Irritable Bowel Syndrome/Tailbone Pain and IBS?

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Question
Thanks in advance for reading this:

I had a bout of bad IBS a couple of days ago and unfortunately had to strain very hard to go to the bathroom. Further, I had to use a number of suppositories just to get back into a normal bowel movement rhythym.

The following day I had some pain on and around my tailbone, as if it was bruised (hurts to the touch).

Its gotten much worse over the past 2 days and today I can barely sit. Its all external, as if I fell on it. Can this happen from straining or do I have something to worry about here?

Thanks again,

Steve

Answer
Steve, thanks for getting in touch and sorry to hear of your suffering. I suspect one of two main possibilities here. The first is an anal fissure. This is a cut or breach in the anal skin surface which can be excruciatingly painful. It is usually caused by excessive straining and can cause not only pain, but bleeding sometimes too. The treatment for this is to make sure you treat your constipation as you have been doing, lifestyle changes such as drinking at least 2 ˝ L a day and taking regular exercise. You can apply local anaesthetic creams to the painful area or consider a barrier cream  (nappy rash cream is ideal). If this doesn’t heal, your doctor can consider treating with GTN ointment, Diltiazem ointment or Nifedipine ointment. These all relax the sphincter muscle aiding healing, but they can all cause headache and dizziness (they all lower blood pressure) so can’t always be tolerated.

The other possibility is a thrombosed hemorrhoid. This is when a hemorrhoid becomes strangulated and clots off as the blood supply is stopped. This is excrutiating as well. These can be treated surgically or medically.

It would seem very unlikely the “tail” or coccyx has been injured giving pain called coccydynia. The coccyx is the bone at the base of the spine and is thought of as our vestigial tail!

Really you need your doctor to take a look and advise you in this matter. Hope the above is helpful Steve, please let me know if I can be of any more help and good luck!

Best wishes

Peter

Irritable Bowel Syndrome

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Dr Peter Thatcher MBBS, MRCPI. IBS Physician & Gastroenterologist

Expertise

I can answer questions on all aspects of IBS or the Irritable Bowel Syndrome, Medicine and Gastroenterology. This would include aspects of diagnosis, investigation and management of IBS and other gastroenterology or medical conditions.

Experience

I am a Consultant Physician and Gastroenterologist in the United Kingdom. I qualified as a physician in 1993 and have been practicing Medicine and Gastroenterology ever since. I regularly run gastroenterology clinics and 1:4 patients have IBS. I am also the web master of IBS Help Online, an Irritable Bowel Syndrome help site.

Organizations
British Society of Gastroenterology Member of the Royal College of Physicians of Ireland Consultant Physician and Gastroenterologist, Royal Cornwall Hospital, Truro, Cornwall. UK

Education/Credentials
Consultant Physician and Gastroenterologist, Fully UK Trained Medical Degree at Kings College School of Medicine & Dentistry 1993 Membership of the Royal College of Physicians of Ireland Examinations 1997

Awards and Honors
MBBS 1993 MRCPI 1997

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