Solving undiagnosible rectal (butt) pain

Why You (almost) Never hear a Dog Fart

And how understanding that helped me solve my pain-in-the-butt problem!       © Russ Lanoie

Apparently many of us humans suffer from problems with our “sitting apparatus,” and some of these problems are a whole lot more complicated to understand and treat than others.  As dogs never seem to have much trouble sitting and we share a common evolution as vertebrates, I’ve discovered that they provide a helpful way to explain one of the possible causes of this phenomenon.

My own problem started years ago, as I recall having to check off the HEMMORHOIDS box on countless military induction medical forms.  Twenty something years later I had an operation to remove those dangling things in hopes of curing what had become a nagging discomfort.  When the surgeon checked his work shortly after the operation, I remember him complementing himself on a fine job. I, however, complained that the sensation that I now characterized as near constant itch was still there.  So he took a sample of the skin in that area and sent it off to some lab only to receive a report that everything appeared normal.

So I tried on my own to solve the problem, experimenting with several salves and creams to stop the persistent itch.  I finally hit upon an over the counter ointment that has cortisone in it.  While this seemed to counter the itch it eventually created a larger problem.  Now, although the itch was gone, the itch turned into a genuine pain.  I have many memories of not being able to sit on any soft chair or car seat without aggravating the pain.  This complicated my life as I spend my days operating a tractor.  At one point, in order to relieve the pain and keep my tractor operating I rigged up a harness that allowed me to stand while driving, in a stance much like the old milk truck drivers of years past or the charioteers of even longer ago.  Hence I called my rigging my “Ben Hur-ting” outfit.  While it helped me keep working, it did little to solve the problem.

My first trip to an MD resulted in a diagnosis, as it typically does, of prostatitis. The first order of business was to try an antibiotic to fight off the infection.  I quickly found that a side effect was to also kill off the friendly bacteria that keep the gut working smoothly.  I recall that, just after Easter Sunday during this treatment, because I ate too much candy (an old habit of a Lenten observer) I was standing at a lecture with one hand trying to comfort my sore butt while the other hand was trying to sooth my belly that was fighting back from my ill-advised indulgence.  The other part of the treatment was to “keep the prostate drained.”  Though this was a generally pleasurable treatment, it did nothing to eliminate the butt pain.

So I started to see specialists, spending much of the time with my patient wife driving while I laid down in the back seat.  We saw a:

  • Neurologist who, I believe, said the pain was in my head;
  • Urologist who probed up into my front plumbing but found nothing wrong,
  • Gastroenterologist who found nothing wrong with my gas,
  • Proctologist, who probed around my butt to see if there was something wrong with some vestigial glands left over from when we still walked on all fours similar to the dogs who eventually helped me understand  my problem. (Think of dogs dragging their butt on the carpet)

And finally a pain clinic where I received a shot of something that would have made the pain go away if the pain had been a result of “natural causes.” I asked the doctor administering the shot if I’d be able to teach in our local school kids ski program that afternoon and he assured me I would.  What he didn’t warn me was that I wouldn’t be able to pee until mid-afternoon when I was in charge of a half dozen third graders riding up the chair lift at our local ski area. The shot didn’t help

Someone recommended acupuncture which was conveniently available at a local clinic so I went for a few sessions.  When they didn’t seem to be helping, the acupuncturist suggested that I come sometime after the clinic was closed and he would light the end of long, slender, soft fabric covered stick of something with Asian symbols on it that I would hold over my head while it slowly burned.  He wanted the clinic empty because he said the burning substance smelled a lot like pot!  He gave me the stick to take home with me and I have not tried it or gone back to the clinic!

At some point in all this, my daughter who is a nurse, suggested that my problem might be the continued use of the cortisone for that persistent itch. While curing the itch, its extended use may have been damaging the skin in an area that tends to be tender anyway, especially for an equipment operator who often pounds around on a tractor seat for hours. She suggested, with reinforcement from a local osteopath, that I simply stop the cortisone and the other local anesthetics that I’d come to use and try using corn starch to keep the area dry.  Eureka, it worked!

Though it did make the itch go away, and I still use it today to prevent that itch from recurring, it did not cure what had become the nagging pain that I can only describe as feeling like I was sitting on a golf ball size rock that was pushing up into my “bung hole” as LBJ colorfully described that part of human anatomy.

[Because my daughter had also diagnosed a pilonidal cyst on the bottom of the spine of another family member, and by now had also become a mental health counselor, I offered to make her a sign that read “J L: Odds and Ends”!]

Just about the time I was ready to see a geologist to find out what kind of rock it was that was causing the pain, I happened to remember meeting someone who would shortly bring resolution to this uncomfortable episode.  Several years before, when visiting my brother-in-law on the West coast, he took us up into the hills north of San Francisco to meet a friend of his.  I remembered that his friend, Dr. David Wise had just written a book called “A Headache in the Pelvis.”  Thinking that his book might hold the key to a cure I procured a copy ASAP.

Dr. Wise explained, in great detail, why this problem could and should not be treated by an MD, but rather a PHYSICAL THERAPIST.  What luck, as I personally know the leading local physical therapist who I promptly e-mailed to see what she knew about treatment for this malady. By another stroke of luck, she e-mailed back and said that, not only was she familiar with the treatment, but at that very moment was heading to the West coast for a seminar by Dr. Wise. Another eureka moment!

ENTER THE FARTING DOG

I point to man’s best friend to help make the cause of the problem as simple to understand as possible.  We all know how a dog reacts to certain things.  When it’s happy, a dog wags its tail, but when it’s nervous or uncomfortable, it often puts its tail between its legs.  It turns out that we humans have this in common with the dogs.  Though we can’t show our cheerfulness by wagging our tails, or react to stress by putting our tail between our legs, we can do a similar thing when we are “up tight.”  We tighten many of our muscles, including our butts in an automatic response to stress or perhaps to discomfort such as a nagging itch.  We also are taught to control our butt muscles at a very early age to lessen the need for diapers.  And, in order to be appropriate in polite company, we often have to restrain our urge to let out the aromatic and often audible offending product of digestion.

So how does this relate to dogs?  To me it’s simple.  Dogs are generally less up tight than their masters, so when they feel the urge to pass gas, it just flows freely through an unrestricted portal, making little or no sound.   Humans, on the other hand, try to let the gas out slowly in order to be discreet.  The gas passing through a tense orifice often makes a satisfying sound if no one else is around or creates embarrassment if in certain company.

So how this relates to us humans, and particularly my pain, is that, by continually tightening the butt muscles in response to gas or, particularly in my case, that continued itch for many years, the muscles simply go into spasm.  Because it is a muscle issue and not any internal medical issue, it is a physical therapist who should do the treatment.

So turning to my friend and her recent training, I started a series of treatments that provide relief to the offending muscles. This was done by “digital manipulation” which probably does not require much imagination to picture, but does require surgical gloves for the provider.  Sure enough, she could tell which muscles were tight and pressured them until they released their death grip.

After several treatments the pain was all but completely gone and has stayed gone for years.  But her admonition, I’m sure backed by Dr Wise’ advice, is to relax those muscles whenever I notice them beginning to tighten up.  I follow this advice religiously, often catching myself tightening up for no good reason.

So a regimen of corn starch to keep the itch from returning and remembering to keep my sitting apparatus as relaxed as does my dog laying on the family couch  has provided more relief than all the “ologists” who should read Dr Wise’ book.

Thank you David Wise.

Note that my brother-in-law, Erik Peper, Ph.D, professor and director of the Institute of Holistic Healing Studies at California State University, San Francisco wrote the endorsement for ­A Headache in the Pelvis and introduced me to the book and to Dr. David Wise.

 Thanks Erik