Msimon,

The bladder issues you mention raise a flag for me. I always have to strain somewhat to empty my bladder completely.

I am guessing this is because of my constantly overtight pelvic floor.

Being male, I have also seen a urologist to rule out any issues with my prostate as well.

While I am waiting to see my pain specialist I have been seeing another doctor who has been treating me with trigger point injections. He is performing these injections through my buttock to target the spasmed muscles.

I must say I have been getting some positive results with more breaks in the pain cycle rather than the usual 24/7 burning. I am getting these done each week so I hope things continue to keep improving. I notice a difference because usually mid afternoon I need to have a rest, whereas lately I have been able to keep going.

It's tough to understand if you never experienced it but if your floor is too lax the BM won't want to come out but rather just stay in there.

Msimon,

I have been experiencing a lot of pushing/ straining is needed to have a bm during the last 3 days... Is this what you also experienced? How did you relieve yourself? I have have not been constipated in a long time but it seems though I am because I have to strain to move my bowels

So sorry to hear that Alyssa. The trouble I found the botox gave me was that the BM would come down and just sit there, almost like I lost my peristalsis. I found that making my stool very loose helped. I used Miralax and Milk of Magnesia and put some fat in my diet. I also found through trial and error (and this will sound gross I am sure) but I would put my finger up there and stimulate the lining of the rectum and that would get things flowing. This was usually after I had already had gone once (I usually go at least 2 or 3 times each day).

How is your stool consistency? Had anything else changed? How is your pain?

The stool consistency has been a little firmer than in the past (not hard) but I too feel as though it gets just stuck there and I rely have to push (strain) for the poop to come out. The burning pain has decreased so Botox has been working but I don't like that I can't poop. I went to physical therapy and she did manual stimulation and I was able to relieve myself, finally.

How much miralax should a person drink to have soft bm? I weigh 112 lbs and am 5'2 if that makes any difference...

interesting...what did she do to get it going for you?

This may sound gross but what worked for me was to put my finger in rectally along the back wall and slowly, while pushing toward the back with my finger, move it down toward the opening. It sort of mimics what it would feel like to have a BM coming out. This would trick my body into creating some peristalsis. I have really had trouble not being able to do this with a fissure.

Glad to hear something worked for you and that the burning is subsiding.

Unfortunately, the Miralax is such an individual thing. I have IBS so I need to take very little and don't have much to offer you there. I do also take Magnesium citrate as a supplement, which helps a lot. Many people on here take that as well.

As a worse case scenerio you could try a warm water enema. You just use an enema bulb from a drugstore and fill it with warm tap water. At my worst this didn't even work. The water would just sort of sit there It may be a matter of things just balancing out for you.

How is your muscle control? Are you able to do kegel exercises still (like do you 'feel' weaker)?

She basically did the method that you use; she also messages the muscles vaginally... An hour later I was relieving myself :) yes I am still able to do kegels. I feel my muscles a little more relaxed

This Friday will be two weeks since getting Botox... Is this something that is temporary? (Straining to have a bm)?

Why do you feel that you need to strain? Like do some muscles feel relaxed but some (like at the bottom) feel tight?

Do you have a follow up appointment with your Doctor?

I hope it will be temporary for you. It depends on what you think the cause is...consistency, peristalsis, muscle imbalance. The muscle balance will continue to change for up to a month so let's hope that is all it will take.

I have to strain to expel the bm... If not then it just stays there! I feel as though I have something stuck up there all day... (Like a cork) but its the stool that just sits there. I took 17g of miralax with 10-12 oz of water and it helped me with going to the bathroom again. I really don't know how relaxed my muscles are but I can feel then more relaxed hence the decrease in lingering burning pain. I have a follow up appointment next month with the specialist in San Francisco... My pt also suggested biofeedback since she felt a bulge in my vagina (rectum full of stool since I couldn't relieve myself) and she thinks it will help.