Anal spasms with Ulcerative proctitis

You should ask your doctor for an antispasmatic medication prescription. Spasms can be painful

Wondering if you have a peri anal abscess, especially because of painful poops. Just been through this. Spasms are very painful.

Do you think your spasms might be proctalgia fugax?

It is a painful feeling that usually occurs at the night. I've had it a few things.

I don't think it's UC related.

UC Medic said...
I dont think its proctalgia fugax. It lasts for hours whether sitting or walking. Usually triggered after BM. The sphinter actually spasms almost shut. Then it will resolve and leave a dull ache. Doctor offered Vicodin for pain but that's not an option since Im constipated. I do have a continual burning raw feeling.

Medic, I have suffered from these painful spasms over the years. I have never had an abscess in my life and only recently diagnosed UC a year ago now. My mother who didn't have UC also suffered from them, so I don't think it is UC related either. Some people are just prone to suffering from them.

There is something simple my mother taught me well over 30 years ago about relieving these excruciating muscle spasms in the anal area and it helped her as well me to get through them. I liken the experience to contractions a woman might??? feel when giving birth and possibly is seeing it involves the perineum area. I am male so I can't compare but my mother did mention birth pain.

This is what my mother did and it worked for me. Hopefully you may find some relief. I am not sure if you are male or female but same method applies to both.

TENNIS BALL PERINEUM MASSAGE

1. Place a tennis ball or something of a similar size on the floor. On carpet or mat is better.

2. Sit over the tennis ball with your legs crossed like Buddha.

3. Place hands on floor on each side of your hips.

4. Rotate the tennis ball on your perineum area carefully by moving your hips around in circular fashion, putting a little increasing pressure on the ball as you roll it around the perineum area in front of your anal area. /en.wikipedia.org/wiki/Perineum

5. Keep doing the pressure ball massage until the pain subsides and repeat over again if pain starts to intensify again.

6. Later you may want to sit in a warm bath or a portable tub large enough to sit your bottom in if you don't have a bathtub.

Hopefully you find this helps you to get through the pain.

Well, the Sig showed mod/ severe proctitis for 10cm. GI upped Pred to 60 mg, trial for a couple of weeks, changed from Balsalazide to Lialda, Canasa and Rowasa twice daily and wants me to consider 6-mp or Remicade. I'm not thrilled but the spasm pain is profound inflammation and needs to be dealt with sooner than later. What is the input on either of these meds ? Can you ever back off? I am scared of the long term repercussions but Ive been flaring off an on for a year.

Immunomodulators are slow working, taking 2-3 months to achieve therapeutic range (ideal healing). And require routine blood monitoring (at least every 3 months) while you're on that medication. These are generic name medications and inexpensive in uc dosages. They're pills.

Biological work in 6 weeks or less. No blood monitoring needed. Biological are given via IV or subcutaneous (just below the skin), self injections. These are very expensive medications, all brand named.

Both have very similar safety profiles and risks, as they both slightly reduce your immune system's capability. Side effects are very rare, but serious should they occur.

Generic mercaptopurine (brandnamed purinethol) or generic azathioprine (brand named imuran) are far more affordable, I'd go with it. A simple bottle of pills you can get at your pharmacy of choice.

Antibodies are a concern but not guaranteed. Some never get antibodies. Some get antibodies quickly despite following best practices. Certainly remicade has the highest antibody risk as it's not fully humanized, it's 75 percent human and 25 percent mouse protein. Everything else is 100 percent human.

One thing to note on Medicare, the biologic drug makers copay assistance programs don't work with medicare. Important as a typical remicade dose might be billed at $6,500, insurance typically disallows /reduces the bill to a payable $3,200. You end up with a few hundred (or more) out of pocket. Every insurance varies but you got to see what specality pharmacy , injectible medications cost you. A lot different than a pill at the pharmacy. It's often hospital-outpatient which can mean more deductibles or co-pays. Biologic billing is confusing and maddening to say it politely haha.

Were you awake for the sig scope? Severe proctitis + scope = OMG awful!! I am sorry you're having symptoms. It sounds like trying a new medication is a good idea. Especially since you're just starting prednisone. Better to start the immune suppressant sooner than later so it's starting to work as you taper off. I made the mistake of waiting, and I ended up relapsing & I had to go back up to 40mg pred which made my course WAY too long...

On the other hand, have you tried steroid rectals? I used to use every trick in the book to try to retain mine, from doing half an enema, going and using the other half, to using a supp if I couldn't retain the enema, to taking a bentyl and doubling the rectals. The steroid supps are way cheaper than canasa, but you'd probably have the most luck holding in the steroid foam (which unfortunately is very expensive - but you should see if it's covered).

Like your bother, I had surgery, but I got a j-pouch. My biggest complaint is probably butt burn. I can keep it managed if I don't eat anything spicy... I couldn't eat spicy with my UC regardless so it's not like it's a new thing to avoid spicy. I eat spicy way more often than I should anyway.

You should also insist on stool tests. :)

I've used proctofoam but it doesnt get deep enough and the dispenser leaks more than gets in.Didnt see cortifoam was available when I looked it up. Last night switched from rowasa back to cortenema and might be better today. Oral steroids make me crazy. I cant sleep, Im hyper, Im not a nice person and Im stupid. Need to get off the steroids. Guess if I start immunosuppressants Im still looking at a long time to taper off steroids. Fortunately I think Im a ling way from surgery. I think I was fortunate that my colitis lessened higher up and settled in my rectum. Hope it stays there. I do not want surgery and feel for all who have had it.

I will be starting mercaptopurine Friday, begin tapering pred from 60 to 40 in 7-10 days and frequent repeat labs soon. Dr says all biopsies & cultures negative from Sig last week and show only active proctitis and inflammation, no infection.

Post Edited (UC Medic) : 11/3/2016 9:13:42 AM (GMT-6)