Post Bowel Movement Pain - No Fissure Found

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Post Bowel Movement Pain - No Fissure Found

Postby Bathbomber » 22 Oct 2018, 21:42

Hello this might be a long post, I have been dealing with chronic rectal pain for over a year now. Over the years I've struggled with anal fissures. I'm 25 years old now but I think I first started having fissures when I was 19 or 20. When I went to the doctor I was misdiagnosed with hemorrhoids and I didn't think much of it. I would notice blood in the toilet every couple months or so and only experience pain when I happened to graze while showering or wiping. I was under the assumption that I hemorrhoids and they would go away naturally.
Three years ago when I was 22 I started experiencing frequent urination. I went through all the tests and came back negative for any bacteria or UTI. Through my own research I diagnosed myself with Pelvic Floor Dysfunction. I even went to multiple pelvic floor physical therapists and they confirmed that my pelvic floor muscles were overly tight. Around the same time I started noticing blood in my stool again and I was finally diagnosed with anal fissures. The fissures cleared up naturally as they always did.
About a year ago I started having persistent rectal pain after every bowel movement. I don't think I was having bleeding at this time so I was not sure if fissures were causing this pain. I made an appointment with a colo-rectal surgeon and he assumed I had fissures based on my symptoms. I tried all the creams, sits baths, and dieting but the pain still remained. Eventually I was given a round of botox but that only seemed to make my symptoms worse. The colorectal surgeon scheduled me for an exam under anesthesia and possible LIS but he didn't find any visible fissures so he just gave me another round of botox.
Since then I haven't had much success treating my post bowel movement pain. Every time I have a bowel movement I have pain that lingers the rest of the day and it is ruining my quality of life. I still don't know what is causing my pain or if it is related to fissures. I recently noticed blood in my stool again so I made another appointment the colo-rectal surgeon. I'm hoping he will have some answers for me. I am willing to do LIS at this point even if it has the slightest chance of providing relief.
Has anyone been in a similar situation or have any insight as to what be going on? any advice would be greatly appreciated!
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Re: Post Bowel Movement Pain - No Fissure Found

Postby notlordofthering » 23 Oct 2018, 05:07

Hi! I could have written this post. I actually had a confirmed fissure that healed. That was five years ago and I'm still having trouble. When it first occured five years ago I had bleeding but I haven't bled in 4.5 years. Going to the bathroom these days is like playing russian roulette. Either I'm stuck with a low grade burning pain for the rest of the day or a low grade pain that increases throughout the day that becomes unbareable.

Somtimes I can go a month or two without feeling anything but usually the anus feels swollen with a burning/sensitive kind of feeling. 3 different surgeons have scoped me several times, also had examination under general anesthesia with botox. They didn't find anything wrong while I was under and the botox made the pain worse for a couple of months. Funny thing is that the sphincter was really loose after botox but I was still in a lot of pain.

Now I'm on Amitriptyline 25mg every night which helps a bit. Also on Co-codamol as needed and stool softeners. Co-codamol works great but I try not to take it too often. I'm currently on the waiting list for pain management clinic, maybe they can try some other meds on me. I'm really depressed and anxious about the whole thing.
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Re: Post Bowel Movement Pain - No Fissure Found

Postby patience_and_healing » 24 Oct 2018, 13:00

It might be more helpful for you to try pelvic physical therapy rather than get on painkillers, or do both concurrently.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
On and off in pelvic physical therapy
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Re: Post Bowel Movement Pain - No Fissure Found

Postby chachacha » 24 Oct 2018, 16:53

Have any of the scopes revealed internal hemorrhoids? Surgeons believe that those can't cause pain, but if they become thrombosed, they can burn and/or cause extreme pain for hours and hours afterward. I believe that the condition is rare though, which is why it took me so long to be diagnosed and treated.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Post Bowel Movement Pain - No Fissure Found

Postby hurtinend » 21 Nov 2018, 16:40

I have the exact same symptoms. A fissure
from years ago is apparently “gone” but I have constant throbbing burning pain up there, especially following bm, no blood.

Pain Clinic sent me for a pudendal nerve block but it didn’t help.

Currently stuck.
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Re: Post Bowel Movement Pain - No Fissure Found

Postby SueMac » 03 Dec 2018, 13:12

Hello, I'm new to the forum but not to pain! I was really interested in this thread as it also sounds a lot like me. I started with on/off anal pain after a BM 10 years ago. No problem was found by a specialist. It went away by itself until 2014 ( 6 years) and it's been on and off last 5 years. Last time I was examined under anaesthetic they found a small prolapse (which was fixed), minor hems and no fissure. I still had pain on and off.

Currently I have like people on this thread, pain after a BM (not always) and when pain comes it lasts all day. I have a particular sore spot on left inside anus which will spread pain/aching into my buttock as well. My GP has prescribed Rectogesic which I started today (and had a headache/fuzzy head all day). I am going to try this but not convinced as no fissure was seen or felt by my GP. There has never been any blood at all, just this soreness or aching pain which drives me to distraction. How are you all getting on?
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