Hi everyone, 34 y.o. newbie here and this is my story - need help with next steps for diagnosis!

Hi all,

Another woman joins the troops! My story is just beginning - and I'm in need of your advice on where to go from here as I have not been officially diagnosed yet.

I'm 34, never married but with a loving partner, never had children, and had been spending the last 10 years of my life living my dream - moving to New York, going to grad school, and after years of hustling, finally landing my dream job with a big promotion a few months ago. I was on top of the world and ready to start the most productive period of my life.

Of course my body found that a perfect time to unleash a surprise that has been building over my lifetime. I have suffered from chronic constipation ever since I was a young girl. In my 20s a gynecologist told me I had an inverted/tipped uterus but not to worry about it.

Symptoms
2 months ago a disturbing symptom emerged - a strange wetness/mucus leakage from my butt that had a foul odor - needless to say, this odor wafting from me was a disaster for the open office/workplace environment and my position as a team leader. I was horrified and baffled and my physician couldn't explain it either.

In the last week my symptoms have been increasing rapidly and in severity:

- Shooting pains in my rectum and vagina and across my sitz bones jolt me awake at 2am like clockwork every night - can barely sleep
- Anal sphincter closes tightly and spasms, and then other times hangs open like it's very loose exposing air/contents of bowels - I suspect because there is pressure/weight on rectum/anus that makes it feel like I have to poop but there is nothing actually there, so it is confused
- Constant feelings of urge to use the restroom (pee & poop) but nothing happening
- Burning in urethra and aching like menstrual cramps across uterus
- Insides feel so heavy, feel I have to slump when I'm standing up
- Difficulty breathing, I can only breathe in short shallow breaths
- Feeling like I'm sitting on an egg, when leaning forward can feel a bulge in vagina
- Having to do strange postures to poop: standing over toilet and pushing on my inner right buttcheek, near the anus. Crossing my left ankle over my right knee and leaning to the right. This is all just to get liquid diarrhea out!

Chronic constipation: a complicating factor
The bowel movements are a huge complicating factor for me. I have had IBS-like symptoms my whole life and have often ignored the urge to go, which resulted in very large poops that no doubt put a strain on my whole system. I rarely feel the urge to go anymore, I suspect I have a slow colon/colonic inertia, and I want to begin healing my gut and start listening and responding to my body (as advocated by Jini Patel Thompson: http://www.listentoyourgut.com). I haven't had a normal poop in a few weeks, and my tongue is covered with white stuff due to acid reflux, breath smells horrible. Can't take more fiber because it stops me up.

Stress, Trauma, Grief
The emotional experience I'm going through is *crushing* - it's a grief and a trauma I haven't experienced since the loss of my mother 15 years ago when I was in college. She died from a small bowel obstruction (she required surgery but she refused and turned to God for a miracle that never happened). I suspect she may have also had pelvic prolapse - but of course no one in the family will discuss this. I am on medical leave now and will probably have to resign from the job I had worked so hard to get. My situation is also putting a lot of stress on my relationship - I have a kind and loving partner but can tell burnout is starting to happen.

Doctors seen:
- I went to the emergency room a few nights ago because I thought there was a bowel obstruction or fecal impaction. The MRI contrast scan showed no abnormalities, except a uterine fibroid and also the comment that there was a lot of air in my vagina. They sent me home with stool softeners - useless.
- Gastroenterologist examined my rectum digitally and with anascope and said he could not detect rectal prolapse. Prescribed valium because my anal sphincter was tensing up and spasming (and also because I was an emotional wreck in his office). Prescribed Linzess for the constipation.
- Gynecologist did not notice anything during my annual exam/pap last week.
- Urogynecologist examined me in vagina/rectum while lying down said she could not feel any prolapse symptoms. Said I should explore my constipation issues more with my GI doctor.
- Colorectal surgeon said I have larger than average internal hemorrhoids and couldn't detect rectocele with his anascope but said he wouldn't rule out the possibility but would need colonoscopy.

I am overwhelmed because I have overlapping medical conditions that need to be treated holistically. My constipation issues and straining over a lifetime have no doubt contributed to prolapse but the prolapse has probably also made it harder for me to evacuate. It's a vicious cycle that I desperately want to break but need a team of integrated health specialists to help me do this!! Otherwise each specialist just sees their part of the picture, which is incomplete.

Next Steps: Which diagnostic tests should I push for?
The worst part is - no one has officially diagnosed me with prolapse. These quickie manual office exams with their hands isn't cutting it. I need to push them for a true diagnostic:
1) I live in New York and want to make an appointment for an MRI Defecography (http://www.mdrny.com/content.php?sect=whatsnew&sub=01_005).
2) Or does anyone know if I can ask for a vaginal ultrasound to at least get a quick picture of what's going on inside?
3) My GI doctor has also recommended a colonoscopy to rule out any disorders/diseases of the colon/bowels. I am afraid this will disturb my prolapse condition even further - does anyone know if this is a risk??

If anyone can help with next steps regarding testing/diagnostics, I would be truly grateful.

In the meantime I have reached out to a Whole Woman practitioner here in New York and our first session is in a week. I have also booked an appointment with Beyond Basics, a PT program that includes pelvic floor dysfunctions (http://www.beyondbasicsphysicaltherapy.com). Is there anything else I can be doing in the meantime?

Thank you for reading this far and letting me vent. I am so grateful for Christine and that this community exists to help women connect with each other and with our bodies. I realize now that I have been so out of touch with my body and what it wants and needs. I know there is a very long healing and learning journey ahead of me but I will take it one step at a time and hopefully with this supportive group of women we can all help each other through the dark days.

With appreciate and gratitude,
BeingHuman