New here looking for answers...My 47 yo husband dx with Stage IV Rectal cancer had a LAR with colonal J pouch and temp ileo on May 16. He had a liver resection 4 weeks later. All is well with that. His huge complaint is the constant rectal pressure, spasams, contracting etc. It bothers him so much it affects everything he does or does not including his mood and sleep. Right now the only that works is dilaudid. He takes one mid morning and during the evening. Of course this is highly addictive I am told. When he was on it after leaving the hospital every 3-4 hours he was literally stoned all the time. This caused him to sleep all the time and not eat and resulted in a 26 lb weight loss, thus they delayed chemo and put him on prednison. The steroid helped and he is eating and gaining but could not wean himself from the two dilaudid. So we went to colorectal surgeon to discuss. He agreed to try to wean off the pain med. He prescribed a low dose of valium, steroid suppository and sitz baths. None work. The sitz bath give temp relief. So they gave us another prescription of the dilaudid.

I have been reading the boards and am wondering about the antispasmatics drugs? Why would the doctor not have prescribed this? He did a rectal exam to check the new construction and could feel the spasams. He called it lower anterior resection syndrome. He has a temp ileo and will keep it through chemo so nothing is passing except muscous.

I need to help him with this as it has totally defeated his mood and ablitity to fight. He was lucky they could cut out the cancer and implant a liver pump to do chemo directly to liver too. He can manage a somewhat normal day on the two pain meds a day and feels he needs it to eat, sleep and be nice. We will talk with Onclogist next week about this issue. We see the colorectal surgeon in 10 days and I talk with his nurse all the time.

Sorry this is so long. I am just trying to figure this all out and get him the help he needs. Thank you
Chris in Virginia

hi chris,
sorry you have to go through this.

when you say spasms i am not sure what type you are referring to. i just talked to my gastroenterologist about anti-spasmatics because i have sphincter muscles spasms that are painful...he said those drugs are more for spasms of the intestines, for people with irritable bowel, and won't help my muscle spasms. i don't know what lower anterior resection syndrome is...maybe jan will chime in and can be of more help...

Thanks Niki...The doctor felt the spasams with a finger when he did a rectal exam. I talked with our pharmacist and they were not concerned about the two pain meds a day if it gives him quality of life and the abliity to put on weight ang prepare for chemo. We will keep trying differnt things. He just wants an answer yesterday. Thanks
Chris

I have developed severe rectal spasms, at times shooting into my intestines that are intolerable. I tried all the anti-spasmotic drugs with no relief whatsoever. I now take two vicodin a day for relief. Without this, I would be in the closest ER because the pain is unbearable.
It sounds as if at this point in your husbands treatment he has found a drug that gives him relief from terrible spasms, allowing him to prepare for additional treatment and help him feel like he can tolerate the condition he is at this point, along with preparing for additional difficult treatment in the near future.
Two narcotic meds per day is really not alot for the shape he is in, what he is going through and what he is preparing to go through. Emotionally, he needs to know that these terrible symptoms will be managed and it sounds like he has found something that works. When he is through with treatment and hopefully full recovery is in sight, the spasms may resolve on their own. The benefits at this stage appear to outweigh a small possibility of addiction. I feel really strongly to stress this; focus on his comfort, when your much loved husband feels as if he has some control over the very real and unpleasant pain he is experiencing, his response to his treatment will only be enhanced. The time may come down the line to wean off, or maybe not. The time to be concerned about a small possibility of a long term addiction is not at this point. I agree with the pharmacists. Assurance for your husband that while he is having these terrible spasms etc, he will have access to his two pills a day (which give him relief)would probably be the most kind and loving act you could do for him right now. It is important that you tell him you believe what he tells you his pain level is, If the dilaudid gives him relief from agonizing spasms, then thank God he found relief so quickly. Unmanaged pain is a very real fear for your husband as he goes through this difficult time. Your love and concern for your husband are very evident. As long as he is getting relief and making progress for his upcoming treatments, I'd put any concerns about "addiction" on the back burner. He not only needs his pain managed, he needs to know it will be there when he needs it.
I'm writing this very late and I've had to re-type it twice, so forgive any repeating or run on sentences. Take Care...Linda

Linda, Thank you for your very thoughtful and understanding post. At this point now that he has the two meds a day he can focus on what he needs to. I was getting such mixed information from different medical specialists. Funny how the pharmacist helped us the most. I am hoping that in time the spasams will subside. I am sure about 10% of it that he fights it and expects it. That is why they tried the valium. Without the pain meds he stops eating and we already have alot to gain back.
Yesterday we started on the chemo phase. They filled his HAI liver pump with chemo for two weeks. No side effects expected. Next week could be the systemic part. Thanks again.
Chris in Virginia