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Lower abdominal pain radiating to legs
I had chronic fissure & bleeding for 6 years . So I underwent kshara sutra thinking it's less painful. But the thread changing sessions went on for 2 months & even after that there was lot of pain & didn't seem like it was healing. So I underwent another fissure tissue removal surgery 4 months ago. I had followed everything doc had told. I was getting better. But I have had pain & can't manage a day without 2 sitz bath. Moreover even after following all that, I've been having a strange lower abdominal pain & further the whole lower body starts paining. More like pulling & burning .I even have the anal pain. There's no bleeding or pus. But pain.I really have no energy to undergo another surgery.This is my 5th surgery & I have other health probs too. Already lost 20kgs coz of previous surgeries.Feeling more weak now. Also want to mention that in college, i had eaten lot of slate pencils for 3 years.Is that the reason?Now i don't eat. I can't quit my job too.Please help & guide 😭 painful
Answers (13)
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I have read your history carefully and I want to say first that what you are going through â 6 years of fissure/bleeding, kshara sutra, two fissure surgeries, 5 procedures in all, and now a new pulling, burning lower abdominal pain going down both legs with 20 kg weight loss â is not "just anxiety" and it is not normal post-operative pain at 4 months. Two things stand out to me. First, the pain now is different from your old anal pain: pulling/burning radiating down the legs and involving the whole lower body suggests either pelvic floor muscle spasm and pudendal/pelvic nerve irritation after repeated anal surgery (very common and very underdiagnosed), or scarring/adhesions in the pelvis. Second, and more important, a young woman with years of perianal disease, repeated non-healing fissures and fistula-like tracks, plus 20 kg unintentional weight loss and inability to eat, must be actively screened for Crohn's disease or intestinal tuberculosis â in India both present exactly like this and are repeatedly missed as "chronic fissure". Eating slate pencils for 3 years is a classic sign of pica from severe iron deficiency anaemia, which is why you feel weak and have no energy for another surgery; it is a consequence of chronic blood loss/poor absorption, not the cause of your pain.
Next Steps
1) Please stop planning a 5th local surgery until the cause is found â more cutting on an undiagnosed Crohn's/TB perianal disease makes things worse, not better. 2) Get these done: CBC with ESR/CRP, serum ferritin and iron studies, vitamin B12, albumin/total protein, stool for occult blood and faecal calprotectin, Mantoux/IGRA and chest X-ray, and a CECT enterography or MR enterography of the abdomen and pelvis. 3) An MRI of the pelvis/perianal region specifically will show any residual fistula track, abscess or scarring far better than clinical examination. 4) See a gastroenterologist for a colonoscopy with ileal biopsies â this single test is what usually settles whether it is Crohn's, TB or simple fissure disease. 5) In parallel, ask for a referral to a pelvic floor physiotherapist: for the pulling/burning pain going into the legs, pelvic floor relaxation exercises, warm sitz baths and a short course of a nerve-pain medicine (pregabalin/amitriptyline, prescription only) usually help far more than painkillers. 6) Correct the anaemia properly â most likely you will need IV iron rather than syrups, and treat the pica by treating the iron deficiency. 7) Please do not quit your job in a hurry; once the underlying diagnosis is treated, the pain and energy usually improve. You are welcome to consult me on Practo with your operative notes and all reports uploaded so I can go through the whole 6-year picture in one place, or meet me in person at Synergy Multispeciality Hospital, Miraj, if travel is feasible for you â this needs a proper joint surgical and medical review, not another quick fix.
Health Tips
Word of caution: go to hospital the same day if you develop fever with chills, a painful swelling near the anus, pus discharge, severe abdominal pain with vomiting and no passage of stool or gas, heavy fresh bleeding, fainting or breathlessness. Also please do not take repeated painkiller tablets on your own â NSAIDs can worsen gut inflammation and bleeding. If your periods are heavy, mention that too, as it adds to the anaemia.
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Proctologist opinion needed
Kindly consult for further advice
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Continue sitz bath 2-3times/day
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Kindly consult with gi surgeon
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Please consult a gastrosurgeon or gen surgeon for better assessment.
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Dr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Kindly consult
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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