Extreme buttock/anus pain from inflammation?

I'm in the middle of a wicked wicked year-long flare. It's been rough but I've learned how to manage my symptoms to have a semi-normal life at least I had until this week... It all started last Saturday, it was one of those bad days when I get up and run to the toilet 4 or 5 times to take a poo for the first 3 or so hours after getting up. After the 4th movement or so I noticed that I had some real tenderness on the left side of my anus radiating all the way to my inner left butt-cheek. As the day went on sitting hurt, walking hurt, clothes rubbing up against it hurt, etc. It got worse through Monday and by Monday night the whole area was throbbing in pain. The whole area felt much firmer in comparison to its mirror image on the right side and I concluded that it must be a very deep abscess that hadn't yet surfaced.

I called my GI on Monday and they ordered me a CT scan of my pelvis but unfortunately the CT department couldn't get me in for a week. I continued to get worse and worse through Tuesday night and by the time I went to bed I could barely walk, had a fever, and felt generally unwell. Wednesday I gave up and went to the ER to get some relief. The CT scan came back with no indication of any type of fluid in my pelvic (or perianal) area but it was noticed I had SEVERE inflammation consistent with acute ulcerative colitis (well duh...). They gave me some dilaudid, a script for pred, and a script for rowasa (which I already use) and sent me home to follow up with my GI in 3 days.

Frankly I am FLOORED that there is nothing else going on in my rectal area. I've had UC for years and been in and out of the hospital a few times with nasty flares. Bloody diarrhea and abdominal pain are common for all of us, but has anyone ever had pain radiating to their rear end from a flare that was so bad that they couldn't even walk?? It seems quite strange.

I can tell you at I currently have the same thing minus the frequent number 2. Terrible anal pain and swelling I can feel when wiping. Its a dull ache all day and certain movements send sharp pains up there. I'm just going to the bathroom once in the morning (thank GOD) and it is so painful I want to throw up or pass out while going. I came out of the bathroom shaking this morning. I have been choking down Tylenol like candy and that is helping me get through the weekend until I can see my GI tomorrow. I'm also fasting today because I have no interest in going to the bathroom again until this settles down. I had this about 3 months back when I was first diagnosed and mesalamine enemas fixed it right away. I'm still on them and, unfortunately, they are no longer working. Sorry you are going through this too. Let me know if you come up with any over the counter fixes. I've tried A&D for baby diaper rash with limited success.

I was going to say abscess too given the amount of pain and fever. Hemmies wouldn't cause a fever.

I feel like I should provide an update in case someone comes upon this thread in the future. I certainly did have an abscess. The ER doc missed it completely despite the MRI and me insisting that I had an abscess when I was told that I in fact did not. My colorectal surgeon actually diagnosed it yesterday when I was there fore a flex-sig. I couldn't even get the words out "Hey doc I have this small mass to the left of my anus and I thin..." before he announced that it was an abscess. He thinks they didn't go "deep enough" on the MRI which is why it wasn't seen, but he was able to diagnose it visually so how the ER coudn't.... I guess I can chalk that up to a lack of experience. So I have been walking around with this thing for over a month now. The moral of this story is that ER docs aren't prepared to handle many non-routine issues. Broken bones and stuff like that, sure, but don't bother taking your butt issues in there unless you are practically near death. Unbelievable.

I feel the same about ER docs, thank god my GI's office is right next door to the hospital I go to for emergencies. He's the one that tells the ER docs what to do in case he can't get to see me himself. I've gone to other hospitals for fluids on occasion, told the ER doc I had a little rectal pain, next thing I know I'm getting an IV shot of Dilaudid.

Thanks for updating and I hope you're doing better.

A good reminder for all of us that doctors make mistakes. Follow your gut (pun kind of intended). If you suspect the doctor is wrong, keep pushing, seeing other practitioners, etc. until you get help.