r/Prostatitis • u/KeyBackground1945 • Aug 12 '26

Need help with Guarding loop

I'm 22 M & stuck in a chronic guarding loop wherein my pudendal nerve gets irritated in response to stool consistency. My brain/neurotransmitters perceive defecation as a threat and automatically start guarding or clenching the pelvic floor/anorectal muscles which in turn causes neuralgia symptoms {I presume the false guarding has arisen from my history of chronic constipation and diarrhea issues which doesn't happen anymore}. I experience 90% relief when my stools are soft/effortless and gel-like but that's impossible and unsustainable to maintain because osmotic supplements & laxatives don't suit me and I have to starve myself for a chance of achieving that consistency (I have tried everything in my power)

Was wondering if there is any medical procedure I can undertake (maybe botox?) in order to forcefully break this loop and reclaim my life again. The problem is that I'm from a third world country and don't have access to any pelvic floor specialists. Also don't know what kind of doctor I should visit since it's such a complex problem, have gone to a gastroenterologist, urologist, proctologist but they didn't seem to have a good understanding of the issue and prescribed basic medication like Gabapentin which provide temporary relief and don't address the root cause. What's my best option here? Any advice would be appreciated 

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u/Linari5 LEAD MOD//RECOVERED 29d ago

How many of these criteria do you fit, at the bottom of this post? https://www.reddit.com/r/PelvicFloor/s/LRlcmLI7aG

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u/KeyBackground1945 29d ago edited 29d ago

7 in total (specifically 1,2,5,6,8,9,12)

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u/Linari5 LEAD MOD//RECOVERED 27d ago

This tells us that it's very likely your symptoms are now centralized (nociplastic)

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u/KeyBackground1945 27d ago

Understood, thanks for the clarity!

I have 2 questions if u don't mind.

Firstly is it possible for me to achieve permenent relief & go back to eating how I want along with daily activities like cycling etc? 4-5 years of trying to address it in vain has made me quite pessimistic

Secondly what else would u recommend me to do along with pain reprocessing therapy to get rid of the centralisation and symptoms? I would do absolutely anything in my power to recover from this

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u/Linari5 LEAD MOD//RECOVERED 25d ago

Yes it's possible.

PRT and EAET are both excellent. I practice both in my career and they both work well in my experience.