Finally reaching out: Advice??

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Finally reaching out: Advice??

Postby Puttin'itbehindme » 01 Feb 2013, 16:33

Hi!! I've been reading this forum for days and finally decided I could use some more personal help, if possible. I have an outdoor job right now (field research for my phd) and every day I'm not working is a day of work i'll have to make up for later; no such thing as sick days for me, but i have to rest given the active nature of my job. Anyway, I think I have both external hemorrhoids (at least, from the looks of it...) plus a VERY painful fissure. I went to the ER a week ago in absolute agony that even Vicodin wouldn't dissipate. (I'll talk more about the pain med situation later.) Doc did a quick exam and I think (through the morphine fog) he said that i had hemorrhoids but that they weren't enough to explain the extreme pain I'd been experiencing. Finally saw a surgeon for consult who tends to do a lot of GI work (I live in a remote area & can't see a single GI specialist within 3 hours of me for a month.) The surgeon never examined me but said I probably have a fissure, and that either way I was to take some suppositories, etc. Because I'm only 31, he didn't think it likely I had anything serious. So here are my symptoms:
1) almost constant burning sensation in rectal area (no itching)
2) spasms & excruciating, sharp pain that comes in bouts, particularly when I have to pass gas, which is wayyyy too often this past week.
3) blood on stool or also just coming from there without a BM, primarily within the last 3 weeks or so now
3) very dark/blackish stools for the majority of my BMs during the 2 weeks prior to my ER visit.
4) something visible externally that is very tender, presumably my hemorrhoid
5) burning pain has been intermittently but steadily increasing these past few months until these last 3, which were precipitated by some constipation, but I do not remember that happening at all within the day before the excruciating pain started...
And, here's what I've been taking in the last 3 days since my doctors visit:
1) Fiber gummies, 2-3/day (5-7.5g, on top of trying to eat fairly well)
2) Simethicone (Antigas), around 540-720mg total daily (which I believe is a lot)
3) Anucort suppositories (only active ingredient I can tell from the box is hydrocortisone, and I don't even have itching...)
4) Tonolane cream for hems (contains pramoxine hydrochloride 1% and zinc oxide 5%)
5) Vicodin - I know this can be bad for C but the pain has been solo debilitating. I don't want to stay on it too long of course.
6) Miralax
Thus far the pain is not subsiding much although rarely as bad as the ER night. I went several days after ER episode w/o a BM and when i finally went, it had one hard part and the rest very soft. This was before I started taking the Miralax, mind you, although I was taking a small amount of henna softener. I felt like I was going to pass out afterward - got suddenly dizzy with foggy feeling and ringing in my ears. I really thought I was going to pass out and decided to wait on the warm bath I had intended to take, despite my extreme post BM throbbing, because I was sure I'd pass out and drown. NOT my funniest night ever, lol. Later in the week, the first night I took Miralax (night before last), I took the full dosage in the evening and had horrible diarrhea in an hour along with excruciating gas and bloating all night (the passing of the gas being the cause of the throbbing, seizing pain like knives down there.) I fearfully took only a half dose last night; no BM yet although it's been just under 2 days so hopefully it will work without killing me. I'm starting to hope it does... :@
It's great to know I'm not the only one in pain, though I wouldn't wish it on anyone. In addition to general advice I may not yet have found on the site, my main questions are:
1) does this sound like a fissure?? I think so, but still... Be nice to know seeing as the doctors don't feel the need to give me a colonoscopy at my age (which I'm ok with). The black stools I was having made me worried it might be something more, but docs (non-specialist) didn't seem to care.
2) if it is a fissure, why the heck am I taking the suppositories and cream that I am? They aren't what people have been mentioning on this forum, although since I seem to have external hemorrhoids too, the cream at least may be helpful. But the suppositories? What do you think?
I read up a lot on the Miralax and it looks like I'll have to just keep experimenting. I also just ordered Calm magnesium supplement online and hope it helps for both softening stools and insomnia. Lastly, I haven't had many BMs lately but do not use TP right now, only wipes (mainly the ones with witch hazel although they don't feel awesome.)
Sorry for the length. Maybe I fall into some kind of category that those of you can help me with since I'm stuck in the middle of nowhere without chance of seeing a specialist anytime soon...Thanks in advance for any help and for the good sense of humor you all seem to have about this ruthless condition! Image
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Re: Finally reaching out: Advice??

Postby richibeno » 01 Feb 2013, 17:17

Hey; yes sounds like a fissure 'i would see a crs surgeon to have a good look he may even want to do exam where he can put you out so you don't feel anything 'fissure pain is very very bad like passing glass when you do a bm , the throbbing burning pains after'
Keep to soft food loads of water,keep taking the stool softner'no coffee or red meats get some nitro cream
Talk hot Spitz baths or bath
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Re: Finally reaching out: Advice??

Postby Savaici » 01 Feb 2013, 19:00

Hi there, Puttin'itbehindme,
Usually dark stools are not a good sign, but it could just be blood in your stools, hence the doc not worried.
My thoughts: the pain you are experiencing sounds very much like a thrombosed hemorrhoid - which is the only thing I can think of with such excruciating pain.
It amazes me how surgeons don't examine and yet diagnose. Have experienced the same, live in remote area, etc. You should really see someone who will put you 'out' so they can examine you properly.
If it's a thrombosed hemorrhoid it will eventually go down, but if the pain is excessive, don't just leave it. Go to the doctor again.
Also, try not to use anything on your rear end except water. Dab don't wipe. I use Johnson and Johnson gauze pads that I run under warm water, after first dabbing with Cottonelle TP, dampened a little under the tap.
Invest in a Sitz bath. You can find them at Rite Aid. Don't worry about trying to use it with running water, just fill it, soak, empty, and start again.
When you feel a little better (and you will), ask the doctor to do one of the simple tests for blood in the stool. There are two different types, one a little less messy than the other...
I hope one of our other members comes along with their suggestions too as they may be different to mine. Just so sorry that you are in so much pain.
Richibeno is right about the food. No junk, lots of water, soft food and not too much of it.
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Re: Finally reaching out: Advice??

Postby marg6043 » 03 Feb 2013, 10:40

like Savaici said dark stools are not a good sign, but could be the diet, also dark stools that looks like ground coffee are a very dangerous sign.
Your discomfort reads like fissures, but just because you are young doesn't mean you should not get a colonoscopy to rule out anything else like internal hemorrhoids, so have that appointment as soon as possible as fissures are very painful without treatment and sometimes they may go away on their own but most of the time they are just ongoing pain and discomfort.
Here you may find a lot of information to help cope with the problems until you get to see a specialist.
Now if you have a fissure and no hem, the hemorrhoid creams will hold back the healing of the fissure as hemorrhoid creams constrict the flow of blood to decrease blood flow, while a fissure is starving for blood. I talk from experience, I treated my fissure that I believed was an hemorrhoid for a long time with creams.
So until you find out what is going on down there Is going to be a trial and error time.
Sorry you are having such a bad time.
Last edited by marg6043 on 03 Feb 2013, 11:28, edited 1 time in total.
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Re: Finally reaching out: Advice??

Postby CrackinUp » 03 Feb 2013, 11:13

Sounds to me like you might have IBS, haemorrhoids and a fissure but I'm no expert. If you have IBS be careful with lots of fibre as it can have random results. If I add too much fibre it makes me have bad diarrhea. In fact the first time I took a stool softener I was immediately on the toilet with diarrhea just like you.
I've had black, tarry stools in the past from IBS. When this was happening to me I also had really bad stomach cramps (stress related). If you do have it, your stools will change on a daily basis and seldom be consistent. It's a stress related illness so if you've been worried about what's going on the symptoms will get worse.
I'd definitely want all that checked out though with a colonoscopy. No point rolling a dice with your life.
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