SolsticePhysiotherapy

@Empoweringpts9 Agree @DrTayAhmed, its like having multiple knee surgeries and never getting PT- the muscles will get stiff and not move well.

When you have #IBD, your Drs need to address pelvic floor! Many times it’s left for patients to decipher thru where to turn & if it’s *worth* acknowledging to their Drs. Spoiler: it IS worth telling them, but Drs should ask! Random pain, sexual pain, fluid collect #MondayNightIBD

@DrTayAhmed @DCharabaty @MondayNightIBD @pelvicptnj Yes internal manual work can help, also some external myofasical work. Sometimes a vaginal dilator can be helpful to relax pelvic floor muscles

@DCharabaty @MondayNightIBD @pelvicptnj In this case doing internal manual work can break up scarring.

For our next #MondayNightIBD we are getting out of our #GI comfort zone & diving into the pelvis: Join us Dec 2,for a convo led by @DrTayAhmed: #GI #CRSurgery #ObGyn #PelvicPT how do you approach & what resources you use for the #IBD pt with #PelvicPain & symptoms? @DCharabaty

@ChancesOur @DrTayAhmed @MondayNightIBD @DCharabaty Agree, #endometriosis could be at play here

@FezaRemziMD @Faiziya @DrTayAhmed @MondayNightIBD @DCharabaty Any thoughts on use of OCP's to manage cyst?

@Faiziya @DrTayAhmed @MondayNightIBD @DCharabaty They can be also very large

@DrTayAhmed @MondayNightIBD @DCharabaty @DrTayAhmed Going along with the polling questions, PT in conjunction with nerve blocks and trigger point injections can help expedite treatment...

@MondayNightIBD @DCharabaty 32FCrohn’s j-pouch failure, RVF repair, now w end ileostomy. Has chronic #pelvicpain, UTI symptoms, U/A neg. Imaging: peritoneal cyst compressing bladder. Cyst drained by IR w only partial improvement of symptoms & cyst recurred. What is your diagnosis+nextstep #MondayNightIBD

@Empoweringpts9 @FITWITMD @DrTayAhmed @MondayNightIBD @DCharabaty Even if reproductive organs are removed, there could still be endometriosis which could be irritating bladder. For those born with penis/testicles, scar tissue, adhesions could contribute to pain. In both, assessing for a hernia would be helpful due to integrity of abdominals

@SolsticePhysio1 @FITWITMD @DrTayAhmed @MondayNightIBD @DCharabaty For sake of discussion, I’d say break it down for each option if it could be different between them. #MondayNightIBD

@Empoweringpts9 @FITWITMD @DrTayAhmed @MondayNightIBD @DCharabaty Meaning reproductive organs were removed or patient was born with penis/testicles?

@FITWITMD @DrTayAhmed @MondayNightIBD @DCharabaty I’d like to add a layer to get your gears going more, Dr Nandi et al...similar/same symptoms with zero reproductive organs so not ovarian cyst. Now what? #MondayNightIBD

@john_damianos @pelvicptnj @DrTayAhmed @MondayNightIBD @DCharabaty Agree with this, this case study touches on treatment of peritoneal inclusion cysts in a patient with chronic #pelvicpain ncbi.nlm.nih.gov/pmc/articles/P…

@pelvicptnj @DrTayAhmed @MondayNightIBD @DCharabaty Need to r/o complication of #IBD before jumping to IC as dx. Similarly unlikely to be simple ovulatory cyst. With h/o IBD+surg, ADHESION most likely➡️PERITONEAL INCLUSION CYST(sciencedirect.com/science/articl…). Consider drainage, OCP, PT, block if needed. #MondayNightIBD

@DrTayAhmed @MondayNightIBD @DCharabaty Pelvic floor muscles can become tight and painful, which can contribute to #pelvicpain. Multiple abdominal surgeries can compromise the ability of the muscles to absorb force, therefore placing more stress on the pelvic floor. UTI sx could be from cyst or tight pelvic floor

@PelvicGuru1 @KIMAwellness @beyondbasicspt

@DrTayAhmed @MondayNightIBD @DCharabaty The cyst is most likely contributing to the UTI like symptoms, so this would need to be managed in conjunction with the pelvic floor #MondayNightIBD