everywomanover29

Food, Mood and Women's Health – Be your healthiest, look and feel great!

Pain

GABA oral rinse reduces burning mouth pain

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Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent burning in the mouth. It affects mostly females, especially postmenopausal women, and conventional approaches are often not very successful. You’ll often see articles and papers with the terms ‘refractory’ and ‘unknown etiology’/unknown causes.

Medications like SRNIs and benzodiazepines

Some studies report limited success with medications like venlafaxine/Effexor, an SRNI and topical and oral use of benzodiazepines such as clonazepam/Klonopin. In this paper, Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome, 8 participants saw their pain diminish by half within 3 months.

Another paper, The Effect of Clonazepam Mouthwash on the Symptomatology of Burning Mouth Syndrome: An Open Pilot Study, reports success with a benzodiazepine mouthwash in half the participants.

Other than the poor quality of life and having to continue to live with pain, the bigger concern is the side-effects of medications like these, plus concerns with tolerance and then issues with withdrawal.

New oral GABA research for burning mouth

It’s for this reason that I’m excited about the recent research, γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects, that finds that both and men and women experienced immediate benefits when using GABA for burning mouth pain.

The burning mouth pain was caused by the application of capsaicin to the tongues of thirty healthy males and females. Capsaicin is the compound that makes chili peppers hot. (I find it interesting that capsaicin was the compound used to cause the burning mouth sensation because this same compound is used in topical creams and patches to ease pain.)  

The study concludes as follows:

Capsaicin-induced burning tongue pain and decreases in WDT (warm detection) and HPT (heat pain) can be ameliorated by rinsing the mouth with lidocaine and GABA solutions.

Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity.

Lidocaine, a numbing medication, was part of the GABA solution in this study, but because it has side-effects that may include anxiety, I recommend a trial of a GABA-only solution to ease the burning mouth pain.

Using a GABA-only oral solution

Using a GABA-only oral solution makes sense given that the likely mechanism of action of topical benzodiazepines in burning mouth pain is via local action on peripheral GABAA receptors found in the nerve fibers of the tongue.

This is also very feasible based on how effective GABA is for other pain such as proctalgia fugax/rectal spasms, and the visceral pain and muscle tension in your gut caused by the bloating symptoms of SIBO (small intestinal bacterial overgrowth) and muscular back pain after a fall.  

How much GABA will help?

As with any use of GABA and the other amino acids, how much will help depends on each person’s unique biochemistry and needs at the time. In the same way I do a trial of GABA with my anxiety clients to determine how much would help, I do the same with burning mouth pain (and other pain situations).

I recommend a trial of a GABA-only product and starting low with 100 to 200mg of GABA swished held in the mouth with some water for a few minutes. This can be used three or four times a day in between meals and with the mg increased slowly based on results.  You can find the GABA supplements I recommend here.

GABA is an amino acid that is recognized for calming physical anxiety and tension and since anxiety (and depression) is very common in those with burning mouth pain, the GABA is going to provide calming benefits too.  

As with any health condition, finding the underlying root causes using a comprehensive functional medicine approach is key. One such root cause may be low GABA and using oral GABA is going to address this one and provide some relief while other root causes are identified and addressed.  

These other root causes can be very varied as explained in the paper Burning Mouth Syndrome. They can include: age-related reduction in estrogen and progesterone levels, lower cortisol, diabetes mellitus and hypothyroidism, allergic reactions to foods, additives and even metals in the mouth, autoimmune connective tissue disorders, nutritional deficiencies (B1, B2, B6, B12. folate, and/or zinc), smoking and candida, and medication side-effects as mentioned above.

Have you experienced burning mouth pain and seen relief with GABA or other nutritional approaches?

If you’re a practitioner, is burning mouth pain common in your postmenopausal clients or patients and what approaches have you found most successful? Have you found GABA to be helpful?

If you are still suffering with burning mouth please share the following when you comment:

  • Your age (it seems to be more prevalent in women 59 and older)
  • If you have anxiety and/or depression now and have been prone to either in the past
  • How you score on the low GABA questionnaire and which symptoms you relate to? This will provide a clue that low GABA may be an issue and the oral GABA rinse is more likely to help
  • How you score on the low serotonin questionnaire (same link as GABA questionnaire above) and which symptoms you relate to? SSRIs have been shown to help in some cases and we know tryptophan/5-HTP help with pain so serotonin support may help too. Perhaps a tryptophan or 5-HTP rinse is worth a trial too?
  • How long it’s been an issue, what approaches you’ve tried and which approaches have helped (even if they only helped a short while or helped the pain a little)
  • Current and past medications (burning mouth is caused by certain medications)

I’d love to gather a list of all this so we can help you and more women who suffer with these awful symptoms.

How much GABA should I use and which GABA product is best?

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The most common question I get about GABA (gamma-amino butyric acid) is the one about the blood-brain barrier and does it even work (it certainly does – read here for information on this one).

The next most common question I get about GABA is this one:

How much GABA should I use and which GABA product is best?

This exact question was actually asked of me a number of times last week after I published: Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth (SIBO). In this blog I share about my trials of using sublingual GABA for the visceral pain and muscle tension in my gut caused by the bloating symptoms of SIBO.

There is no simple answer! It requires a blog post to provide a good answer because we are all unique, have different needs and these needs can even differ at different times depending on the issue and what is going on in our lives at the moment.

Let’s first do a quick recap of GABA (gamma-amino butyric acid) in case this is new to you. GABA is a calming amino acid that can be used as a supplement to raise GABA levels (GABA is also a neurotransmitter. It’s one of the amino acids I use most frequently with my anxious clients (together with tryptophan). GABA helps with the physical anxiety and tension, as well as panic attacks. New research shows it also helps with inhibition of unwanted thoughts and may also offer gut protection after alcohol consumption. It also helps with stiff and tense muscles and muscle pain and spasms.

How I have benefited from GABA

Here is a quick summary of how I’ve benefited from GABA supplements. I use this information to inform my use of GABA to help with the visceral pain I now experience due to my SIBO (more on that below).

If you have never used GABA or if you’ve used it once or twice, reading this should give you a clue as to why there is no one answer and how we need to use a trial approach to figure out what is best for each situation.

This also illustrates that there is no one size fits all for everyone and even for the same person under different situations.

  1. The anxiety and panic attacks I experienced 15 years ago:
    1. I used 1-2 GABA Calm three times a day and a combination GABA product at night. GABA Calm contains 125mg GABA and the GABA product contains 200mg GABA. My anxiety eased and my panic attacks stopped in a few days, giving me immediate relief and hope while I started to address all the other root causes like gluten sensitivity, adrenal issues, low zinc, gut health, low vitamin B6 and more
    2. The doses of GABA I used for my anxiety and panic attacks are typical amounts my clients benefit from and I would not have someone start on 500mg.
    3. If someone is a “pixie-dust” person and very sensitive I’d have them start with a pinch/dab or ¼ of 125 mg GABA Calm.
  1. The “ice-pick” headaches on the top of the skull that I discovered were caused by neck spasms:
    1. Physical therapy, high doses of GABA and high doses of magnesium were essential.
    2. Because of the low doses of GABA I had used for my anxiety years before this, I started with low doses of GABA increasing slowly from 200mg up to 1000mg GABA. This higher amount worked for me at this time for this injury.
  1. Throat spasms and the loss of my voice due to vagus nerve issues caused by a terrifying plane ride:
    1. Based on my prior ice-pick headache experience I now knew I could tolerate higher doses and started with 500mg GABA and used more as needed.
    2. I must have been really low in GABA because I was actually able to use upwards of 5 (and sometime more) doses of 500mg a day and not feel too wiped out, even during the day.
    3. That’s a lot of GABA for me – as I mentioned above 125mg to 250mg used to be enough for the anxiety I experienced 15 years ago.
    4. I write more about all this here: Vagus nerve rehab with GABA, breathing, humming, gargling and key nutrients (with videos to demonstrate immediate effects when using GABA sublingually)
  1. Rectal spasms/proctalgia fugax. These seem to be related to SIBO/IBS and I still experience these from time to time.
    1. I have found that 250mg to 500mg GABA opened onto my tongue works best for me for this particular muscle spasm.
    2. Again, it eases the spasms and pain in a few minutes. I write more about this here: How GABA eases agonizing rectal pain and spasms in under 2 minutes
  1. A back injury in August causing severe muscle spasms and pain.
    1. Again, based on my previous experiences using GABA, right after my fall I started taking 1000mg of GABA powder every few hours (held in my mouth for 1-2 minutes) and then reduced it to 2 or 3 times a day as needed.
    2. I share more in this blog: Acupuncture boosts GABA to reduce back pain and oral GABA further reduces the pain
    3. In the above blog you can also read some research about the mechanism of how GABA supplements ease inflammation and tracheal spasms associated with asthma.
  1. Visceral pain caused by SIBO.
    1. My SIBO is really well-controlled with diet but I’ve been having pain, bloating and insomnia while doing this herbal SIBO protocol. I suspect the cellulose in one of the herbal products is causing this bloating and pain after dinner. It was getting so bad it was keeping me awake (this is typical when I am accidently exposed to problematic foods and get a flare-up).
    2. SIBO patients can have visceral hypersensitivity where their pain can be due to the pressure of the gas that is produced and the muscles in the digestive system actually contracting against this pressure.
    3. It got me thinking about how effective GABA is for relieving muscle tension and how much it’s helped me in the past. I also use GABA with my clients all the time for relief of their physical anxiety and stiff and tense muscles. There are GABA receptors all over the gut and I recently discovered that GABA is important for motility.
    4. Over the last 2 weeks I’ve trialed 300mg GABA (opened on to the tongue) a few times to ease the pain and pressure and it’s been amazing at how much it’s helped and how quickly it’s eased the pain. I’ve used it as soon as I notice the bloating starting and it GABA helps me sleep too (as does the tryptophan I’ve also added). I suspect I could safely double this dose in the evening and may do this if the lower dose isn’t enough some evenings. I’ve also used it some days the next morning when I wake with the bloated ache in my belly.

How much should I use and which GABA product is best?

I have a blog post listing the products I use with clients: The Antianxiety Food Solution Amino Acid and Pyroluria Supplements

Always read the precautions (there is a link on the above blog) and do the amino acid questionnaire (the link is also on the above blog) before starting a trial. I also recommend reading the amino acids chapter in my book The Antianxiety Food Solution so you are a well-informed savvy consumer.

If you’re doing a trial for anxiety and panic attacks:

  • If you can use tyrosine the Source Naturals GABA Calm product is the one I use with most of my anxious clients.
  • The other GABA products listed on the supplements blog need to be opened onto the tongue and started with a low dose (100-200mg is a good starting dose) and increase based on symptom relief. More can often be used at night, especially if sleep is also an issue – sometimes up to 500mg.

If you have SIBO/IBS and are doing a trial for visceral pain:

  • I’d suggest NOT starting with the Source Naturals GABA Calm because the sugar alcohols can be problematic for some individuals. Or if you do, be aware that it may not help and may make things worse in the short-term. Personally, I have not found this product to be an issue with my SIBO and I have very few clients report an issue.
  • The other GABA products listed on the supplements blog need to be opened onto the tongue and started with a low dose and increased based on symptom relief.
  • For a client totally new to GABA I’d start with 100-200mg in the evening and also increase slowly over a few weeks based on symptom relief, up to 500-1000mg.
  • For early morning belly pain I’d start a client on 100-200mg because too much in the day can make you feel tired.    

If you have other pain issues:

  • For a client totally new to GABA I’d start with 100-200mg in the evening and increase slowly over a few weeks based on symptom relief, up to 500-1000mg.  Depending on the pain more may often be needed and higher doses can often be tolerated during the day.
  • Keep in mind that pain can have any many root causes and it may be more than low just GABA or may not be due to low GABA at all. Other factors to consider include but are not limited to: low serotonin, low magnesium, low endorphins, inflammation, structural damage, low omega-3s, gluten issues, Lyme disease etc.  Physical therapy and acupuncture are wonderful approaches to include too.

As you can see from my experiences above it’s a matter of doing trials to find the ideal amount for you for your particular situation.  

If you’ve used GABA supplements for anxiety, visceral pain or other muscles spasms I’d love to hear from you.

This GABA-pain connection is not well recognized and I’d love to have more people know about this as a possible option. The more we share our experiences the more we all learn.

If you plan a trial similar to any of the above I’d also love to hear your questions and feedback.

Pain Treatments That Work: My experience with GABA for anxiety and pain

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My friend and colleague, occupational therapist Phaedra Antioco, is a pain expert, has been in pain herself, and she’s on a mission to help you heal. She is host of the Pain Treatments That Work 2.0 online summit that runs Sept 2 – 9, 2017.

She’s bringing together more than 25 experts, including me, to share unique and innovative approaches to pain healing—approaches that work when nothing else has. You’ll learn:

  • Healthy ways to move your body, without pain, so you can get the exercise your body needs, and enjoy the myriad benefits including decreased anxiety, better health, and more fun.
  • Tips for managing stress so you can find more joy in each day.
  • How to find deeper meaning and more fulfillment in your life.
  • How to let go of physical and emotional pain and get through your day happy and pain-free (Really! It is possible).
  • Effective treatments that work … including some you may not have heard of.

I share more about my recent back injury and how I used GABA – sometimes in pretty high doses – to ease this recent pain and how I’ve used it and other approaches for the pain I’ve experienced in the past. Wow I hadn’t realized how much pain I’ve experienced in my life until I prepared for this interview (climbing injuries, car accidents, neck injury from poor posture at the computer, shingles, a tick bite and more!)

We also talk about the anxiety connection to pain and how fear can make us clench up and make the pain worse. And the role of GABA and tryptophan in this instance. Phaedra shares how much GABA helps her and her clients too!

I also asked Phaedra to share her expertise on pelvic floor adjustments:

Pelvic floor dysfunction commonly occurs from scars from abdominal/pelvic surgeries, childbirth, traumatic falls and injuries, and even too much sitting. Symptoms of Pelvic Floor Disorder in both men and women can cause chronic pelvic pain, inability to sit for long periods of time, urinary or rectal incontinence, painful intercourse, painful menstrual cycles in women and erectile dysfunction in men, to name a few. 

Manual internal treatment of the pelvic floor, using a myofascial release and craniosacral therapy approach, makes an excellent treatment choice for pelvic floor dysfunction due to the gentle-nature of treatment techniques. 

Pelvic floor treatment begins externally with releases of the abdomen and pelvis. Once a therapeutic relationship is established, internal treatment may be recommended.  Results often include relief from pain, improved sitting, walking and sleeping, and better elimination!

I also share my concerns with using collagen and gelatin for healing and how they may actually be lowering serotonin levels and contributing to anxiety and depression in susceptible individuals

I see everyone raving about gelatin and collagen (and rightly so – they are amazing) and yet no-one is addressing that fact that gelatin is actually used in tryptophan-depletion studies to lower serotonin. And it really concerns me that this aspect is ignored

You can register here.

I do hope you can join us!

Acupuncture boosts GABA to reduce back pain and oral GABA further reduces the pain

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I fell and injured my back last week but I am doing much better already. I’m going to be sharing a series of articles on post what I’m doing to ease the pain and heal – acupuncture and cupping being two of the approaches. As well as heat (with a hot water bottle), I’m also using a long list of nutrients such as:

  • high-dose fish oil and curcumin (as anti-inflammatories)
  • relaxing magnesium
  • arnica for bruising
  • GABA for relaxing my muscles and helping with the acute pain, and for easing the fear and anxiety (initially I was very fearful I had a serious back injury) and
  • DPA (d-phenylalanine) for the endorphin-boosting pain-relief

Today I’m going to share some research on GABA and how it helps with pain reduction and muscle tension, and how the acupuncture actually boosts GABA (as well as endorphins) to reduce pain.

Based on the examination I have soft tissue bruising around the lumbar area (L3 to L5). Sitting had been impossible until 2 days ago and even now I have to alternate between sitting and standing. I also twisted my ankle in the fall so initially standing was even challenging!  

I had one acupuncture and cupping session last Saturday and will be having another one this coming Saturday. I felt some immediate relief after this session and my back has been getting better and better each day.

Oral sublingual GABA for the acute pain and muscle relaxation

In the interim, between acupuncture/cupping sessions I felt I needed relaxing support for my stiff and spasming back muscles so I immediately started using high doses of GABA for the acute pain. And it’s been working amazingly well.

Right after the fall I was taking 1g of GABA powder every few hours (held in my mouth for 1-2 minutes) and now I only need to take it 2 or 3 times a day as needed. This is the dose I started with only because I know this dose works for me for the rectal spasms I sometimes experience. I always have clients do a trial and start low and increase slowly based on need and response. The starting dose is typically 125mg as found in GABA Calm but I suspect this is likely too low if you are someone needing pain relief.

With the oral sublingual GABA I feel relief from the pain within 5 minutes and it lasts a few hours.

My pain level was 10/10 and is now down to 2/10 most of the time with a few times during the day when it is 4/10. I’m walking, standing, able to turn over in bed and sleep through the night, and able to get off the bed without assistance. I can now also put on my yoga pants, socks and shoes myself – these were impossible tasks in the first 5 days after my fall!

Acupuncture boosts GABA and downregulates substance P and CGRP

I have not been able to find research on oral GABA for easing pain but do have some research to share. In this first paper, Effect of electroacupuncture on thermal pain threshold and expression of calcitonin-gene related peptide, substance P and γ-aminobutyric acid in the cervical dorsal root ganglion of rats with incisional neck pain the authors state that it is known that acupuncture therapy effectively reduces post-surgical pain, but its mechanism of action remains unclear. The aim of the study was to investigate:

whether expression of γ-aminobutyric acid (GABA) and the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) in the primary sensory neurons of cervical dorsal root ganglia (DRG) are involved in electroacupuncture (EA)-induced analgesia [pain reduction]in a rat model of incisional neck pain.

The conclusion is as follows: acupuncture increases the pain threshold i.e. it reduces pain and the mechanism is likely related to

downregulation of pronociceptive mediators SP/CGRP and upregulation of the inhibitory transmitter GABA in the primary sensory neurons of cervical DRGs

In case you’re not familiar with the terms substance P (SP) and calcitonin gene-related peptide (CGRP) I’m going to explain what they are, how they are connected to pain and why downregulation helps with pain reduction.

What is substance P (SP)?

Founders and Directors of Neuroplastix, Marla Golden, DO and Michael Moskowitz, MD share this about substance-P (SP), the main pain neurotransmitter:

It has five basic functions in the body. They are pain, inflammation, anxiety, depression and nausea. Even though these seem like negative experiences, they are important for survival. Problems arise with excessive production and release of Substance-P.

They share a very descriptive video that:

depicts a nerve injury causing a massive release of Substance-P, up to 5 times greater than in acute pain. This diffuses out to three to five times more local area. This is a major way that the pain map expands in persistent pain and keeps the pain going.

Be sure to watch the video on this page.

What is calcitonin gene-related peptide (CGRP)?

Calcitonin gene-related peptide (CGRP) is relatively new marker for pain as this recent review paper discusses – Calcitonin gene-related peptide and pain: a systematic review

The present review revealed the association between measured CGRP levels and somatic, visceral, neuropathic and inflammatory pain. These data suggest that CGRP may act as a neuromodulator in non-headache pain conditions. However, more studies are needed to fully understand the role of CGRP in nociceptive processing and therapy of chronic pain.

Oral GABA lowers substance P and CGRP in asthmatic children

As I mentioned there is no research on the effects of oral GABA on pain reduction so I’m going to extrapolate from this study on asthma – Effect of gamma-aminobutyric acid treatment on plasma substance P and calcitonin gene-related peptide levels in children with asthma.

In this study of 75 children with asthma, 36 children were in the GABA treatment group and received oral GABA (25-30 mg/kg per day) in addition to standard asthma medications. For a 100 lb /45 kg child this would equate to 1125-1350mg of GABA per day.

The conclusion of the study is that oral GABA

can significantly decrease plasma levels of SP and CGRP in children suffering from acute asthma.

The authors propose that airway inflammation may be a factor in asthma and since GABA reduces SP and CGRP, eases neurogenic inflammation and tracheal spasms, it may offer a new approach for the prevention and treatment of asthma (this is my best translation from the Chinese paper).

In summary, oral GABA, used sublingually has helped me tremendously with the acute pain of my muscle injury, and it helped ease the anxiety and fear I felt right after the incident.

As you read above, I am using more than just the GABA, but because it works so quickly I saw benefits right away and had hope while all the other approaches are starting to slowly help too. I just love that I get to experience this first-hand and share it with you – although I would have preferred not falling and that initial severe pain!

I also have a good history of GABA helping me so this was a clue for me to try it now. It was my life-saver when I first experienced my terrible anxiety and panic attacks and helped me tremendously within a few days.  I also did very well with GABA when I used it for throat spasms during  my vagus nerve issue after that scary plane ride, and another incidence when I was getting terrible ice-pick type headaches that turned out to be a jammed neck issue.   I really am a GABA girl aren’t I!?

I have used high doses of GABA like this with one client who had a back and neck injury after a construction accident. It also helped him tremendously.

Have you used high doses of GABA for muscle injuries and seen improvements like this? Or do you use this approach with your clients/patients?

How GABA eases agonizing rectal pain and spasms in under 2 minutes

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Proctalgia fugax is described as a condition that leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing.  

This paper describing proctalgia fugax shares how this pain can

recur over weeks, is localized to the anus or lower rectum, and can last from seconds to several minutes with no pain between episodes. There is no diurnal variation. There are numerous precipitants [preceding factors] including sexual activity, stress, constipation, defecation and menstruation, although the condition can occur without a trigger.

Although the cause of proctalgia fugax is unclear, spasm of the anal sphincter is commonly implicated. The condition may be more likely to occur after sclerotherapy for hemorrhoids and vaginal hysterectomy. There are also associations with other functional pathologies, such as irritable bowel syndrome and anxiety.

My story

I have experienced this awful anal sphincter spasm and pain myself so I want to shine some light on this condition and offer the simplest and most effective solution: oral and sublingual GABA. It works to completely eliminate the pain in 1-2 minutes! And it can also be used to prevent a full-on spasm if you catch it in advance. More about this below.

Let me first share my story so you can relate to the pain. I started to experience this a few years ago. It was right after my aunt died from rectal cancer and my immediate thought was that I was dying of cancer. That’s how bad the pain was. It’s like nothing I’ve ever experienced and I’ve had some pretty bad pain experiences: shingles, a tick bite headache, ice-pick headaches from a neck injury and poking my eye on a tree-branch while hiking.

For me, since it initially used to happen during the night, it felt like I was in bad dream and was lying somewhere injured and in agony. I would half wake-up moaning in pain, not quite grasping how the pain I was feeling could be so bad. Then I would come fully awake and feel the need to bear down (as in needing to have a bowel movement) but this would actually make it worse.

How do others describe the pain?

When I shared this paper on facebook one woman said her rectal pain and spasms last 20-30 minutes and is bad a childbirth.

Someone else shared that her husband “complained of feeling like a knitting needle was being driven through his anus.”

What do I think my triggers are?

I have not had sclerotherapy for hemorrhoids or a vaginal hysterectomy. I do have a history of anxiety and panic attacks (in my late 30s) and do have IBS/SIBO right now and I suspect that both low GABA and IBS/SIBO are my biggest root causes. I no longer have any anxiety but since I respond so well to GABA I assume my GABA levels are not optimal (likely due to the SIBO). I suspect exposure to hidden sources of gluten could also be a factor, and this could also affect my GABA levels.

Medications or heating pads as a solution?

I didn’t ever consider the conventional approaches which include: botox, benzodiazepines, SSRIs, Gabapentin, lidocaine, oral diltiazem, topical glyceryl nitrate, nerve blocks or salbutamol.

A warm bath has been reported to help but I was looking for a 1-2 minute fix (and less if possible). Once you’ve experienced this pain you’ll understand that you not imagine running a bath in the midst of a spasm and waiting to get in it.

Heating pads do also work but can take 20 minutes to take effect and that is simply too long for most people.

The first solution for in-the-moment relief (takes 2 to 12 minutes)

After the first episode I started searching online and because I didn’t know it was called proctalgia fugax I searched for “rectal cramp”, “rectal spasm”, “anal cramp” and came across forums with hundreds of women asking about it and describing their pain.

But no-one really had a solution and many had seen their doctors without much success. The best solution that many people use is 30-60 seconds of finger pressure (with the finger wrapped in toilet paper) in the anal sphincter during a spasm. Sometimes this is needed for up to 2-3 mins and sometimes doing this 2 or 3 times a few minutes apart is needed. Think about how you put pressure on a calf muscle spasm to stop the cramps. This works well but the agony can last for the entire 2 to 12 minutes (depending on how many times it has to be done).  Adding a small amount of arnica cream onto the toilet paper seems to helps too.  

How common is it?

It took more searching and reading and then I discovered what it was called. Once I found a name for it and started looking into I was surprised to see how common it is:

The prevalence of proctalgia fugax in the general population may be as high as 8%–18%. Many patients present to primary health care physicians and often do not require further consultation because the symptoms are fleeting. This condition is more common among women than among men, and usually affects patients between 30 and 60 years of age.

Although it’s more common among women I worked with a male client who experienced this. During one of his episodes, the pain was SO bad he actually passed out and hit his head on the bathroom floor.

The best solution for almost-immediate relief (takes 1 minute)

I know that GABA works amazing well for physical anxiety and stiff and tense muscles and I decided to try GABA in the midst of a spasm. It worked amazingly well and within 1 minute the terrible pain started to ease. It does need to be taken sublingually and I have found that 250mg to 500mg opened onto my tongue works best for me.

Each person would need to find the ideal amount for their needs but at night this should be a reasonable amount. During the day this could be too much and make you sleepy or too relaxed.

I’ve also used a combination of sublingual GABA and theanine with similar results.

I know GABA isn’t readily available everywhere so I did an experiment with taurine and found I needed more (at least 1000 mg) and it did take longer (2-3 minutes) to get relief, but it did work.

THE immediate solution for preventing the spasm

But I have now gotten to the point where I can nip it in the bud and prevent the spasm altogether – by taking sublingual GABA at the very first hint of an ache or twinge. I’ve been fortunate that when this does happen (about once a month and sometimes every 2 months) it’s around 8-11pm.

The long-term solutions for getting to the root cause/s?

We always want to get to the root cause of an issue and that is the next step. I reached out to the practitioners in my community to ask them how they help their clients and patients with this and what approaches they have used to end the spasm and pain. I will be sharing some of their solutions and how to get to some of the root causes in part 2.

UPDATE: Here is part 2 – How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

I’d love your feedback!

I’d love your feedback so I can learn what works, so we can all learn from each other and so others get answers quicker than I did.

Have you ever experienced this rectal pain and spasms? And what has worked for you?

I’d love to know if it is more common after sclerotherapy for hemorrhoids and vaginal hysterectomy? Have you had either? Or any surgery in the abdominal area?

Do you also have IBS/SIBO?  What about celiac disease or gluten sensitivity?

Do you currently have anxiety or mood issues or have a history of anxiety or mood issues?  How many low GABA and low serotonin symptoms do you have – here is the questionnaire  (a paper from 1965 mentions that patients with proctalgia fugax have been described as irritable, perfectionistic, meticulous, obsessional, tense, and anxious)

If you’ve tried GABA or these other approaches (or decide to try them) please come back and share.  Too many people don’t know about this and it needs to change!

Interview: Heal Your Pain Now + the fear-pain connection

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If you struggle with chronic pain from an injury, autoimmune disease, fibromyalgia, joint pain, arthritis, anxiety, depression or have tried everything without success, Heal Your Pain Now provides natural solutions to eliminate pain and return you to a life worth living.

I recently had the pleasure of interviewing Dr. Joe Tatta, physical therapist and nutritionist, author of this wonderful new book and a dear friend!

You can watch the interview here:

 

And here is a summary from our great interview:

What is chronic pain – it’s about protection. Acute pain like an ankle sprain tells you to rest and heal; chronic pain – persists beyond 3 months and is less about protection and more about the brain being in a hyper-sensitive state.

The human body has innate ability to heal i.e. the body has a natural anti-inflammatory process and tissue will heal in 3 months. After those 3 months it becomes less about the actual tissue and more about what is going on centrally in the brain and nervous system.

Central sensitization or the hyper-sensitive brain: we have a neural signature specific to you and your pain experience.

It’s based on what you believe about pain, are told about pain, your memories, your emotions, input from body (such as tightness), your thoughts, touch and sound.

With central sensitization pathways light up in the brain causing pain and in some instances those pathways never quiet down. The more we can be educated about pain the faster we can release this central sensitization and the pain.

An example: You and I had backpain – my life: mom is a nurse, my backpain comes and goes, I can move a little, I go to work, do some chores and basic exercise; in your life your grandmother had really bad back pain, was in a wheelchair and said back pain is the worst pain you could ever have. This may make your pain persist. Fear causes pain to persist over a long period of time.

Fear and pain: it can be actual fear or perceived; fight or flight – muscles tense around the spinal column; blood is shunted away from the spinal muscles because you’re getting ready to run or fight; when it’s persistent there is no blood flow and no healthy nutrients going to the spinal muscles; cortisol levels become elevated – they are inflammatory and very powerful at laying down memory patterns (which can make pain persist).

When you lessen fear you promote relaxation and in general pain disappears very fast.

When you hear all this the brain repatterns – you’re doing a mini cognitive behavior session just listening to and watching the video of us interacting! (I love this!)

Myth: chronic pain has to be chronic – no! Replace the word chronic with persistent because language is really important for creating these pain memories.

Myth: imaging studies like xrays and MRIs are correlated with pain. Often we see intense pain with normal xrays, sometimes no pain with awful rays.

There is also the emotional aspect – when someone in a white coat holds up that xray and says you have this issue it can start that fear response and the pain can be worse.

This fear pain connection is fascinating and I asked if it common knowledge

  • The average physician only receives 4 hours of pain science education in 12 -16 years of education – most of what they learn focused on medications, injections and surgery. We currently have a biomedical model (xray and injection or surgery, injections or medications) but we are moving to a biopsychosocial model (movement, nutrition, mindset, the brain)
  • The book has 40 pages of evidence based research (if you’re a practitioner and would like access to the papers let me know in the comments and Dr. Joe can get them to you)
  • I suggest using the book to educate yourself and your doctor

Medications prescribed for pain: Opioids (oxycontin, codeine, morphine) #1 drug prescribed for pain. CDC and NIH: You should not prescribe opioids as first line of treatment for chronic pain. They are highly addictive – 3 million addicted to them; 2 million die each year; opioid-induced hyperalgesia – the more you take the more pain sensitivity you have and the more medication is needed.

Side effects: constipation caused by opioids and you’re prescribed medications for the constipation; called OIC (opioid induced constipation) – changes the microbiome, fecal matter is bound up, you get leaky gut, inflammation starts in gut and there are impacts on neurotransmitter production like GABA and serotonin (and then increased anxiety and depression).

Other medications used are SSRIs – depression looks very similar to pain in the brain – when you heal the gut you can balance serotonin

Gabapentin and NSAIDs and benzodiazepines are also prescribed.

The book covers ALL pain – any chronic (or persistent) pain that has been around for 3 months or longer

Nutrition: diet is the #1 way to reduce inflammation – food is medicine approach; 100% whole food (if it comes in a box or a can or is made by man it has no place in your diet especially if you have chronic pain); farm-raised beef, wild fish, fruit and vegetables, healthy fats i.e. a modified Mediterranean diet.

Then use a gut-healing protocol for removing inflammation and addressing autoimmunity – remove gluten, dairy and sugar. In 3-7 days people see their pain decrease from 8/10 to 2/10.

“I don’t think I have arthritis and I don’t think I need this Aleve – I think it was the gluten I was eating”

If you slip a little and have some gluten then you realize you can’t even have any and you’re educating yourself that food is medicine. It’s very powerful

With gut healing, if you have autoimmunity take out eggs and GMOs (soy and corn) too; there is more clinical evidence around nightshades – if you can heal the gut you can often tolerate small amounts.

The ketogenic diet is last phase: 65% – 75% fat, 5% carbs (from fibrous vegetables) and the rest is protein. It’s awesome to regulate blood sugar, helps central sensitization (we know because those with seizures do really well on a ketogenic diet). With seizures glutamate is high and GABA low and the ketogenic diet helps balance out these in your brain and calms the nervous system and decreases pain; upregulates ATP (energy molecule) which helps with pain. Brain fogs goes away.

The ketogenic diet is not for someone with type 1 diabetes, who is pregnant or in acute adrenal fatigue

Do a trial of 3-4 weeks and cycle into ketosis every 4-6 months.

Intermittent fasting tricks body into thinking body is starving.

A big plane flies over at the 41 minute mark! Enjoy the laugh with us!

With intermittent fasting do a 14-16 hour fast overnight, say 6pm to 9am the next day

Mini-fasts: protein shake in the morning or evening – the meal is smaller; or use bone broth – healing for gut and collagen for your joints!

Supplements: omega-3s (2000 to 4000mg); curcumin (in oil – really important to help absorption); vitamin D 5000-10,000 IU; some kind of proteolytic enzymes; GABA for pain and anxiety and central sensitization.

If this feels overwhelming and you feel you need more support (in addition to reading the book) Dr. Joe does have a group program

It’s called Heal your Pain Heal your Life  – 6 week process, a Facebook group group, Q and A calls, and social support (which is huge if you have pain and can’t get out of house, or if others can’t relate to your pain, plus for the community support)

Movement, sedentary syndrome, sit rise test: movement is medicine and has to be in your life in some form. Even 5 minutes twice a day can help. It sends signal to your brain “I can move a bit and I’m safe”, you build confidence and fear decreases, releases endorphins, quiets down the nervous system

Sit rise test – cross your legs and lower yourself down to the floor without your hands and then stand back up. It indicates a long life-expectancy; they are not sure why – cardio effects? Balance? It tests strength and vitality; if you can’t do it – practice each day. Third world cultures sit on the floor to communicate – when you move joints in full range it lubricates them.

I’m a climber, skier, mountain biker, windsurfer and have had many injuries and worked with wonderful physical therapist and yet I have learned so much from Dr. Joe and this book! I will use it for prevention of injuries and pain and for the next time I am injured and in pain.

Dr. Joe ended by saying

Keep moving forward, we’re going to change the pain paradigm and give people their lives back!

This is the book summary:

In Heal Your Pain Now, Dr. Joe Tatta teaches you how to regain control of your life by breaking the cycle of persistent pain. Following Dr. Tatta’s program, you learn the role of the brain in pain–and how to use your brain to STOP your pain; how nutrition can eliminate the inflammation in your body, which is exacerbating your pain; and how to overcome Sedentary Syndrome and choose the best movement strategy. Dr. Tatta provides quizzes, self-assessments, meal plans, shopping lists, recipes, and exercises to support you throughout the program.

As I mentioned in the interview I really appreciate the very unique perspective Dr. Joe brings to healing from pain. His expertise from the physical therapy and movement world is so beautifully meshed with the power of nutrition! He covers the foundational information for eating an anti-inflammatory diet, an excellent gut healing protocol, healing supplements and with much fascinating reading on intermittent fasting and the ketogenic diet.

Dr. Joe explains these concepts brilliantly: the brain in pain, central sensitization, myths around pain and the biospychosocial model of pain. With the work that I do with anxious women like you (and men too), the pain connection to fear is very relevant; and the fact that stress, anxiety, post-traumatic stress disorder (PTSD), or depression are danger signals that can actually make the pain worse depending on how “sensitive” your nervous system has become.

Also, since many of the same pain medications are also often prescribed for anxiety, this book is a wonderful resource for someone with both pain and anxiety. But best of all, this book offers real solutions for everyone suffering from any kind of pain, and a solid understanding of the mechanisms.

I’m sure you’d like access to what we talked about during the interview:

 

Please let us know which parts of this really resonated with you and what you’re looking forward to implementing for your pain.