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Sigmoid Colon Spasms and Proctalgia Fugax

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Hi everyone! I’m a 24 year old woman suffering from intense, crippling abdominal and rectal pain ever since my celiac diagnosis two years ago and was wondering if anybody else experiences anything similar. 

Every now and then, I get an intense cramping/stabbing/burning pain in my lower abdomen and back, mostly on the left side. It comes on gradually and feels “twingy,” and sometimes spontaneously resolves without much pain and other times develops into excruciating pain that can last up to 10 hours. The pain is colicky, so it ebbs and flows in intensity, going from 3/10 pain to 10/10 keel over and help kind of pain. I frequently will feel an intense need to have a bowel movement, and almost always the BMs will be normal and formed, occasionally they will be a little fluffier and floatier than normal. On a regular day i will average 1-2 BMs, but on these days I can have up to 10 BMs. I almost never have constipation or diarrhea. Frequently these episodes are also accompanied by intense waves of rectal pain, which feel like I’m being knifed up my butt. 

Patterns I’ve noticed:

-frequently happens the day after I’ve been drinking more heavily than normal, which makes me think dehydration could play a role

-frequently happens in the week leading up to my period, which makes me think hormones could be playing a role

-started shortly after going gluten-free. My doctor does not think this sounds directly related to celiac, but I wonder if cutting out common sources of fiber like whole grain wheat could have caused a problem. I started a fiber supplement (psyllium husk) per my doctor instructions yesterday, we’ll see if that helps 

Things that make it feel better-

-NSAIDS. Can’t explain this one, doesn’t make much sense to me but for whatever reason ibuprofen and naproxen are one of the only things that really make a big difference. I try not to take them unless the pain is unbearable because both of my previous endoscopies have shown ulcers in my stomach

-heat- heating pads and a hot bath feel very nice 

I have also had a pelvic ultrasound during the pain to rule out ruptured ovarian cysts.

I’m good about being gluten-free and don’t really think this has to do with being glutened. I last had an endoscopy about 6 months ago and my duodenum seems to be fully healed, other than some residual intraepithelial lymphocytes (Marsh 1). My ttg and ema have also fully normalized. I never experienced this type of pain before my diagnosis and going gluten-free.

I saw my GI doc yesterday and he suspects sigmoid colon spasms and proctalgia fugax, which is ultimately unharmful just unpleasant (a form of IBS). Today I had one of the worst episodes I’ve ever had of this pain, going on 9 hours of crippling pain now. I started fiber supplements yesterday and hopefully with time it will help, but I’m feeling very frustrated and worn out by this and was just wondering if anyone else experiences something similar, what you do, just really anything. It really interferes with my life and puts me out of commission for the whole day when it hits. 


Extra thought: I have a lifelong history of “overactive nerves” one could say. As a child I had severe sensory integration disorder which resolved with therapy and time I guess, I have severe hyperhidrosis and had a thoracic sympathectomy 9 years ago to sever the nerves that cause sweating in my hands (my surgeon said my nerve bundles were the biggest he’d ever seen), I have chronic shooting wrist and hand pain for no apparent reason, notalgia fugax, an unknown itchy spot on my back likely from nerve overactivation, etc etc. I’ve read from Stanford and other sources that IBS could be caused from hypersensitization of nerves in the colon. Anyway these things could mean nothing, but just an observation I had about myself and am interested to hear others thoughts and opinions! 


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I hope you are feeling better!  I don't know what would help with the pain.  Maybe Pepto Bismol?

My first thot is possible Crhon's Disease, but it seems like your doctors would have tested for that.

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