I had exactly that same sensation when I was doing pretty good a few weeks ago. I use diltiazem (still do) and the BM hurt and it hurt until I'd wiped off and for up to ten minutes after. I was basically painfree the rest of the time.

hi Bum_UK,
So are you still having that pea sized lump (or what they refer as hemorrhoid) or did it go away after application of the cream you mentioned ? Are you still experiencing pain during the initial BM ?

Hey sunshine_atl, if it's an internal hem, those generally do not cause pain. I'm not certain if nifedipine will heal an internal fissure, I imagine it could do that, but I'm no expert on this. Internal hemorrhoids can bleed if irritated, and once your fissure heals perhaps you could look into the CRH banding procedure.

thanks very much patience_healing for your response. With the use of the niphedipine gel, I do feel a bit of minor relaxation in the area, but still getting the occasional twinges of minor pain & definitely still having the initial sting when having BM. It may be due to the internal small hemorrhoid, as I don't feel the fissure anymore, because it seems most people here say fissures hurt nearly all the time, but my discomfort only happens when passing a stool, & shortly thereafter. It's only there when the stool first comes out (which is a little hard) and then the soft stool passes out with minimal or no pain. There is no blood in the stool, I am applying the prep-h cream as well to take care of the hem. hoping that I get cured with this, and don't have to go for a surgery.

What you are describing definitely sounds like a fissure. Some days I have the same experience as you, some pain during a BM, and for a short time after. Then nothing for the rest of the day except with long periods of sitting. It's possible the fissure just isn't visible any more upon examination. I really hope you can heal without further intervention.

sunshine_atl wrote:hi Bum_UK,
So are you still having that pea sized lump (or what they refer as hemorrhoid) or did it go away after application of the cream you mentioned ? Are you still experiencing pain during the initial BM ?

Sorry for the late reply. I still have it and it prolapsed more after my third BM this morning. I managed to get it back in. I'm seeing the CRS tonight and I'll see what he says.
I do still have pain with the initial BM. It's not as bad as in the beginning but it still hurts.

thanks very much patience_healing for your response. After applying the prep-h cooling gel for quite a few days, I now don't feel any pea-shaped lump/boil during application. When I do have a hard stool, there is a very slight/minor pain but then whole day I do not experience any pain as such. After my bowel movement/bath, I do apply the prep-h cooling gel again (if I don't then I can feel the itching sensation). Once I apply this gel, I feel good and no pain at all. If I do take the laxative the previous night, it's even better due to softer BM (but I don't want to get used to the Miralax). do you still feel I should visit the doc for the minor pain/twinges during initial BM or will it eventually go away ? appreciate your response and thanks for your time.

I think it sounds like you're pretty much healed up! I think you might be experiencing pain from the leftover fissure or perhaps from scar tissue. Are you able to be active without pain too? If it makes you feel better to find out what's going on in there then definitely go back and see your doctor. It may eventually go away but it would help you to know whether you've healed.

I think you are absolutely correct, it's probably the scar tissue. Today I did had a harder BM, but the pain was not like the one I used to have before (when the pea-shaped lump/boil existed). Also after the BM, I am not feeling the same type of pain, just having a little itching sensation. May be it's because of the scar tissue being stretched during the BM. Any idea if this heals up automatically ? Or should I keep on applying the h-prep cooling gel. I also have the niphedipine gel and the hydrocortizone creams that were prescribed by the rectal surgeon during my CRS visit. not sure which exact one would heal up the leftover fissure/scar tissue. Should I keep on taking the Miralax laxative each night for a softer BM (just don't want to get used to it) ?

appreciate your response and time in this matter. thanks again !

Hydrocortisone will thin out the scar tissue so that's the opposite of what you want to do. Nifedipine will help keep things relaxed and improve the blood flow so no harm continuing with that. I think scar tissue is something that just takes its own time and can't be hurried. You sound like you have a lot of concerns though and I think it's best to have one more follow up visit and clear up all your questions.

I think miralax is fine to keep taking for now. It's not a habit forming laxative unlike Senna and others so don't worry about it for now until you are fully pain free.