Medical Questions > Conditions and Diseases > Digestive and Bowel Disorders Forum

Anismus - Anyone Else? Treatment Options?

I'm a 24 year old female suffering from anismus or "anal sphincter dyssynergia". I'm looking for other people who share this digestive disorder.

What have you been thru and what are my options?

The only alternative to surgery I can find is biofeedback which isn't working very well for me. I'm learning about botox injections and possibly acupuncture.

I started a yahoo group for people with anismus. It is located at http://health.Groups.Yahoo.Com/group/anism us/

if you have anismus, please join and help me. Share your story and knowledge.
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First Helper midgiemidge
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replied May 4th, 2009
Anismus
I will go several days with incomplete evacuation of feces and it drives me nuts. Other days I'm fine. Every once in a while I even get severe watery diarrhea (just one isolated bout) OR I won't have a BM for two or three days at a time! Also about every three to four months I get a horrific pain in the anus....a severe aching/throbbing pain that only goes away after taking 600 mg of ibuprofen and once in a blue moon after having a BM I'll get this horrible aching/throbbing anal pain....it's horrible and so severe that I start to sweat! The good thing is this intense pain last maybe a few minutes but it feels like eternity! I know I should go see a GI specialist. I know it's not life threatening and the severe pain is rectal spasms. I am 48 years old and simply do not recall EVER having such fickle bowel habits or that horrible pain in my younger years. I drink fiber drinks, yogurt with fiber......drink plenty of water and still have the incomplete evacuations. Once every blue moon I'll have a perfectly normal BM.
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replied May 18th, 2009
Dealing with Anismus / Puborectalis Muscle Dysfunction
1) Stay hydrated.
My physical therapist told me to drink 1 ounce of water per day for every 2 pounds of body weight. I think that's a little bit much, but perhaps they say that because most people will not reach their goal. 1 ounce for every 3 lbs of body weight works for me. Signs that you're dehydrated include a white tongue and yellow urine. You can't judge your hydration by how often you urinate because you may be oversensitive and urinate frequently, even though you're not getting enough fluids. That's what was happening to me for 2 years before I was diagnosed.

2) Eat right.
Eat plenty of fruits and vegetables. Eat rice, bread, and dairy only in moderation because they can lead to constipation. I avoid ingesting too much non-soluble fiber at one time because this tends to lead to firmer stools for me. Whole grains are good for you, but you need to get the majority of your fiber from fruits and vegetables. I particularly like to eat a banana every day for potassium. I find dried fruit to be a convenient addition to my diet. More importantly, Activia yoghurt every other day helps keep me regular.

3) Be gentle.
At home I wipe myself clean with moistened toilet paper, and only use dry toilet paper to dab myself dry. On the go, I have found a product that I like called The Final Wipe. I keep them in my desk at work, and put one in my wallet when I'm going out. It closely resembles a wet-nap, so it's not particularly embarrassing to be caught with when you are forced to empty your pockets. After removing everything I can with moist toilet paper, I wet my fingers and massage my pelvic and rectal areas for a short while. Then I dry the area and apply a small amount of chap stick. I haven't found any other product that soothes as well. (It's another product that isn't embarrassing to have in your pockets. Just don't share it with anyone.) I barely insert the stick at all, but most of the nerves are right at the end anyway. Then I wash my hands really well in hot water with anti-bacterial soap.

4) Rock! Don't push!
There's a good chance that you aren't voiding everything when you defecate. You might not be able to tell one way or the other. I stand over the toilet and relax as much as I can and let gravity help things a long for a bit. When things are just about to come out, I sit. After I'm mostly empty, I lean on the sink to my left while still sitting on the toilet. After 20 seconds or so, I lean to the wall on my right. I go back and forth like that for a little while, and most times I'll work something out. Sometimes I'll only work out some gas or nothing at all. The important thing is that I void completely without pushing.

5) Stretch.
There are a lot of stretches that can help, and I have a routine that I do at least twice a day: after defecating and before I sleep. These include hamstring stretches, hip rotator stretches, abdominal, and lower back stretches. The most useful of these I perform just before defecating as well. My physical therapist told me to do Kegel exercises, but never instructed me to do them while I was stretching, which I find to be very helpful. It's the only time that I feel what a good relaxation of the area is supposed to feel like.

6) Massage.
Every night before bed I spend a few minutes massaging my perineum, rectum, and tailbone. I use a Conair Touch and Tone Massager. I don't like to use my hand because I like to be very passive and relaxed during the massage, but you probably could use your hand. As a man, I can give myself an extremely short perineal massage after urinating, which usually helps evacuate a few extra drops. I'm not sure how that would work for women. I also use a Homedics shiatsu massager for my back sometimes.

7) Relax.
Remove as much stress from your life as you can, and make time for relaxation. I enjoy spending time with my wife in our hammock staring at the sky and talking.

Cool Exercise.
Don't do high impact exercises like running or strenuous activity such as weight training. Don't ride a bike unless you're sure it's not hurting you. I find swimming and inline skating to be the most tolerable. I haven't purchased a rowing machine, but I expect that rowing would be another tolerable exercise. Don't push too hard, and don't forget to stretch a lot after any exercise.
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replied June 1st, 2011
anismus pelvic floor dysfunction
i was diagnosed with pelvic floor dysfunction and animus. i am a 25 year old female who never experienced anything quite like this. it is a very stressful and frustrating medical issue to have but i have found a possibility at returning to normalcy. i go twice a week for biofeedback in conjunction with mayofascial(spelling) trigger point relaase therapy where the PT does internal rectal stretches and pressue on trigger points of tightness and pain. so far it has been helpful because the windows of pain and dysfunction become less frequent each week but i was told beforehand this is a long term process for a permanent fix and that there is no faster way to be rid of this terrible affliction.also i am given pelvic floor exercises to strenghten those muscles because they all affect one another. hope that helps, find a physical therapist in your area who does such a technique and hopefully it will provide you with relief. see a proctologist or a gi doctor, do whatever it takes to find someone who is experienced.oh and read the book a headache in the pelvis to hear more about this condition.
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replied March 10th, 2012
Anismus - Childhood Sexual Abuse
I have just been diagnosed with anismus due to childhood sexual abuse. The diagnosis is part relief, part worrisome:

* I am relieved... to have a name to call my problem without the indignity of reliving
childhood horrors.

* I am very worried because I have been told that treatment must involve INTERNAL touch. This is freaking me out, which does not help with the anismus/pelvic stress problem.

Has anyone had internal treatment?

Would you mind being really detailed describing it so I can see what I am getting myself in for?

I would hate to freak out with an unknown clinician and leave in tears and humiliated.
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replied March 16th, 2012
do not be scared, read the book "A Headache in the Pelvis" it touches upon many details of this terrible affliction. i will attempt to summarize my awful experience, but it has been working slowly but surely so i would strongly suggest you get over your fears and see how your body responds...my anismus began just due to generalized anxiety/starting birth control which altered my bowel habits. i would suggest you go to a trained professional (a physical therapist that specializes in pelvic floor dysfunction) mixed with doing pelvic floor excercises. it was not as scary as i anticipated though it was initially embarassing and a little awkward.
i started going twice a week, then once a week, now once a month and i am almost discharged! My symptoms are at maybe a 1 or 2 when they were at a 10. my goal is to be at a zero. ill explain the treatment:
therapist has you lie on your back with a heating pad on your lower back for 10 minutes. then you change into a gown and the therapist does an external lower back and buttock and thigh massage(anywhere you are in pain) then they do internal work where they insert their finger gently inside and find the points of tension and hold and then release/ stretch the internal muscles. this takes maybe 10 minutes.lastly, you do your course of pilate type stretches in the gym. this therapay program is time consuming bc you are relaxing the muscles gradually and re-training your body to stay in a relaxed rather than tense state BUT IT WORKS.
i used to urinate two times a night and all day long and i was having rectal pain and discomfort. now i have a very minimal rectal pain and some issues still going to the bathroom but i do not wake up in the middle of the night at all to urinate and go much less frequently durign the day. also my back pain and buttock pain is virtually gone. for me its just the remnant of rectal discomfort thats taking the longest to be completely alleviated.
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replied March 17th, 2012
Thank you so much for your detailed reply.
I'm seeing a specialist physiotherapist this week.
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replied March 26th, 2019
Hi my physiotherapist advised me to do the following breathing exercises: inhaling as much air as possible,( the air should fill your lungs and chest case) then graduallly exhaling the air. During this exercise your pelvic floor should be pulled upwards during inhalation and then it should gradually relax as you slowing exhale the air.This exercise helped me only to a point. Now I can feel my pelvic floor muscles are tense (in the past I did not feel any tension in this area and could not find out why I had bowel and sphincter problems), but now these muscles are still tense but I regained just a bit of its flexibility and I can feel these muscles. The other exercise that was advocated to me as sitting on the floor with folded arms, head facing the floor, the forearms and forelegs lying horizontally on the floor and propping the corps. The back should form the shape of letter "S"- Buttoms and head should stuck out, whereas the mid part of your back should be "concave" Sit in this position as long as you can because it allegedly streches the pelvic floor muscles. You can watch TV sitting like that.
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