I am a new member. Greetings everyone.
I wanted to throw this out there. I am currently being treated for Tenesmus, or Hyper-defecation. Some docs also interpret this as incomplete evacuation, but it is more of an issue with the brain-gut connection mis-firing. And it is the pudendal nerve that is involved in defecation so this is the nerve which is mis-firing. There is generally not pain involved, just a constant urge to have a Bowel Movement, even when the rectum for the most part is empty or hardly full. Very uncomfortable and very disconcerting. Has anyone suffered from this malady or is anyone aware of treatments for this condition. Much obliged. Depueman
Pudendal Nerve Sensitivity upon defecation
Re: Pudendal Nerve Sensitivity upon defecation
I do suffer from this problem for 18 months since the start of my PN. I am taking fiber, laxatives etc and I know it is really very hard.
Re: Pudendal Nerve Sensitivity upon defecation
I am in a program at Northwestern University in Chicago where they are training me to ignore the urge, that it is really a false signal, as oft-times when I attempt to go again after a BM there is nothing left to go. They are telling me we have to re-train the brain-gut signal so that this sensation to defecate again goes away since it is a false one in the first place. The pudendal nerve is involved in defecation and in transmitting this false signal or sensitivity.
Re: Pudendal Nerve Sensitivity upon defecation
From the people who visit this forum, we usually hear of people who have this feeling relating to urination, not so much defecation. The pudendal nerve innervates the bladder sphincter and also the anal sphincter -- I don't know if what you are feeling is due to the PN misfiring from the anal sphincter. Have they given you any idea of how successful the treatment program is that you are trying?
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Pudendal Nerve Sensitivity upon defecation
Violet, they are basically trying Cognitive Behavior Therapy on me and asking me to learn when to recognize a "real urge" to have a BM. This means not responding to every little sensation in my rectum and then trying to go have a BM. Most of the time this attempts involve constant straining and effort which in turn not only messes up the pelvic floor muscles but also the nervous system signals. You do this long enough and you do not really know what is legitimate. Lots of people misinterpret this as constipation, and there may be to some degree, but for the most part usually the straining is because there is nothing left in the rectum of any substance to have a BM with.
The therapist in charge of the program sounds pretty sure about it. Even though I have had what I thought was Irritable Bowel Syndrome for a year now, I am working a completely new angle and have only been in the program a month. I am told it takes a bit of time to retrain the brain-gut connection as I have spent the past year messing it up with straining and attempting BM's multiple times a day....mostly unsuccessfully as well I might add. Ken
The therapist in charge of the program sounds pretty sure about it. Even though I have had what I thought was Irritable Bowel Syndrome for a year now, I am working a completely new angle and have only been in the program a month. I am told it takes a bit of time to retrain the brain-gut connection as I have spent the past year messing it up with straining and attempting BM's multiple times a day....mostly unsuccessfully as well I might add. Ken
Re: Pudendal Nerve Sensitivity upon defecation
It sure can't hurt to try that route, Ken. I hope it will be successful for you.
You might want to check out one of the pudendal PT's at least for an evaluation to determine the state of your pelvic floor and to get additional input on whether you are on the right track with your possible diagnosis.
Violet
You might want to check out one of the pudendal PT's at least for an evaluation to determine the state of your pelvic floor and to get additional input on whether you are on the right track with your possible diagnosis.
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Pudendal Nerve Sensitivity upon defecation
Hi depueman,
That is great you are doing cognitive therapy!
Once many years before pn, I went through this period of having to urinate quite often. Of course I had every conceivable test to determine what was wrong with my bladder and all tests came back negative. A urologist told me no matter how many times I felt like going in an hour, ignore the feeling, and when the hour is up, only then... could I urinate. It didn't take very long (a week or less) and my bathroom habits were back to normal. The bowel or bladder can be trained, just like when we learned not to go in our pants when we were tots. Of course there can be anatomical reasons, and that's a different story.
I know exactly what your talking about with pn and defecation. Before pn I was chronically constipated for about four years. Who knows maybe that helped to bring about pn, although I never strained, I spent too much time trying to have a bowel movement . Now that I have pn my body has completely done a 180 and I have the opposite problem. I don't have diaherra but somedays I have bm's 4 to 5 times a day. That causes a big pain flare, not in my rectum but where the nerve is. When I have one of these days I take an anti-diaherra medication and that controls how many times per day I go. This has made a huge difference for me! Between not sitting and bm control, the nerve has really started to calm down and starting to have almost pain free days without drugs! I also have learned to drop my pelvic floor muscles as explained in Amy Stein's book, "heal pelvic pain." I sure hope this trend continues! It is coming close to my one year anniversary of pn and even though my pain has been mild, everyone on this site knows, chronic pain wears you out! I want to be able to sit again. I have not sat in all this time, which means I never go out to eat, don't drive my car, stand when I visit friends, no plays, movies, etc. I'm looking forward to hopefully one day tell my story in the success part of this site!
That is great you are doing cognitive therapy!
Once many years before pn, I went through this period of having to urinate quite often. Of course I had every conceivable test to determine what was wrong with my bladder and all tests came back negative. A urologist told me no matter how many times I felt like going in an hour, ignore the feeling, and when the hour is up, only then... could I urinate. It didn't take very long (a week or less) and my bathroom habits were back to normal. The bowel or bladder can be trained, just like when we learned not to go in our pants when we were tots. Of course there can be anatomical reasons, and that's a different story.
I know exactly what your talking about with pn and defecation. Before pn I was chronically constipated for about four years. Who knows maybe that helped to bring about pn, although I never strained, I spent too much time trying to have a bowel movement . Now that I have pn my body has completely done a 180 and I have the opposite problem. I don't have diaherra but somedays I have bm's 4 to 5 times a day. That causes a big pain flare, not in my rectum but where the nerve is. When I have one of these days I take an anti-diaherra medication and that controls how many times per day I go. This has made a huge difference for me! Between not sitting and bm control, the nerve has really started to calm down and starting to have almost pain free days without drugs! I also have learned to drop my pelvic floor muscles as explained in Amy Stein's book, "heal pelvic pain." I sure hope this trend continues! It is coming close to my one year anniversary of pn and even though my pain has been mild, everyone on this site knows, chronic pain wears you out! I want to be able to sit again. I have not sat in all this time, which means I never go out to eat, don't drive my car, stand when I visit friends, no plays, movies, etc. I'm looking forward to hopefully one day tell my story in the success part of this site!
Re: Pudendal Nerve Sensitivity upon defecation
Laura, very interesting. I will bring this up with the Northwestern folks next week, ie., that the urges have also effected people in their urinating, not just defecating. And, like you, Northwestern has asked me to go at set times each day insteand of obsessing about it all day long. This takes away some of the tension. So it would appear the pudendal nerve is involved with both urinating and defecating and can easily be thrown off course. (Interesting though that you had constipation but did not strain, how did you pull that off?)
As to PN, I can separately report that as a long-distance bike rider with an improper saddle (bike seat), I had to to undergo PT a couple of years ago for what I thought was a bruised tailbone. The PT I saw in the Chicago suburbs diagnosed it as pudendal nerve entrapment. This PT was known as a national and international educator on pelvic floor therapy. After about 10 sessions, my PN entrapment was eased and I am now pain-free back to long-distance bike riding (albeit with a new type of saddle that she recommended as well). So, this is not now the reason I joined this forum, but I am one that can come here and say I was healed of pudendal nerve entrapment pain through intensive physical therapy.
As to PN, I can separately report that as a long-distance bike rider with an improper saddle (bike seat), I had to to undergo PT a couple of years ago for what I thought was a bruised tailbone. The PT I saw in the Chicago suburbs diagnosed it as pudendal nerve entrapment. This PT was known as a national and international educator on pelvic floor therapy. After about 10 sessions, my PN entrapment was eased and I am now pain-free back to long-distance bike riding (albeit with a new type of saddle that she recommended as well). So, this is not now the reason I joined this forum, but I am one that can come here and say I was healed of pudendal nerve entrapment pain through intensive physical therapy.