I had fissurectomy surgery Monday 12/21. The pain has been rough recovering for a few days, but for some reason I had no urge to BM. I was drinking mineral oil every night, taking Metamucil for fiber, and taking stool softeners, all things my surgeon said to do. Finally tonight I took milk of magnesia, and I got the urge to go. To say it was the worst pain of my life is an understatement. I was clearly constipated and had hard stool, and just the attempt to push it out was causing an incredible amount of pain. After like fifteen minutes, I finally got the first bit out. Then I sat in a sitz bath and got a tiny bit more out. Lots of blood and pain and tears the whole time.

The problem is I also feel like I have some hard bit of stool stuck right where my sphincter muscle is. The muscle wants to relax but it can’t close around it again because of the crazy pain. I’m stuck in that I feel like I can’t push it out, but it also won’t go back in. I don’t understand what I did wrong that put me in this position to begin with.

I don’t know if anyone can lend any support or encouragement to me, but I feel like now it will never heal and I fully ruined the surgery progress. The pain is immeasurable. I don’t know where to go from here.

I doubt that you did anything wrong. Every body, and I mean every body, is not like other bodies, so what works for some (or many) may not have worked for you. Often with time though, things sort themselves out, and the milk of magnesia that you took tonight, could still have more effects over the next minutes or hours. Also, your body could do as it should and move that stool along and out. Also, most surgeries are not so easily ruined, so hopefully nothing you've done tonight will have an effect on your long-term progress. I'm really sorry to hear about the pain, but once things get moving again, you should be better on that front too.

I've never had a fissurectomy, but after my hemorrhoidectomy, I stood over the bowl to have my movements, rather than sit on the seat. There was much less pain, and the stool seemed to come out more easily that way.

Did your surgeon give you a # to call if you had an emergency or questions? I'm sure that someone with medical knowledge could help put your mind at rest and perhaps even suggest something else that could help.

Thank you so much for the reassurance Cha Cha. I did call the office today and it was closed, so I called the answering service hoping they’d get the Dr to call me back. I explained that I was constituted and had a hard time going with lots of pain and blood. The answering service called me back, not even the Dr (I really haven’t liked this Dr but he’s the only CRS near me) and told me the Dr said to just follow the instructions I was given after the surgery. He said my only other option if I’m concerned is to go to the ER.

So I decided that if my next bowel movement goes anything like last night where it feels stuck or I can’t pass it, then I will go to the ER. I just hate to spend the money to go when it’s possible they would just give me an enema or something, you know?

For now just trying to feel hopeful that maybe my next BM will be much easier and I can push it out without major problem. I’ll update as I go.

How annoying.

Good idea to go to the ER though, even though that would be such a pain in the butt (ptp). I've been to the ER a couple of times for constipation, and I've found that they usually will suggest more laxatives before going for an enema at this point (5 days?), but I don't know what part of the world you're from, or what their practices are there.

Again though, I hope that you start moving your bowels soon, so that you don't have to do anything else at all. Good luck.

I had my mom come over to attempt an enema on me because I tried for a BM again and couldn’t get it out. I used my finger to get tiny pieces off but the main mass is still stuck in there because it’s too painful to pass. My mom put the enema in the tiniest bit and I was screaming out in pain. I couldn’t believe that noise was coming out of me. She had to stop because the pain was so extreme that the enema would never go all the way in. We decided I need to go to the ER.

I’m sitting now waiting to be called back. Hoping sometime soon. It sucks that I can’t have anyone wait with me because of covid. I’m in a lot of pain and when I told the guy that I’m bleeding constantly, not just when I go, he said he would have to send me to the proper ER and not the quick room. So I think that means I’m getting a bed and maybe admitted. I’m really hoping they’ll knock me out or give me pain meds and then digitally get the feces out. I think once I get through this initial tough one, the rest of my recovery could be alright. It’s just this first super hard piece.

I will update once I see someone after I’m called back. I’m in a really large amount of pain right now so I hope they call me soon.

So once in the ER, they examined me, then called my surgeon. My surgeon said he had “no recommendations”. I actually heard them talking because the main Dr station was close to my room, and they were saying, “She came in here in pain, and the guy is telling us to just send her home with nothing? We can’t just not treat her at all.” I did appreciate that they were trying to help me.
They ended up putting lidocaine on me to numb me a bunch back there, and then the nurse successfully was able to give me an enema. I went home and passed a little bit more, and then this morning I passed it all. I was so relieved that I finally moved that stubborn stool.

The pain afterward was horrendous though. The ER Drs prescribed me lidocaine gel, so I put that on afterward and ended up taking one Oxy pill since I have a bunch left from surgery. After many hours the pain finally became manageable. Tonight I really felt the need to BM again and even though I was scared, I did. It was much much much easier, and I passed it with very little pushing. Unfortunately immediately after, a crazy bad stinging started. I took a sitz bath, took some ibuprofen, and put in lidocaine. It’s now two hours later and I’m still hurting and in pretty high pain.

I’ve seen a lot of people on here who had LIS say that their pain after a BM was never usually more than when they had their fissure. It just seems like many other recoveries were much easier than mine. I’m not sure when I will stop having so much pain after an easy BM. I am frustrated that my CRS gave me a fissurectomy and not LIS because I’m wondering if this is why my recovery is so much harder.

In the meantime, I’m taking stool softener three times a day, miralax once a day, and eating a mainly plant based diet with some high fiber bread too. I’m feeling hopeful that all my BMs in the near future will be soft and easy. Just going to have the wait until the pain lessens. I’ll ask my surgeon about it at the follow up next week if it hasn’t improved.

Wow. Your surgeon sounds like a real stand-up kind of guy. VERY nice that the ER staff were so helpful though.

I hope that your next movements are far less painful afterward than those you've had already, and that if things aren't going well that your surgeon can determine why not and do something about it.

Day 8 after surgery:
I had diarrhea yesterday, so I took that as a sign to finally stop drinking the mineral oil at night. Gonna stay on softeners and miralax and hopefully that will keep everything soft still. Passing the diarrhea wasn’t bad at all but I still had an incredible stinging afterward for hours.

This morning I had a small BM and then a little more about a half hour later. They were both pencil thin stool, still really soft, but again, not very much. I really haven’t been eating much at all so I’m hoping that it emptied me even though it didn’t look like much. Now I’m having some intense pain afterward though. I’m glad passing everything is easier. I just wish the following hours weren’t so painful.

I’m trying to stay positive that I’ll improve faster now that my stools are soft. I’m eating a lot of plants and veggies, not many carbs except for a slice or two of fibrous bread. Almost no dairy. No red meat. I’m down to less than 1000 calories a day and I’m not sure if that hindering healing as well. I know I should eat more but it’s like I’m scared to. Plus I get full very easily.

Once some of the pain goes away I’m going to try to walk around for 20-30 minutes. I know exercise will help. Right now it’s just tough to focus on much else but the pain.

You mentioned that you had a followup "next week", but that was on Sunday, so I don't know if you're going in later this week, or have to wait until next week.

I know that your surgeon isn't overly kind, but if you call his office again, to let them know that you're still experiencing a lot of pain (and don't sugar coat it), they might be able to get you in sooner. Also, he may ASSume that all is well with you now, if you haven't called to update him on the situation.

As far as exercise goes though, it can either help or hinder. Exercise increases blood flow to the area which helps healing, but if you have an open wound and the exercise stretches or breaks it further, that wouldn't be good at all. I am not at all knowledgeable on this front though, so you really need to ask a medical practitioner if exercise in your situation would be good or not. Even your GP, or a telehealth # might be able to advise you, if you can't reach your surgeon or get an answer from him.

My follow up is January 5th. And my surgeon told me after the surgery that I should be walking around and doing light chores again starting the day after surgery, because it would help me heal. That’s why I’m trying to be more active (but not overdoing it because the post op stuff says not to even lift heavy things).

Tuesday night after I wrote my last post was very bad. I had bad diarrhea for a few hours. Eventually all that came out was just water. I’m thinking that the miralax and three stool softeners maybe is too much and caused it? The pain afterward was sooooo bad.

In the bright side yesterday was my best day yet since surgery! I had some pain in the morning but no BM, though a lot of itching (which I took as a sigh of healing). I tried to eat a little more normally and not just fruits and veg exclusively.

But I just had a BM this afternoon and I had to strain a little and it was a little bit hard I think. I’m trying to hard to figure out the right combination of food, stool softeners, and how often to take miralax so that my stools are nice and soft but I don’t get diarrhea. I’m feeling frustrated and kind of like I had a setback because there was bleeding after my BM today. I am so terrified that I’m going to reinjure the wound site and undo any healing.

I guess I’m going to keep experimenting. I’m trying miralax every other day and two stool softeners a day right now. I think I’m going to go back to a very very low carb diet again and try to eat mostly fruits and vegetables again. I need to get this right.