Why Am I Still in Pain?

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Why Am I Still in Pain?

Postby queenofpain » 10 Sep 2014, 15:54

I developed a fissure in September 2006, and had LIS in October 2011. I was in pain post-surgery until December 2011, and then things began to improve. In May 2013, I developed pain which at times feels different than fissure-related pain. I don't know whether this is related to LIS scar tissue or whether I have a hemorrhoid. I often can identify a sore spot at the 3 o'clock position, which feels like a bump. There is itchiness in the anal area, at times, burning after some bms, and scanty traces of blood at times in my underwear. I'm now on my third CRS who plans to do a colonoscopy this month so that he can see the state of the area. He said if I'm too tight or in spasm, we won't be able to do the procedure. He said the internal muscle is tight despite LIS; that's part of my anatomy, and he can see why I'm in pain. Here are my questions:

1) What is pain from spasm like? We're always told we're experiencing spasm, but I'm wondering if my pain is hemorrhoidal, and has been misdiagnosed.

2) A few times a year, I'll awaken early in the morning to a cramp-like pain in the anal area. I have to walk it off for about an hour. Even though this pain is more intense, I far prefer it because I know it will subside and not linger for days or weeks. This type of pain feels like what spasm should feel like to me, like a muscle cramp in the leg. Does anyone ever waken to a cramping sensation in the anus?

3) Has anyone not been able to do a colonoscopy because of spasm or tightness?


Thanks for all your help. I hate this pain!!!










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queenofpain
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Re: Why Am I Still in Pain?

Postby Savaici » 10 Sep 2014, 20:03

Can only give you my different pains:

When my fissure first surfaced the pain was like a vice gripping the sphincter after a BM and not releasing its grip for about eight hours., occasionally tightening to make the pain even worse. I could not sit or stand without pain, and only found relief with a muscle relaxant at night. Lost about 35lb as just ate veggie soup. For about 18 months. Passed blood with every BM. Pain level, every day, was at least 7 out of ten and I have a huge pain tolerance.

Eventually, the spasms subsided (did not have surgery). I did self dilation, turned to a healthier diet, though still not very much. I am vegetarian, except for fish once a week.

Now the pain comes and goes, but not the spasms of the past. Still have the "full" sensation and poop more times a day than previously, and IBS, but I just live with it now.

That is a sum-up of how it is for me.
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Re: Why Am I Still in Pain?

Postby queenofpain » 12 Sep 2014, 12:59

Thank you for your reply, Savaici.

Your reply illustrates how different each of our stories is. The common denominator. though, is the chronic pain, and the mystery behind it. You would think that when a fissure or LIS site is healed, there would be no more spasm or pain. It's almost as if the sphincter is changed 4-ever, once torn. I'm sure we all wish we could have the day back when we suffered a fissure in order to do things differently. Thanks again for your thoughts.
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Re: Why Am I Still in Pain?

Postby Jbl22424 » 13 Sep 2014, 23:56

Spasms feel like burning to me. Like a hot poker in the butt. Just terrible! When it's not as bad it ebbs and flows over 30-90 seconds where I'll have a minute pain free and then a minute where my butt is burning and so on. This occurs starting after a Bm, worsening for a few hours, then lightening over a few hours till it's gone. When the pain is the worst, I know my butt is tight because of how it feels and sounds to pass gas. There are no silent farts when in spasm :) hope that helps
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Why Am I Still in Pain?

Postby queenofpain » 15 Sep 2014, 09:49

Thanks for your reply, Jbl22424 . I have burning, too, but thought maybe it was internal hemorrhoids or the Miralax or possibly, M.O.M. You're confirming my fear, though, that I'm still experiencing spasm. All this, after healing from fissures (I'm told I healed right away, long before I elected to have surgery), and LIS. My situation has been worse since May 2013, and it seems there is a bump or so maybe at the surgical site. It comes and goes, and that's why I think there is a hemorrhoid. My CRS said internal and external hemorrhoids are contiguous, and the implication was we shouldn't be speaking of them as separate entities. When I first tore myself, my regular doctor told me I had internal hemorrhoids and an anal flap. No CRS I've visited ever mentioned either of these, even when I had surgery. At any rate, I need to have this colonoscopy, so that the CRS can get a clear view of the anal canal. I hope I'm not in spasm from the preparation the day before, or he won't be able to do it. Also, I find myself fighting the establishment to give me anti-nausea drugs for the sedation. Any type of drug like that makes me dizzy/queasy, and I wish they would just listen.

Thank you so much for your insights about 'burning.'
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Re: Why Am I Still in Pain?

Postby pafen » 15 Sep 2014, 21:19

I have seen many specialists because of this left sided burning. Most recently my colorectal surgeon did a sigmoidoscopy and diagnosed it as spasm of the puborectalis muscle.

My colorectal surgeon agreed it could have been an anal fissure hidden in the folds of the anal canal. So of course I proceeded with the LIS surgery.

Didn't seem to fix the problem though.

This all seemed to start following a hemorrhoidectomy. That surgery should be avoided at all costs!
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
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Re: Why Am I Still in Pain?

Postby queenofpain » 16 Sep 2014, 13:44

Hi Pafen,

Thank you for your reply. I thought I was about the only one that LIS didn't help, unless I have some other issue. This is why I don't want any more surgery in that area. It's too painful, takes too long to recover, and hasn't helped so far. Yet, if they can clearly identify the culprit, I'm willing for more intervention. Now, others have success, but I'm skeptical about the 95 - 99 % cure rate in the literature. Maybe they didn't cut enough with me, though.

I hope you achieve the relief you need soon. Thanks, again.
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Re: Why Am I Still in Pain?

Postby Alyssa » 08 Oct 2014, 13:49

Queenofpain,

I too suffer from Chronic pain despite being declared healed; I was diagnosed with Pelvic Floor dysfunction since my muscles were tight. I also had this same burning (intensity increases with the longer I sit on my rectum); since I had Botox injected in the pelvic floor muscles the burning sensation has lessened (it has not eliminated completely; it will be 5 weeks this Friday). BM were very painful before (hot coal exiting out of my hole but now feel as though BM is scrapping the wall and slight stings). My anus still does not feel normal (prickly painful irritation left) and don't know if it will ever be..
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Why Am I Still in Pain?

Postby queenofpain » 08 Oct 2014, 14:21

Hi Alyssa,

Thanks for sharing your story. Well, I had a colonoscopy under monitored anesthesia on 9-26. The CRS said all appears normal with the colon and sphincter (no inflammation, no polyps, no hemorrhoid issue). He only could see some scar tissue. He said I have some stenosis, and he stretched the muscle while I was under. He said that usually works and keeps the canal open for a few years. Well, wouldn't you know it, my pain returned last Thursday. He's a very compassionate, down-to-earth doctor (my third CRS), and he said he feels like a failure. It's not his fault. I don't seem to respond to anything: natural intervention, prescription creams, prescription muscle relaxants, lateral internal sphincterotomy, stretching. He said I could have the pelvic floor or nerve or other evaluated. I don't think he thinks that that's the problem, though. He doesn't think this is spasm, either. I'm very confused. The second CRS said it was spasm, and that I needed to get off some of the stool softeners. He said the #1 cause of stenosis is liquid stools. This CRS said he had no problem, though, opening the muscle and performing the exam. On top of it, I was laid off my job, and don't feel I can look for another in all this pain. This is a nightmare. I'm going to work on weaning myself from the stool softeners, and see if the muscle will stretch. Thanks again for sharing.
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Re: Why Am I Still in Pain?

Postby Alyssa » 08 Oct 2014, 16:40

Not a problem... I just hope that we all get to the root of the problem... I am tired and depressed too!
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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