This topic is about someone who had a proctocolectomy with abdominoperineal resection, which means their colon, rectum, and anus were removed. Three months after the surgery, they are experiencing some uncomfortable symptoms. Here's a breakdown of what they're going through and some advice that might help:

- They are having sudden and intense abdominal pain.
- They feel a strong and distressing urge to have a bowel movement, even though it's not possible anymore, often referred to as a "phantom" feeling.
- Despite these symptoms, their MRI scans and blood tests have come back normal, and medications like anti-inflammatory and anti-spasm drugs haven't helped.

Here are some suggestions and insights that might be useful:

1. For immediate relief, try sitting on the toilet and bearing down as if you were having a bowel movement. This might help ease the phantom urge.
2. Consider seeking further medical evaluation. Even if MRI and blood tests are normal, there could be other issues. Getting a second opinion from another colorectal specialist might provide new insights.
3. Discuss the possibility of tenesmus with your doctor. This is the persistent sensation of needing to pass stool, and it's important to address it if it continues.
4. Understand that these sensations might be related to nerve or muscle healing. Nerves that were cut during surgery can cause these feelings, and they may decrease over time.
5. One option for managing symptoms is to talk to your doctor about low-dose Ativan (lorazepam), which has helped some patients reduce discomfort and anxiety.