Upon waking - immediate burning...

[JAT]

Hi.

I was wondering if anyone else has these symptoms: Immediately upon waking up in the morning and as peristalsis begins... I have burning in my pelvis, perineum, and rectum. Rarely the burning is relieved by a BM. Unfortunately however the only thing that helps are pain medications. Additionally, I feel as though I need to urinate constantly - all day and virtually every day but with very minimal results. I could relieve myself and literally 1 second later I feel as though I have to go again. Does any of this sound familiar? Lastly, I know that I read a medical article somewhere that this condition/disease can cause constipation. One physician recently indicated that this condition does not cause this and I'm trying to locate an article or two indicating that it does. If anyone is able to steer me in that direction I would be most appreciative in order to present it to that physician. He has been very helpful, does admit that he is not an "expert" on the topic of PN/PNE, but I would like to at least show him that I'm not nuts. Note: years ago after being diagnosed with a coccygeal fracture the orthopedic surgeon did indicate to me that I may have some issues down the road due to the fracture, one of which having to do with constipation.

I'm in the process of trying to determine which physician/practitioner/surgeon I should see - unfortunately there is absolutely no one in my area (Wisconsin), my insurance is through Wisconsin, all but one of my physicians are in Illinois and there aren't any physicians in that state either who are well-versed (if at all) on the subject of PN/PNE. With the latter being said however, for one everyone I see is out of network - but - I don't want to go to someone who happens to be closest to me - I'm trying to determine who would be the best - in all aspects of medical care as of course this is my health and we all deserve the best.

I truly, truly appreciate this site and am relieved in many respects that I found it; if it weren't for this site and the information available I sincerely doubt that I would be what I believe to be on the right track. As my gynecologist stated, "I think you may be on to something", this, after 12+ years of excruciating pain and countless specialists who have gotten me absolutely nowhere other than causing my insurance premiums to skyrocket more than most consequently destroying our financial status and substantially more anguish.

Again, I appreciate everyone's input.

[janetm2]

Not sure about proving the constipation issue but habe you shown the doctor the symptom list on the homepage with your list of symptoms. Also in the FAQs off the home page is a letter to give to doctors as an initial education on this condition.
Janet

[Violet M]

JAT, I don't recall any publications on constipation being caused by PN but Dr. Howard's brochure mentions there is a relationship. http://www.urmc.rochester.edu/smd/Rad/Pudendal.pdf. It's on page 2 under "symptoms". You could also go to pubmed and type "pudendal" and "constipation" in the search bar and you might come up with something. Numerous PN patients have reported problems with constipation on the PN forums but whether it's PN that causes constipation or constipation that causes PN may depend on the person.

The right doctor for you will depend on what type of treatment you are interested in pursuing. Are you wanting to try conservative therapies or are you thinking nerve blocks\surgery? Have you ruled out sacral nerve root issues? Have you tried ganglion impar block?

Constant feeling of needing to urinate is a common symptom of PN. Antidepressant medications might help. Surgery helped in my case.

There are some good PT's in Wisconsin but I don' t know if any are near you.

Take care,

Violet

[greeneyes]

While I am not aware of a connection between PN/PNE and constipation, there does seem to be a relationship between pelvic pain and irritable bowel syndrome. I have had IBS for most of my life and my primary symptom is constipation. JAT, you may not have IBS but the pelvic pain and constipation could still be related. I have done some research on this subject and there are certain conditions that often appear in conjunction with pelvic pain. Besides IBS these include low back pain (which I also have), interstitial cystitis and fibromyalgia. I think there are others as well but I don't recall the entire list.

Greeneyes

[helenlegs 11]

Could the constipation be due to medication JAT? I just know it undoubtedly is in my case and getting the balance right with tramadol (in my case) intake and movicol/senokot can be problematic.
Helen