Hi everyone,

I had an abscess drained on October 31st, 2014 and a fistulotomy for the corresponding fistula on January 7th, 2015. It took 3 months to heal, but when it did it left a small dimple. Initially (the first 3 or 4 months after full healing) I didn't have any problems with it or with the Metamucil (which I had been taking since the fistulotomy), but in recent months I have had issues with mild remnant liquid stool draining into the "dimple" (it looks like a small keyhole) for about an hour or so after every bowel movement. It is not of any medical significance (at least, I don't think it is) but it can be quite annoying and end up going back to wipe with my wet wipes 4 times or so over the hours. I even purchased a bidet and, while it certainly removes the pain from excessive wiping, it does not fix the consistent catching of stool in the little dimple. I also consistently have solid but fairly messing poops; I eat plenty of fiber and am very healthy. I have noticed the messier the poop the more cleaning that is required in the dimple long after the primary anus is clean. The dimple will come clean, but then 10 minutes later have mild liquid stool in it again. Not enough to get on my underwear or anything (no problems with "skid marks" haha) but it itches and is worrisome from an infection standpoint. The only thing that has changed since this began is that I quit using the Metamucil because it was giving me intestinal issues (primarily excessive gas but also mild cramping), the minute I stopped using it these went away. Funny thing is, the first few months I used Metamucil I didn't have these problems, maybe my body just decided it had enough? So now I'm torn between to unenviable options- have cleaner poops with less wiping but also constant and uncomfortable gas pressure on my anus (as well as occasional intestinal distress) OR have an anus that always requires excessive cleaning and I stress to the point that I don't even poop away from home.

So, to get to the point, IS there a form of bulking agent that won't cause me to have such intestinal discomfort? Or am I destined to be wiping this dimple for eternity. The excessive wiping does not hurt my anus itself, but it does leave the dimple red and irritated. Has anyone had any success? I suppose this is a MILD form of incontinence I am experiencing and I have read the corrective surgery is NOT recommended. I'm an otherwise healthy (no Crohn's, Diabetes, etc....at least as far as I know) 32 year old male. I have added a photo attachment here so you can all get an idea of what I'm dealing with. I apologize if it is graphic. As you can see the open wound was quite large (where the mild discolored healed skin now is present) and the dimple is fairly small (its fairly shallow, it looks deeper in the photo than it actually is) and I have a skin tag which has been present for 20 years or so.

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I have put your image with a spoiler!!

Have you tried Metamucil capsules? I couldn't drink the "powder in water version", but can easily take the tablets. They're more expensive, but you may not need as large a dose to keep the stool solid. You can also use no-name psyllium fibre capsules (I get mine from Walmart and they're about 1/3 the price of Metamucil itself). Maybe the release of the capules won't annoy your gut as much, or at all?

What is it that is bothersome about the metamucil? Is it gas? I have heard that increasing fibre gradually allows the body to adjust so it doesn't produce so much gas.

Also, do you take a probiotic supplement? I find they help my gut. I have IBS and used to be more 'windy' but since I take a particular probiotic it seems to help that.

chachacha wrote:Have you tried Metamucil capsules? I couldn't drink the "powder in water version", but can easily take the tablets. They're more expensive, but you may not need as large a dose to keep the stool solid. You can also use no-name psyllium fibre capsules (I get mine from Walmart and they're about 1/3 the price of Metamucil itself). Maybe the release of the capules won't annoy your gut as much, or at all?

It also might be worh trying methyl cellulose capsules if those psyllium capsules don't work. My Dr said psyllium and methyl cellulose work slightly differently but they both basically do the same thing (bulk stools). He said it all depends on the person. Some people will react better to one or the other.

Yes, thanks for mentioning that. I used to use methylcellulose (ie., Citrucel) as I have IBS and am really prone to gas. It gave me no extra gas but I didn't find it was great when needing extra peristalsis. If you just want soluble fibre (makes soft BMs) this is a great alternative. Just make sure you drink lots of water with it.