Hello everyone,

Of late I am having trouble with the initial part of the stool which seems hard and dry. It leaves the are very sensitive to burning. I want to point out that after that initial hardness everything after that is fine. I have BM everyday in the morning so my issue is not that I don't go regularly and the stool just sits there getting dehydrated. I eat healthy. I wonder if milk (cereal for breakfast) or bread (2 pieces max once in a while) is my problem.

I feel like no amount of surgery (has LIS twice) will cure me if I don't fix this issue.

I used to take miralax very night but my CRS asked me to wean off of it slowly and I've been off it for about 8 months now. I don't want to go back to something synthetic or habit forming( I know the jury is still out on that one). But can someone suggest something? I am so fed up with this ordeal. It's agonizing to not be able to use the bathroom stress free.
Thanks.

Hi Buddy, I have this exact problem too, and I have read many others with the same dilemma. It's completely natural, as the oldest poop is the dryest, and comes out first. The past week I was actually on a good run by holding off on eating until late in the day...like breakfast at 5PM, so that the food would not have too long to sit in my colon before my morning dump. It actually helped a lot. My poops flowed much easier. Today wasn't great though, for some reason, and it was bloody again. I too have had 2 corrective surgeries for this. What are your next steps? I never thought I'd say this, but do we just have to get over it and live with it? I am not OK with that route, I want a nice clean pristine butt without blood or pain. I am going to talk to my doctor about colostomy or even another surgery.

I remember you asdf. I had no idea you had another surgery that didn't work. I can't believe that there will never be a solution to this horrible problem we have but I could just be in denial.
Around the end of January. Dr feingold did an exam under anesthesia on me and said my rectum is 100% healthy and he wouldn't know that I've had 2 surgeries if I hadnt told him. As a result he didn't need to do the kenalog thing.
This baffles me no end. May be I have some sort of IBS which doesn't let the BM be consistently normal. But don't IBSers have other bowel problems too? I don't have any of that like pain in the abdomen etc. so I am out of my wits trying to figure out what I can do. I eat all right, I am a hermit these days with zero social life at the ripe old age of 28. Oh what a life! Sorry for the rant ...

So you do not have a fissure then?

I had a flap procedure after the LIS failed, and I still pooped blood every morning and my butt hurts. So I'm going to quit my job and move into my mothers basement. I'm 26 and I haven't really done a social thing in quite a while either. Very very sad about it.

I did not know you went to Feingold, I just made an appointment to see this guy and ask about the kenalog thing...Why wouldn't he do it on you? I'm going to see him in 6 days (cannot wait), and I'm hoping he will at least try it. Do you know if he can do it in the office?

So far in my life I've dealt with doctors for 4 separate issues; they've done absolutely horribly on each.

Eosinaphilic Esophagitis- Gave me steroids and a double dose of prilosec, which has a side effect of causing brittle bones. After two years, I broke a vertabrae this fall, from GOLFING! Never heard of that! If I wasn't so distracted from my fissure, I'd be really depressed about that because it probably means I can't golf or exercise. But thanks to my fissure, I haven't gotten around to worrying about it.

Irregular Heartbeat - Have a ton ton ton of palpitations all day including ventricular tachycardia, so they gave me medicine they has a side effect of causing you to pass out from low blood pressure, so I couldn't take it for more than a few days...So I just live with it. The next step is to have an ablative procedure in my heart, but if they can't fix a fissure, there's no way I am going to let them jiggle an electrode into my heart.

Fissure- Don't need to say anymore here of course.

My dad got esophageal cancer 2 years ago. They gave him chemo, but nobody checked his white blood cell counts (which were already very low from his crohn's disease). Count went to zero, he got a fever, died within a few days.

O and just to clarify, my fissure isn't really a fissure at all, it's a hemorrhoidectomy surgical wound that has not closed, which was, of course, at the hand of my last CRS. So he fucked that up as well.

I'm so sorry to hear about your ordeal. Seems like there are a lot of health issues going on with you. Do you suspect they are inter-connected at all? I would not worry about your job right now. Easier said than done, I realize, but it would make a lot of sense to fix ourselves once and for all and then get back into the work force. I have come close to quitting work one too many times. Somehow, I just pop a painkiller and troop forward, only to find myself contemplating quitting the next day all over again. So, I can totally understand where you're coming from.
Dr. Feingold is good. I can't attest to his surgical ability because he hasn't operated on me but he comes across as a doc who is sure of himself and hands you the options straight without any frills (however bitter they might be, I've broken down in his office more than once for sure). But at the end of it, he is only doing his job.
He didn't use kenalog for me because he couldn't find anything wrong, no fissure nothing. He asked me to see an OB/Gyn to assess any pelvic issues that may be causing my pain. On that front too, nothing seems wrong with me.
To answer your question, I am not sure if he can do the kenalog injection in the office. I would assume that anyone with a fissure would not be able to tolerate anything done to their butt without knocking them completely out in an OR.
As for my condition, Im really at the end of my rope. I live in fear 24X7, I get relief for 1-2 weeks and then I'm back to square one with pain and all that anxiety. I have tried changing my diet but haven't found anything that will keep my stool consistent enough to help me heal. I don't know what's next for me. A poison pill that I could shove down my throat sounds like a pretty good idea though.

I think poison pill sounds just perfect right now, but I'll hold off if you do, at least so we have each other to bitch to.

Hi SSK!

An important question to answer regarding the 'hard stool' at the beginning is 'how long has that been in there?' As you probably know, the longer the stool is in you, the drier and harder it becomes. The question of bowel motility is therefore important. If you can speed it up to a healthy rate (while still digesting properly) this will help.

You can test motility by adding non-digestible things in your diet (corn, flax seeds, I've been told blackened sesame seeds, beets--which just come out died red) and seeing when they come out.

In testing my motility, I have found that I expel all previous days food as long as I don't eat after 8pm (I eat at 6:00, about, with a small snack before 8pm). That is--about 12 hours before defacation.

I have gotten rid of the hard caps, for the most part, by doing the following:

I poop twice every day, in the morning. Once before breakfast, once immediately after. I induce the poops by taking ginger tea the previous night (which speeds motility) and a few swigs of prune juice at bed time. This ensures that I go shortly after waking. For breakfast, I have a tablespoon of chia seeds (lots of soluble fiber) with oats, flax seeds, and peanut butter--also 17g miralax and 400mg magnesium oxide. I drink about a liter of water at minimum with the meal, and the stomach distention generally triggers a need to poop. If not, I drink a cup of coffee and then out it comes. Coffee gets a bad rap with anal fissures, and I understand why, but it's a matter of priorities. Which is more important to you--making sure you ensure good bowel motility or dehydrating your stool mildly? I know that if I don't poop twice in one day, I am going to have problems the next. Getting it out in the morning makes it so I don't have to think or worry about it the rest of the day...and coffee is certainly a healthier alternative to stimulant laxatives.

Spend some time learning about your body.

I really feel for you guys. I had to move back home for a bit and am still here recovering its painful and lonely. My heart gors out to you both and may god present you both with a solution!!