This topic is about a man from Maryland who had a colostomy surgery in July 2022. The surgery was meant to help his pelvic-floor muscles rest, but instead, he has been experiencing severe and worsening pain in his anus, rectum, penis, and abdomen. Despite consulting multiple specialists and trying various treatments, he hasn't found relief. He is reaching out to the community for advice and support, hoping for sensitive and understanding responses.

Here are some suggestions and insights shared by the community:

1. Offer empathy and reassurance, emphasizing that this is a safe space where his painful experiences are taken seriously.

2. Consider seeking evaluation at major medical centers like Johns Hopkins, Washington Hospital Center, or Georgetown University Hospital, where specialized teams in colorectal, neurology, and pain management might be available.

3. Re-evaluate the original diagnosis. Chronic constipation can weaken pelvic-floor muscles, so it's important to confirm primary pelvic-floor dysfunction with objective tests like manometry or defecography, rather than relying on assumptions.

4. Review current laboratory work, especially focusing on white blood cell count and C-reactive protein levels, to rule out hidden infections or inflammatory processes.

5. Obtain targeted imaging, such as a pelvic MRI, CT scan, or nerve studies, to identify any structural or neurological sources of pain that could explain the symptoms in the genital, rectal, and abdominal areas.

6. Monitor whether pelvic-floor exercises trigger or alleviate pain, and observe if all pain sites flare up simultaneously or separately. This information could help doctors determine whether the pain is muscular or neuropathic in origin.