Rectal burning sensation (sorry to be so blunt)

[tlhowell]

Does anyone have trouble with rectal burning made worse when sitting in the power chair? Multiple cushion combinations have been tried and every over the counter remedy has been tried. Prescription level lidocaine and pain relievers including Norco. I'm currently on gabapentin and Lyrica in case it's nerve related pain. Not really working. Very reluctant to try opioids that contribute to constipation that will lead to other problems. Not being able to sit in my chair for more than a couple hours, with extreme pain, is a life changer as it severely restricts what we can do and where we can go. Any suggestions???? Thank you

 

[KimT]

Have you been examined by a gastro or proctologist? It could be an anal fissure or hemorrhoids. The treatment for them is not the same. Does it hurt when you have a BM? Is there blood in your stool.

I knew I had bad constipation and ended up with hemorrhoids. I treated them but, in the process, gave myself an anal fissure and THAT was extremely painful. I ended up healing it by using an ointment containing lidocaine and a calcium channel blocker. Hemorrhoid treatment uses vasoconstrictors and, I believe, overuse of this is what caused the fissure.

I had the hemorrhoids zapped with laser, then I was able to work on healing the fissure.

Can you get to a proctologist to have a proper diagnosis? Sometimes they treat with with botox which takes care of the spasms. That was going to be my next move, if the cream didn't work.

 

[tlhowell]

Thanks Kim for responding. Yes, Mike did see a proctologist. He was examined externally and internally and he said he didn't see any obvious problems. Lyrica wasn't working , and morphine and stool softeners are his next attempt. Didn't want anyone else to experience this pain and issue, but was hoping someone could suggest something we haven't tried.

 

[lgelb]

Lyrica (pregabalin) is the successor to gabapentin, so I wouldn't be taking both. And if they're not helping, nor lido, it doesn't seem like nerve-related pain.

Is a Roho cushion whose inflation has been double-checked with the butt in the chair, in use? Or if the cushion is solid, is it gel? Has the seat-to-floor height and footplate height been reassessed? What's the bed surface like?

If bouncing while moving in the chair hurts, I'd re-evaluate tire pressure and clean the casters.

If it's simple dryness, something like A&D ointment or grapeseed extract ointment overnight might help. It sounds lurid but pics of the area just after waking and after some time in the chair might tease out where the worst insult is occurring. I would also try massaging the base of the spine.

Best,
Laurie

 

[KimT]

I use Colace (clear) 200 mg. a day plus 1,200 mg a day of magnesium to soften stool and help with daily BM.

I also use coconut oil to prevent dryness.

Sometimes you can have spasms and nothing obvious is found. My spasms were caused by the fissure and it took a long time to heal. They were sure I'd need surgery but I did not.

I notice when I sit for a long time my bum gets sore, then it feels like sciatica and even gravitates to the back of both legs. I found a nice cushion that works better than my ROHO at a store called Relax The Back. It is soft memory foam and I take it everywhere along with my back pillow.