Painful BM

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Painful BM

Postby AFpers9 » 01 Jul 2019, 06:24

Hi 45yr male here. Have been experiencing very painful BM for a week now. I had feequent pressure to have BM but not much came out.. Went to a GI doc who diagnosed a gissure and gave hydrocortisone 2.5%. Did not help. Went to a colorectal surgeon who could not see a fissure visually and tried to do a digital exam but was very painful. He said it could be a fissure or an abscess and prescriped a nefedipine + lidocaine cream. He said if it is a fissure then the ceeam would help and if not he will have to examine me under anesthesia. The cream seems to have helped to take out the pressure (is that spasm ?) But the pain during BM is very much there. I have a few questions :
I was told that id it is fissure the cream would porvide rapid relief but i have no pain relief. Does it take longer ?
Should i get examined under GA ? My concern is that the examination with a scope itself could hurt the area so much that it might exacerbate the pain ?
Pl. Help
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Re: Painful BM

Postby appleapple » 01 Jul 2019, 12:19

I'm currently recovering from a fissure that is rather deep in my anal canal and not visible to the eye by visual examination. I was given the same treatment by my CRS (nifedipine and lidocaine) which did absolutely nothing for me. Response to topical treatment could really vary from person to person.

I personally would refuse to be examined under the scope with an active fissure, but that's just me.

How bad is your pain? Is it during the BM (from the fissure site itself) or post-BM (spasms of your inner sphincter)? Are you keeping your stool soft enough (two things: keep it soft, and keep the diameter of the stool thin). Soft/thin stool is probably #1 thing to do in fissure healing.
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Re: Painful BM

Postby AFpers9 » 01 Jul 2019, 13:30

Pain is very bad 10 - havent experienced anything like that before. The worst is during BM. Post BM I used to get spasm ( i used to get this pressure to go and my sphincter would clamp down - is that a spasm ? ) which was also painful but not as much. After using the nefedipone cream this spasm is gone but the pain during bowel movements is bad. Also i havent had a BM for the past 30 hrs. I have gone to the bathroom but only a little comes out. I have been having psyllium husk for a 3 days already . How did keep your stools thin ? How are recovering ?
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Re: Painful BM

Postby appleapple » 01 Jul 2019, 13:45

AFpers9 wrote:Pain is very bad 10 - havent experienced anything like that before. The worst is during BM. Post BM I used to get spasm ( i used to get this pressure to go and my sphincter would clamp down - is that a spasm ? ) which was also painful but not as much. After using the nefedipone cream this spasm is gone but the pain during bowel movements is bad. Also i havent had a BM for the past 30 hrs. I have gone to the bathroom but only a little comes out. I have been having psyllium husk for a 3 days already . How did keep your stools thin ? How are recovering ?


Yeah I can relate. My pain level used to be up there too, and my spasms lasted pretty much all day, wiping me out completely.

I now take 1 cap of Miralax, and my diet is mostly fruit/veggie and a small amount of protein. Most food I eat are cooked into a liquidy, soft form. I used to take a hemorrhoid treatment supplement that contained psyllium husk in it, but it made my stool more formed (larger diameter), so I stopped it. For the past week or so, my stool has been the perfect Bristol type 4. I include cod liver oil, coconut oil, olive oil, and ghee butter in my diet, to lubricate my digestive system (and the stool too). I also use a propolis/cocoa butter suppository 3 times a day, which I think probably helps to keep the stool soft too.

My recovery diaries:https://anal-fissure.org/fissure-diary-debilitating-spams-from-3-31-2019-t25330.html
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Re: Painful BM

Postby appleapple » 01 Jul 2019, 13:47

Oh also, the one time I got backed-up stool after I got this fissure, I ended up having to inject liquid glycerin up my bum to make myself go. It wasn't pleasant though.
help-please-backed-up-constipated-today-what-to-do-t25560.html
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Re: Painful BM

Postby AFpers9 » 01 Jul 2019, 14:08

Thanks. I cant take a lot fats ( coconut oil ) because i have famlial triglycerides. I eat healthy otherwise - have kept to vegetarian diet . Lots of whole grains ( whole wheat breads, oat meal etc ) . I workout 4-5 days as well. Not sure what else i can do.
Btw i took metamucil before the doc gave me the nefedipone and i was going BM multiple times - maybe that was due to the spasms ?
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Re: Painful BM

Postby appleapple » 01 Jul 2019, 14:22

AFpers9 wrote:Thanks. I cant take a lot fats ( coconut oil ) because i have famlial triglycerides. I eat healthy otherwise - have kept to vegetarian diet . Lots of whole grains ( whole wheat breads, oat meal etc ) . I workout 4-5 days as well. Not sure what else i can do.
Btw i took metamucil before the doc gave me the nefedipone and i was going BM multiple times - maybe that was due to the spasms ?


I don't think the spasms would make you want to go more. It's more likely diet related, or probably related to the supplement/stool softener you take.

I go once a day in the morning. When my fissure was at its worst, the sheer thought of going more than once a day would make me depressed. Lol. if you can still work out, you are probably in much better shape than I was a few weeks ago. I was in level 7-9 pain all day, and could only lie on my stomach in bed. Keep a positive attitude! I've already come a long way, although not completely healed yet. We all can and will heal!!!!! =)
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Re: Painful BM

Postby AFpers9 » 02 Jul 2019, 07:59

Its now third day without a full BM. Yesterday i had Docustate sodium 100mg in morning ,mirilax in the night. Today i have had to go BM several times within a short duration but very little (about a inch !) each time. Each BM is ofcourse painful. Not sure what to do.
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Re: Painful BM

Postby appleapple » 02 Jul 2019, 08:25

AFpers9 wrote:Its now third day without a full BM. Yesterday i had Docustate sodium 100mg in morning ,mirilax in the night. Today i have had to go BM several times within a short duration but very little (about a inch !) each time. Each BM is ofcourse painful. Not sure what to do.


Are you drinking enough water?
Maybe switch to a different diet? I feel like many of us here have to go through some sort of experiment to figure out how to produce the perfect Bristol type 4 stool. I certainly had to.
Do you feel any splitting sensation (of the wound) when you go?
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Re: Painful BM

Postby AFpers9 » 02 Jul 2019, 08:40

I think so. I have had 2 glasses of water in the last 3 hrs. Plus a smoothie (fruits and vegetables ) . Oatmeal and millet in buttermilk.
My diet has been pretty much whole grains - brown rice with some beans and tomatoes ( chiplote type) and salads in buttermilk dressing.
Its painful when i go BM but i don't think its the splitting kind.
I am thinking of trying an enema - do you think it will be dangerous at thia stage ?
Should i try more docustate sodium ( its not yer 24hrs since i had the Mirilax )?
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