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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 (17)
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I am sorry you have been through this much at only 21. Two things are going on and they need to be separated. First, the persistent anal pain 4 months after fissure surgery and multiple kshara sutra sessions is most often due to anal sphincter spasm and a non-healed or recurrent fissure, or scarring/anal stenosis from repeated procedures - your dependence on 2 sitz baths a day fits spasm. This does not automatically mean a 5th operation; a lot of it is treated medically with sphincter-relaxing ointments, stool softening and pelvic floor physiotherapy. Second, the new pulling/burning lower abdominal pain spreading to both legs and the whole lower body, plus severe weakness and 20 kg weight loss, is not explained by a fissure at all. In a young woman that pattern makes me think of pelvic floor myofascial pain, a gynaecological cause (ovarian cyst, endometriosis, pelvic infection), a urinary cause, or - importantly given your history - nutritional deficiency and anaemia from the weight loss and poor intake. Eating slate pencils for 3 years is itself a classic sign of iron deficiency (pica), so iron and other deficiencies are very likely and can by themselves cause aching legs, exhaustion and low pain tolerance. Please do not read this as cancer or as something needing more surgery until it is properly worked up.
Next Steps
1) Please get these tests: complete blood count with peripheral smear, serum ferritin and iron studies, vitamin B12, vitamin D, thyroid profile, blood sugar, ESR/CRP, urine routine, and an ultrasound of the abdomen and pelvis. In your case ferritin and the pelvic ultrasound are the two most important. 2) See a colorectal surgeon for one careful examination of the anal region (with examination under anaesthesia if it is too painful) to document whether there is a residual fissure, a stricture/stenosis or sphincter spasm - this decides treatment, and a 5th surgery is not the automatic answer. Many post-fissure pains respond to sphincter-relaxing ointment, stool softeners and pelvic floor physiotherapy/biofeedback. 3) See a gynaecologist too, since the pain radiating into both legs with the whole lower body aching needs the pelvis assessed. 4) Continue your sitz baths - they are safe and helpful. Keep stools soft with high fibre, 3 litres of water and isabgol at night. 5) Please start eating again, in small frequent meals with protein and iron-rich food; your weakness will not improve while intake is low. Iron and other supplements should be started on the basis of your reports. 6) The 20 kg weight loss and your low mood/energy also deserve attention - chronic pain at 21 with a job to hold down takes a real mental toll, and support for that is part of the treatment, not a weakness. Please carry all your previous operation notes and reports to the visit. I will gladly review everything with you on a Practo online consult, or you may consult me at Synergy Multispeciality Hospital, Miraj.
Health Tips
Please do not take repeated painkillers on your own or agree to another procedure before the above work-up. Go to a hospital immediately if you develop fever with chills, a hard painful swelling near the anus, heavy bleeding, inability to pass stool or urine, fainting, or severe continuous abdominal pain with vomiting.
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Consult a gastroenterologist.
I can understand,it's very distressing to go through such tough situations.
There is a possibility of internal haemorrhoids. Or malabsorption disorders etc....
Loosing 20kgs is not a good thing. Finding what exactly is causing this pain is mandatory in your case.
Continue sitz bath . There is no harm in doing it
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High risk as long years history.
CONSULT SUPERSPECIALIST LIKE GENERAL SURGEON.
HUGE QUERY.
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Contact me through Practo for treatment and guidance.
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Needs proctologist opinion for detailed evaluation
Kindly consult for further advice
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Kindly connect and provide proper history
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This is a high-risk, complex recurrent anal-pain case,
needs re-evaluation of the diagnosis and the source of pain.
Your symptoms need a fresh assessment rather than immediately undergoing another surgery.
Persistent pelvic pain can also have non-anal causes.
please see a colorectal surgeon/proctologist at a tertiary centre and take all previous operative notes, pathology reports and investigations with you.
Next Steps
Cap SOMPRAZ-L/OD BBF
TAB MACROID 1000 mg Thrice a day for 4 days f/b twice a day for 5 days
TAB GABANT NT 100 mg/HS
P/W Livoluke RF FIBRE 2 tsf with lukewarm water/ HS
Cream SITCOM FORTE LA/BD
SITZ BATH WITH BITADINE THRICE A DAY
ADEQUATE HYDRATION AND HIGH FIBRE DIET
REVIEW AFTER 7 days
Health Tips
Your case sounds complex, and I’d be happy to guide you regarding the appropriate evaluation and treatment approach.
If you want to discuss your symptoms in detail, you can connect with me on WA business- 77 260 46 121,
I’ll take your complete history and guide you about the appropriate next step.
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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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What you describe is called Pica. Check your iron levels. You may be iron deficient Which may impair fissure healing
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I understand that you have been through a lot of pain and multiple procedures. Persistent anal pain 4 months after surgery, along with lower abdominal pain, significant weight loss and increasing weakness, needs a proper medical reassessment.
These symptoms should not automatically be attributed to the fissure alone. Recurrent/non-healing fissure, anal sphincter or pelvic-floor spasm and other gastrointestinal conditions may need to be considered.
Your previous history of eating slate pencils may be associated with pica suggested iron deficiency, which can contribute to weakness and anaemia, although it cannot by itself explain all your current symptoms.
Please consult your treating colorectal surgeon/proctologist, and a gastroenterology evaluation may also be appropriate. Further examination and investigations can be decided by the doctor based on your clinical findings.
Next Steps
- Arrange an in-person review with a colorectal surgeon/proctologist.
- Discuss your persistent pain, abdominal symptoms, 20 kg weight loss and weakness with the doctor.
- Your doctor may consider blood tests such as CBC and iron studies to assess for anaemia/iron deficiency.
- Depending on the examination, further gastrointestinal or pelvic investigations may be advised.
- Avoid proceeding with another surgery until the cause of the persistent symptoms has been reassessed.
Health Tips
Continue adequate hydration, maintain a fibre-rich diet and avoid straining during bowel movements. Warm sitz baths may provide symptomatic relief if they are comfortable for you.
Given the significant weight loss, increasing weakness and abdominal pain, please do not delay an in-person medical assessment.
Seek urgent medical attention if you develop fever, increasing swelling or pus around the anus, severe worsening abdominal pain, heavy bleeding, vomiting, fainting or severe weakness.
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The intestines are inflammed because of the past medical history. Surgery is just a cure for the present condition. You need to stop future such developments. Kindly consult with me on 94 two six eight six 78 nine six.
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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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