Hello,
As I mentioned in my introduction thread, I recently went to the ER after waking up in extreme pain last friday. It is now tuesday and I still find myself heavily relying on the painkillers prescribed to me to get through the day. The primary issue that I'm currently having is extreme pain when trying to have a BM. The pain is so extreme that most of the time little if nothing at all comes out. I find myself having to go back over and over again but I never fully feel like i'm emptying out. Mornings seem to be the worst, and then as the day goes on, i get better and better towards the end of the day (not sure why that is.) But I still have some level of pain that follows me throughout the day.
I realize that one of the issues is when I have a BM, it feels like my sphincter muscle is clamping down super hard around the stool that is trying to pass through, and this is EXTREMELY painful. The pain gets even worse if I try to fight against it and stretch it back open. I'm drinking a lot of water, taking dulcolax stool softner, and eating pleanty of vegetables and grains, but even if the stool is soft i'm gettting this extremely painful BM. I called back to my CRS office today, and they basically told me to keep doing what i'm doing and it should get better. My issue is, I'm supposed to return to work on thursday, and I'm concerned this will not get better by then. I work at a office where I have to sit most of the day and often in meetings. With the type of pain i've been going through these past 5 days, I don't know how i can make it through 1 work day, or even drive to and from work.
I'm hoping there are some tricks to the trade on here as far as trying to relax that sphincter muscle do that it doesn't clamp down so hard when trying to pass stools. I know i need to do more sitz baths, but its painful for me to sit on a sitz bath for more than 5 minutes. I can lay down in a bathtub, but its difficult to do that multiple times a day. Any extra advice would be appreciated.
Thanks
Chibi

Hi Chibi,
I would suggest trying another laxative like miralax. A lot of people here have had more luck with it than dulcolax.
You can also try sitting in more of a squat when you go. Get something about 7" tall to prop your feet up, say a stack of books or a bucket.
Breath into your belly when you are having a BM.
Some people on the forum have found pain relief from coconut oil. Also sweet bee magic cream. Or just some plain old vaseline petroleum jelly as lubricant before you have a BM. That way the stool doesn't rub your AF and even slips out easier.
You really shouldn't strain at all. It will make it more painful and stop the AF from healing.
You might also look into a second opinion from another CRS.
-Tanya

Workingonit replied with lots of info while I was tapping this out on my iPad, but will post it anyway
Sorry that you have found us, so to speak, but welcome to the forum!
It sounds like you are experiencing spasms, the bane of most of our lives here. You cannot control the internal sphincter, only the external, and it is the internal that spasms and stops healing of a fissure. When it spasms, it is difficult to get a good flow of blood to the region, hence the difficulty in healing and the use of a baths to get the blood flowing down there.
You will see that most here suggest using Miralax. I use MOM, and eat very lightly. Still each BM is hell and spasms take time to settle down afterwards. I only sit on the Sitz bath for about five minutes, change the water, and do it again. Three times in all.
There is no one size fits all on here, so difficult to say what works for me might work for you. Just trial and error and research on here and on the net. Going back to work is an individual thing, so hope that it works for you.
Best of luck and hope some of what I said helps.

Thanks Tanya and Sav. I have some MoM at my house right now, so I'm going to go ahead and try that. If MoM doesn't work then I'll get some Mirilax.
I will also check out the Vaseline. I'm willing to do almost anything to get through with this pain. I'll let you guys know how the MoM works out tomorrow.
Thanks
Chibi

Ask you CRS to prescribe a muscle relaxer (like Flexeril) or Valium. Valium has worked wonders for me. It does a great job of relaxing the sphincter muscles. You just have to be very careful not to abuse it or you can become addicted.
If you can't sit in the bath, get a removable shower head. It's a great way to keep everything clean and relax the muscles at the same time. I turn the water on as hot as I can stand it and spray directly into the anus for several minutes. Most removable shower heads have multiple settings, so you can find a setting that is comfortable for you.
You can also use a heating pad, which can help relax the entire area.
If none of this works, you may want to check into biofeedback. This can train you to relax the pelvic floor muscles. The sessions are expensive, but well worth it. I have had four sessions and I'm already seeing results. Studies have shown that 85% of participants are able to significantly relax their sphincter muscles after 9 sessions. By relaxing the sphincter muscles, bowel movements are easier to have, which can help reduce the spasms.
Good luck!

Hello all,
So I wanted to give an update as to my status. I took the Milk of magnesia last night (3 tablespoons). I woke up this morning at about 5 am feeling like I had to pass stool, but when I tried, I ended up passing a bunch of gas. An hour later I tried to pass again and found myself having the pain with only a few pebbles of bm passing. I then decided to lay on a heating pad for a while. When I got back up I ate some oatmeal and then I FINALLY passed a large BM. To my surprise it wasn't as painful as in the past (though there was still some pain), and I don't seem to be having high amounts of pain afterwards. I'm currently sitting on a heating pad again. I still don't feel like I've completely emptied out, hopefully this will begin me being more regular.

One day at a time. That's the hardest part, getting your digestive system in order.
AFs take a lot of patience.
Tanya

Hey guys,
Wanted to give another update. So far after having taken these antibiotics a few days along with my high fiber diet, I've noticed a great drop in pain while having a BM and post BM pain seems to shorten in duration to almost only 30 minutes! That's right 30 MINUTES! this is literally the first time since august of last year where the majority of my day is not spent in pain. It makes me wonder if the fissure or rectal tissue had been infected all this time? Hopefully the pain with BMs will continue to go down. I still get sore if I stand for too long, and I'm also still sore when I first wake up in the mornings. I did however drive an hour to a wedding and sat at it for 3 hours without any pain last night. I've stopped using the percocet and lidocaine for the past 2 days.
For the first time in a while I feel like I see a light at the end of the tunnel. Ill keep repairing back to let you guys know how it goes.

Glad that you are seeing an improvement. Just keep on the road that you've set yourself. Read through what others have done on here. Steady as you go, so to speak! It takes time, and there can be setbacks. But, we are here.

What's MOM and what does it do?