Lower Abdominal Pain and Uncontrolled Rectal Pressure

Lower abdominal pain with straining at the anus?

Hello doctor, I would like to ask about something.
For the past year or so, I have occasionally experienced pain in my lower abdomen.
During these episodes, I involuntarily tighten my anus, and the pain lasts about 10 seconds.
It feels like I'm floating upwards when the pain occurs, but it doesn't feel like the pain associated with the urge to have a bowel movement.
I would appreciate your insights.
Thank you.

Liu Xiansheng, 20~29 year old female. Ask Date: 2016/03/24

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Please visit a colorectal surgery clinic.

Reply Date: 2016/03/24

More Info

Lower abdominal pain accompanied by involuntary rectal pressure can be a complex issue that may stem from various underlying causes. Given your description, it is essential to consider both gastrointestinal and neurological factors that could be contributing to your symptoms.

Firstly, the sensation of pain in the lower abdomen, particularly if it is episodic and lasts around 10 seconds, could be indicative of several conditions. One possibility is that you might be experiencing spasms in the intestines, which can occur due to conditions like irritable bowel syndrome (IBS). IBS is characterized by a combination of abdominal pain and changes in bowel habits, including diarrhea and constipation. The involuntary rectal pressure you describe may be a result of these spasms, causing a reflexive contraction of the pelvic floor muscles and the anal sphincter.

Another potential cause could be related to pelvic floor dysfunction. This condition can lead to abnormal muscle coordination in the pelvic region, resulting in pain and pressure sensations. In some cases, pelvic floor dysfunction can be associated with stress, anxiety, or previous trauma, which may contribute to the involuntary muscle contractions you are experiencing.

Additionally, it is important to consider the possibility of gastrointestinal conditions such as diverticulitis, appendicitis, or even hernias. These conditions can cause localized pain and may also lead to changes in bowel habits or rectal pressure. If the pain is severe or accompanied by other symptoms such as fever, nausea, or changes in bowel movements, it is crucial to seek medical attention promptly.

Neurological factors should also be considered. Conditions affecting the nerves that innervate the pelvic region can lead to abnormal sensations and involuntary muscle contractions. For instance, nerve entrapment or irritation in the lower back can sometimes manifest as abdominal pain and rectal pressure.

Given the complexity of your symptoms, it is advisable to consult with a healthcare professional who can conduct a thorough evaluation. This may include a detailed medical history, physical examination, and potentially imaging studies or endoscopic procedures to rule out any serious underlying conditions.
In the meantime, keeping a symptom diary may be beneficial. Documenting when the pain occurs, its duration, any associated activities, and dietary habits can provide valuable information for your healthcare provider. Additionally, practicing relaxation techniques, such as deep breathing or mindfulness, may help manage any anxiety related to your symptoms.

In summary, lower abdominal pain with involuntary rectal pressure can arise from various gastrointestinal, pelvic floor, or neurological issues. A comprehensive evaluation by a healthcare professional is essential to determine the underlying cause and develop an appropriate treatment plan.

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