I am a T4/5 complete paraplegic woman, 58 years old, 28 years post injury. Among a lot of other problems related to the accelerated aging process I experience the last 2-3 years, i have very frequent episodes of AD every day, specially in the afternoon, 7-9 pm, and so i have to take antihypertensive drugs sublingually (captopril) and then face the hypotension, the sensation of empty or numb head and the tinnitus. I have a third grade hemorrhoidal disease ie mucosal prolapse reducible after manual handling and anal sphincter hypertonia which causes to me difficulties and AD during bowel program. I did not find any other cause for AD, my suprapubic catheter is working, I have done intravescical botulinum injection, plain film (intestine full of gas),cystoscopy, colonscopy, (many polypes) i don?t have any bone fractures, pressure sores, kidneys or gallbladder stones, no syringomyelia and i tend to consider ? maybe i am wrong- the hemorrhoidal disease and the anal sphincter hypertonia as the cause for AD. I feel good only 2-4 hours after the bowel program and if it is a succesfull one, (peristeen) ,the rest of the day, I feel belly discomfort and abdominal pain, non the old pain i am a complete, a new one but is always pain, intestinal spasms with or without AD or with or without sweating which always comes like a rendez vous 7-9 in the afternoons or 11-13 in the morning. The morning all the symptoms are always milder. 2-3 hours after eating i have intestinal spasms and if I do not pass any intestinal gas during the resting postprandial time which is very common for me, I have to suffer the hole afternoon or go back to bed and try to eliminate some gas by pressing my belly. I did a very conservative Lords anal stretch and I drink a medicinal natural herb which helps me to eliminate some gas but not always. After this operation my blood pressure during AD episodes is lower (150/100 instead of 190/110 before operation) but is still present. My surgeon suggested me a Longo stapler hemorrhoidectomy but I am very concern for the operation itself and specially for the postoperative period because of Autonomic Dysreflexia. Does anybody have similar problems or experienced a Longo stapler hemorrhoidectomy? Are there any other alternatives?