Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Lower Back Pain Before Bowel Movement?
Question: Lower back pain worse before bowel movement. Saw pcp and ob this week. Neither did a pelvic exam. Xray clear. Colonoscopy clear 2 yrs ago.
My ob believes its musoskeletal but forgot to mention pain worse before bowel movement
My ob believes its musoskeletal but forgot to mention pain worse before bowel movement
Brief Answer:
Please hive me more information.
Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
Read and understood that you have backache which is more so before bowel movement.
Also noted that you have consulted PCP and OB but did not do pelvic examination. X-ray normal. Colonoscopy was clear 2 years ago.
I would like to know a few details to help me to assist you more.
Please give details about bowel movements, any symptoms related to gastrointestinal or genitourinary system.
Is the pain localized and notifiable to a particular area or point?
Any enhancement with movement of the back?
Any other additional information that you would like to provide.
So that we can discuss further.
Please hive me more information.
Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
Read and understood that you have backache which is more so before bowel movement.
Also noted that you have consulted PCP and OB but did not do pelvic examination. X-ray normal. Colonoscopy was clear 2 years ago.
I would like to know a few details to help me to assist you more.
Please give details about bowel movements, any symptoms related to gastrointestinal or genitourinary system.
Is the pain localized and notifiable to a particular area or point?
Any enhancement with movement of the back?
Any other additional information that you would like to provide.
So that we can discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Here is some more detail as i tried to pay close attention this morning. The pain is always a dull ache. It is primarily in what appears to be sacrum area or just above. Im not great with anatomy but looking at images seems to be the srea. I will say its not confined there but goes out to left and right from there. With this mornings bowel movemrnt though it was soecifically in that area.
The pain has been there about a year but did want to note i had a csection 3 months ago. The baby dekivered early at 28 weeks and didnt go full term so weight gain wasnt too bad.
As far as bowel movements, they are brown in color not tarry or abnornal. While i can get constipated or have diarrhea, the stools are loose not hard. Obviously not aleays but When i say loose that means they pass easily but are not what i would consider to be diarrhea. They also arent so firm thst i have trouble passing them. Alrhough again, i do have firmer and looser which would seem normal. I dont have issues eurh urination .
The pain has been there about a year but did want to note i had a csection 3 months ago. The baby dekivered early at 28 weeks and didnt go full term so weight gain wasnt too bad.
As far as bowel movements, they are brown in color not tarry or abnornal. While i can get constipated or have diarrhea, the stools are loose not hard. Obviously not aleays but When i say loose that means they pass easily but are not what i would consider to be diarrhea. They also arent so firm thst i have trouble passing them. Alrhough again, i do have firmer and looser which would seem normal. I dont have issues eurh urination .
Brief Answer:
Looks to be a local problems.
Detailed Answer:
Thanks for your feedback.
As per the additional information you have provided, there looks to be a local problem over the area you have mentioned and this can be myalgia, sacroiilitis (inflammation of the sacroiiliac joint)
It is observed that most of the patients with low back pain get enhanced pain with loaded colon and get marked relief the moment the bowel movement occurs. This is probable nerve mediated that the loaded colon causes to perceive more pain in the low back area.
Well, the issues with the bowel are not very prominent and can first concentrate on the actual painful area, get a clinical evaluation and examination done by an Orthopedic Surgeon, for for MRI/CT scan of the low back including that for sacroiiliac joints to.
Proper diagnosis and treatment of this area should solve your problem.
I hope this answer helps you.
Looks to be a local problems.
Detailed Answer:
Thanks for your feedback.
As per the additional information you have provided, there looks to be a local problem over the area you have mentioned and this can be myalgia, sacroiilitis (inflammation of the sacroiiliac joint)
It is observed that most of the patients with low back pain get enhanced pain with loaded colon and get marked relief the moment the bowel movement occurs. This is probable nerve mediated that the loaded colon causes to perceive more pain in the low back area.
Well, the issues with the bowel are not very prominent and can first concentrate on the actual painful area, get a clinical evaluation and examination done by an Orthopedic Surgeon, for for MRI/CT scan of the low back including that for sacroiiliac joints to.
Proper diagnosis and treatment of this area should solve your problem.
I hope this answer helps you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That seems to map to what i researched. Odd that primary care didnt note that as an option. Is there any concern that cancer or a tumor could be causing this or is it very unlikely?
When i push on the area it does seem to ache more. Also tend to get pain in groin area too. Lastly, my right hip gives me issues and noticed it more this week once i started exercising again.
When i push on the area it does seem to ache more. Also tend to get pain in groin area too. Lastly, my right hip gives me issues and noticed it more this week once i started exercising again.
Brief Answer:
As explained.
Detailed Answer:
There will be referred pain in case of cancer, meaning there will not be local tenderness that you are getting on pushing.
The pain in the low back usually can give spasms of the muscles say in groin or so as a reflex mechanism or as adoptive measure.
But the primary cause causing pain in the groin or in the right hip should get a clinical examination and investigations if necessary by an Orthopedic Surgeon. Then only it will be possible to decide whether this is primary problem or as a result of the low backache.
Lastly, If CT scan or MRI of the area is required for a particular area, it will automatically scan the lower abdomen and pelvis to rule out any cancer.
As explained.
Detailed Answer:
There will be referred pain in case of cancer, meaning there will not be local tenderness that you are getting on pushing.
The pain in the low back usually can give spasms of the muscles say in groin or so as a reflex mechanism or as adoptive measure.
But the primary cause causing pain in the groin or in the right hip should get a clinical examination and investigations if necessary by an Orthopedic Surgeon. Then only it will be possible to decide whether this is primary problem or as a result of the low backache.
Lastly, If CT scan or MRI of the area is required for a particular area, it will automatically scan the lower abdomen and pelvis to rule out any cancer.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Last allowed exchange
My doc also did a full blood screen panel to rule other things out. My alt and ast came back high. They were high last year at this time (although not as elevated) but after an ultrasound didnt even show that i had a fatty liver. I dont know if they were elevated more this time because i drank alcohol the night before (2 glasses wine) and have been averaging 1-2 glasses of wine/nightly over the last three weeks. Concern on the levels and any association to back pain? AST= 45 and ALT= 93
Lastly, if the pain is slightly to left and right of center of back is that still considered the sacrum? My pain is primarily center (clearly sacrum area) and just to left and right of center
I tend to focus on the cancer diagnosis but with no other symptom than back pain that seems more pronounced prior to a bowel movement seems unlikely, correct? The reason i ask is that Primary care doc isnt requesting an MRI or CAT scan right now. He wants to try physicsl therapy initially. Im ok with that as long as it wont turn out to be cancer.
Thanks for your help and thoughtful responses to my remaining questions.
My doc also did a full blood screen panel to rule other things out. My alt and ast came back high. They were high last year at this time (although not as elevated) but after an ultrasound didnt even show that i had a fatty liver. I dont know if they were elevated more this time because i drank alcohol the night before (2 glasses wine) and have been averaging 1-2 glasses of wine/nightly over the last three weeks. Concern on the levels and any association to back pain? AST= 45 and ALT= 93
Lastly, if the pain is slightly to left and right of center of back is that still considered the sacrum? My pain is primarily center (clearly sacrum area) and just to left and right of center
I tend to focus on the cancer diagnosis but with no other symptom than back pain that seems more pronounced prior to a bowel movement seems unlikely, correct? The reason i ask is that Primary care doc isnt requesting an MRI or CAT scan right now. He wants to try physicsl therapy initially. Im ok with that as long as it wont turn out to be cancer.
Thanks for your help and thoughtful responses to my remaining questions.
Brief Answer:
ALT/AST may be due to alcohol. Request for further tests.
Detailed Answer:
Hi.
Thanks for your feedback.
ALT and AST may not be related to the back pain as there is a definite history of alcohol consumption as you have noted.
The pain on the either side of the sacrum is most probably due to Sacroilitis- that is inflammation of the sacro-ilic joint.
The pain in the center may be just an extension of hte pain in the sacroiliac jaundice.
High degree of suspicion alone can help in early diagnosis and proper treatment.
Hence I liked the way you are thinking , which is absolutely correct. I think you should discuss/request the Doctor to go for MRI scan of the affected area.
You are most welcome and thanks for your appreciation.
You can certainly ask further questions.
or put a new question to me by using the link below:
http://bit.ly/askdrtchandrakant
ALT/AST may be due to alcohol. Request for further tests.
Detailed Answer:
Hi.
Thanks for your feedback.
ALT and AST may not be related to the back pain as there is a definite history of alcohol consumption as you have noted.
The pain on the either side of the sacrum is most probably due to Sacroilitis- that is inflammation of the sacro-ilic joint.
The pain in the center may be just an extension of hte pain in the sacroiliac jaundice.
High degree of suspicion alone can help in early diagnosis and proper treatment.
Hence I liked the way you are thinking , which is absolutely correct. I think you should discuss/request the Doctor to go for MRI scan of the affected area.
You are most welcome and thanks for your appreciation.
You can certainly ask further questions.
or put a new question to me by using the link below:
http://bit.ly/askdrtchandrakant
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
