Quick recap: had LIS+Fistulotomy back in August. The Fistula wasn't healing properly, so I had to have another fistula surgery on October 25th. Things were going awesome, and a couple weeks ago the CRS said everything looked to be healing up nicely, only a little bit of scar tissue still there, but he said he expects it to strengthen over time... Well, this morning I was a bit constipated and, I know I shouldn't have done this, but I wanted to get it out so I purposely strained a little bit to get the BM out, turned out the tip was hard and a bit deformed, but the rest looked ok. Well, I didn't have pain or anything, but when I wiped I did see some fresh blood. And I had some itching today with it. I had a similar situation prior to the CRS telling me everything was healed, where I got constipated which caused some blood. Needless to say, this scared the crap out of me this morning! I guess the area is still quite sensitive? I have been a bit cocky with my diet lately, drinking beer quite a bit days in a row which I think may have dehydrated my system a bit and been part of the reason I got constipated.... now I realize that I really need to keep up the fiber and good diet and cut my beer intake way back (thinking about once a week). I should have known the area was still sensitive as it just recently healed up. This was a bit of a wake up call..... Anyone else here experience anything similar to this? Also, what do you do if you feel like your constipated on the toilet? Is it best to just hold back and not go and wait until it's able to come out more smoothly? Any advice would be appreciated. I really need to get back to my better diet again though, this morning was a huge wakeup call. How long after surgery is that skin down there still quite sensitive?

From what I have read, it takes almost a full year for the skin to return to normal. I would def. cut back on the beer, to maybe once a week!! are you still eating high fiber?? I would also take the Miralax to continue to have smooth soft BMs. I am not ready to give it up yet. Many have had a little blood weeks after they were healing so I really don't think that is abnormal. Go back through the threads lots of info

I've had blood ten weeks after LIS. Its usually because of a bit of hard stool. I think its best to go to the loo when you can naturally have a BM without straining. Not that I can always manage that, its so tempted to try and just be sure you've got everything out. Do keep up the high fibre diet, I think its more of a lifestyle change as a opposed to something to do temporarily, once you've had a fissure. I do the high fibre thing and hardly any alcohol and I still get a bit constipated so I think it can happen to anyone really. I suppose we've just got to try our best to keep it to a minimum. Good luck with it, it should heal up soon in any case!

I have noticed too, if I skip a fiber dose it will come back to bite me.

It is so important to stick with the regime of eating right/ drinking plenty liquids/ and stool softeners.. I'm so scared of this awful pain that I had last month that made this gramma cry :(..
Hang in there sweetie and plz take care.. God heal us all..

I think I got a little too excited when the CRS told me it was all healed up except a little scar tissue that should strengthen over time. I started skipping fiber a little bit and eating pretty much carelessly, not to mention lots of beer multiple nights in a row! Wasn't the smartest thing to do. I guess you could say that I celebrated a bit prematurely! I should have known that the skin down there is still super sensitive. I strained and probably had a bit of a re-tear of sorts, that's what now it's a bit itchy again feeling like it's healing again, but I'm not getting discharge again though, so that's good. A minor setback I suppose, but it was a big wake-up call! Had normal BM's these couple days after that bout of constipation and the blood is gone, so it looks like things are on their way!
I realize now that I need to stick with this high-fiber diet even longer after the initial healing as the skin is still not as strong down there. I've got a good regimen that works for me, gives me BM's in the morning before I even leave for work, if you guys are interested: Bowl of Quaker Oatmeal in the morning with a slice of hi-fiber bread, then at work I have some triscuits which are good in fiber and a nice snack. For lunch it's California style mixed veggies that I cook up at the beginning of the week with a little olive oil, then later in the day I'll have some blueberries with green tea (I think the blueberries REALLY help), and then near the end of the work day I will have mung bean sprouts with more green tea and water. Dinner varies when I get home. I have another dose of my fiber supplement after dinner. Then before bed 1 more dose of the fiber supplement (so 3x a day for that) along with my 2 stool softeners.
Basically after this setback I had a few days ago, I've gone back to my pre-surgery diet! And I decided to have beer only on Friday nights, but to be sure to follow up with lots of water before bed, and of course the diet that I mentioned will be the full day of that.