer.
That was about 9 months ago, and the scars are healing nicely, but I do get the occasional symptoms that you describe. The surgeon said that there would be some weird sensations as the system heals, but every time I feel a pain in the area where my rectum used to be, it scares me because I think its the cancer coming back.
Only another ostomate would understand this.
I don't have any good advice, but I can, and do, feel empathy for your sister.
Good luck, I hope you find the answer.

I don't bite my nails, 'cause I don't like the taste of whats under 'em.

The white zone is for loading and unloading only- FZ.

daphne's picture
PoopReport of the Year AwardSite AdminComment Content ModeratorComment Quality Moderatore 6000+ points

This reminds me of people who lose their arms and can still feel their fingers moving on the phantom arm. I feel so bad for this person and hope she finds relief soon. What a long road she's already had.

I wonder if the water retention associated with the menstrual cycle makes the inflammation worse.

Nice post, Motherload, and I'm also glad you're back.

.....hugging bunnies since 1969

.....hugging bunnies since 1969

sittingpretty's picture
Comment Quality Moderatori 2000+ points

Wow. How wicked is that? Poor poor girl. Keep taking her for second opinions until someone can help her.
...And their flesh like dung. Zeph. 1:17

...And their flesh like dung. Zeph. 1:17

Squat-n-leaveit's picture
Comment Quality Moderatork 500+ points

Had a friend that lost a leg. His missing big toe itched. (still does!)

Anonymous Ileostomate's picture

As a female ileostomate I get these symptoms at the time of my period as well, although not as often or as painful as this woman describes. I ascribe it to the fact that, when I had my bowels, I would often get upset stomach and diarrhea during my menstrual cycle. Now that that is gone, my stomach can still get upset, but I can't go to the bathroom and pass gas or poop. Hence, the uncomfortable feeling. I find it helps to sit on the toilet and bear down. I don't think it could be proctitis- an inflammation of the rectum, seeing as this woman no longer has a rectum. More likely it is the phantom pain, which gets worse for many females that time of the month.

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