Hello,
My name is Tami, I'm 38 y/o, married and have 4 kids. I've been reading through this site since Monday and am so impressed with the compassion and knowledge you all have for one another. I hope you can help me out.
I hope someone here can help me figure out what is causing my horrific pain so I know how to properly treat it. This past Sunday night on the way to bed I went to the bathroom not feeling anything unusual like being constipated or stomach pain. What ended up was 3 hrs of the worse pain in my life and I've given birth 4 times ( 3 sections, 1 VBAC natural, suffer from horrible migraines and had stage 4 endometriosis and 4 laps to manage that so I know a bit about pain ) and I have never ever felt anything like this. I had been sick for about 3-4 days and hadn't eaten much, therefore hadn't really had any bm's and honestly hadn't thought about it. Having never suferred from constipation and going regularly without the aid of laxatives, I've never really given a whole lot of thought to my bathroom habits, so what happened Sunday, was a total shock to me. I had to manually disimpact myself, which is horrible for anyone, but especially someone who has never been constipated to this extent. As I was in the process of the disimpaction I felt around the outside of my vaginal area and I could actually feel the stool packed inside and I couldn't believe the extent of the constipation. Also, I have never had hemorrhoids in my life, even after 4 kids. But as I was tending to my bathroom problem I could feel what I believe to be a hemorrhoid suddenly there which didn't surprise me after what my bottom just went through and I figured I would be sore the next day, maybe even the next. What I didn't expect was what I've been going through since then, which has been horrid.
I can't have a bm without feeling like liquid lava is pouring right through me. I've screamed, prayed -loudly and while crying - begged and cried while having a bm because the pain is almost more than I can handle. I've read just about everything on the internet about what I have and how to treat it and I've come up with an AF and am leaning towards that heavily because of the descriptions of the burning and severe pain when having a bm. But then I have this hemorrhoid, or what I believe to be a hemmie on the outside of my rectum, well actually it kind of looks like it's snaking out of the top of it. Of course not being in the best position to see it, I asked my husband to take a close up pic of it ( yes gross, but I need to know what it is to treat it effectively ) and it does appear to be a hemie at the top of my rectum. I don't know what is causing me the pain, inside or out. I've read of internal hemies prolapsing out, external hemies, AF, anal skin tags, etc. I'm so confused I don't know what the heck this is and how to treat it. I have bought every Prep-H product, tucks pads, use vaseline between bm -no help-, some cream called balenol, zinc oxide, and I do the sitz baths all the time. Here are my symptoms. Could someone please give me their best guess. I realize you all aren't doctor's but I have no insurance and well, with 4 kids money is tight. I was wondering if maybe the trauma of the constipation and disimpaction that night just caused me to be sore and it will get better except for the hemie thing? Oh, my husband did say that my hemie had gotten smaller since he looked at it Sunday, that's good right? Sorry for all the questions. Please help!!!
Symptoms:
Severe burning with BM
After BM blood is present on TP also with mucus
Pain is always there even after sitz bath
Anus seems very tight when trying for bm[b]

It's really not possible to know what is the cause of the pain you are having, and really, if it continues with good home care you really will want to have a doctor check you out. The constipation could have caused a fissure, or it could aggravated a hemorrhoid that needs time to calm down. There is also the chance that a hemorrhoid has thrombosed. There is also an outside chance it is an abscess. In any of these conditions the anus will be tight as the internal anal sphincter is spasming in response to the pain, regardless of the source.
Keeping bowel movements soft in whatever way works for you (fiber, water, stool softeners), taking sitz baths to encourage relaxation and improve circulation, and elevating your legs when you are sitting or lying down will all help. Lubricating with something like Vaseline before a bowel movement can help reduce pain during a BM. You can also try gentle therapy with ice (insulating the ice with a washcloth so it doesn't get too cold) to help with the pain.
Don't put off a doctor visit for too long if the pain continues at the same intense level with no improvement. With conservative measures at home you should see improvements in the coming days, not worsening pain.
And above all if you develop any sign of fever or increased redness in the area, seek medical attention.

jr said it all.
You wouldn't put off the doctor if it was one of your kids, and your kids need you to be healthy. So for their sake, see a doc.
To me, because you don't mention blood, it sounds like a thrombosed hemmie. So there is a good chance a doc can help you with that right away.
This is just my opinion.
In future, you need to keep an eye on how much fluid you drink. It is so very important to stay hydrated.
I sure hope you feel better soon!
-Tanya

I am new to this forum too, so I cant give much advice, but I would say drink plenty of water, get something from your pharmacy that will make your stools soft, and eat plenty of veg, I made sweet potato and broccoli soup the other night and my stools were amazingly soft the next morning. Best to see a doctor, I thought i had internal hemmies for four months until my doctor told me as it was so painful it probably is an anal fissure.
Good luck and keep us posted.

I agree with jr and workingonit that it is possibly a thrombosed hemmy, though can't say for sure, only that you should take yourself off to the doctor. Having had a thrombosed hemmorhoid, I know what hellish pain that was and I took myself off to the doctor.
So best bet=doctor.
Feel better soon.

Thanks everyone! I've investigated the thrombosed hemmy and unless it's inside where I can't see it, the one on the outside is not black or blue. Most of my pain is from inside. I do have blood after my bm when I wipe. Never in my undies or when I urinate. It also hurts down there when I cough - I didn't even know I used those muscles to cough. I'm looking for a doc in my area that specializes in this problem. I just have to make sure that I use that money wisely. In between bm I am sore down there and sometimes get pressure. In looking at the pic my husband took, my area looks normal (to me) except for what I believe is the hemmy, which my husband says has gotten smaller since Sunday when this happened. Of course we aren't doctors, but our financial situation is not good, so if I have something that I can treat at home and it just takes time to see results, than I of course want to do that. I'm just trying to gather as much info as possible.
Any advice on how to handle the intense burning with my bm?
Thanks!

Ice wrapped in cloth works wonders x

That does sound more like a fissure. But still worth getting checked.
A lot of people here lubricate their anus with a bit of vaseline petroleum jelly before their BM. So it slides out easier. Then jump in a stiz bath after to ease the spasms. I don't get spasms, but people say they can feel like a burning sensation, after the BM (sometimes hours after). The only real relief seems to be warm water or a heating pad. Or ice like jinglecy says. The ice might be nice on your hemmie too.
There are over the counter analgesics, but most people say they either don't do squat or they are irritating.
Everyone seems to be different.
My doc says to keep the area as dry as you can. So when not in the tub, a hairdryer is great and kinda soothing too. Bit of an acrobat act though :)
-Tanya

Just went out tonight and bought a sitz back that fits on top of the toilet. Um, hate to sound stupid, but how in the world does that work, I mean I'm a big girl - 6ft tall - and so I have bigger "parts" is this a one size fits all or am I missing the point of how this works. I have just been using the bath tub but it's getting harder and harder to get in and out 4x a day and figured the sitz bath on the toilet would be easier.
I also have Lidocaine Jelly. I wondered if that would be good to use before a bm? Has anyone here found that a little in your rectum before bm helps the burning?

Lidocaine hurt like the dickens when I used it. Vaseline was the only lubricant that gave me no problems. My Sitz bath fits over the loo, but I am 5'6" so had no problems. If when you are sitting on it and your tush does not rest in the water, you will have to go back to being in an ordinary bath. I soak every time pain is too bad, and also in-between pooping, to relax the anus. Oh the joys...