Sharp pain during BM after fistulotomy has healed

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Sharp pain during BM after fistulotomy has healed

Postby Cporosus1 » 07 May 2015, 16:40

Hi everyone,

My fistulotomy wound healed about a month ago. For the past week I have had a sharp pinching pain from near the wound site when I BM and it aches for a bit afterwards. I have noticed some of the other parts of the anus are tender as well. There is no discharge. In two of the dozen or so bowel movements I have had since then I have noticed a very small, tiny faded bit of blood. I am curious as to if I have hemorrhoids, a fissure or if it is the scar tissue hurting. It still aches if I press lightly on it. Is this all normal? Anyone have similar experiences? I saw my general doctor the day prior to the pains developing and he said the wound was all healed up but that I had a scar and that my anus itself had "cracks" from moisture/drying. I asked it they were fissures and he said no. I scheduled an appointment with my CRS for Monday, but I'm beginning to feel like a hypochondriac, but I'm just so paranoid about any pain in that area now.
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Re: Sharp pain during BM after fistulotomy has healed

Postby msimon » 07 May 2015, 23:09

Maybe you have cracks in the scar tissue forming when it stretches during a BM. After having my last surgery I get this with BMs and my physio says it's because scar tissue is very weak and doesn't stretch well. My CRS says I may get some blood at this site for years to come because it takes 1-2 years to reach 80% of its original strength. My physio thinks it needs to be mobilized/softened, which is to say controlled stretching. Maybe something to talk to your CRS about. Of course it could be hemmies too. Hopefully your CRS can put your mind at ease on Monday. Let us know how it goes. My fingers are crossed for good news for you.
Dec '13 Fissure from anoscope
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Re: Sharp pain during BM after fistulotomy has healed

Postby Cporosus1 » 07 May 2015, 23:29

Thanks msimon,

That's what I assume as well, since there is no discharge and it's been going on for about a week now (has gotten a tad better) with no formation of abscess or anything. It feels very similar to the pain I had during the last tiny bit of healing in early April. My surgeon is a tad on the quiet side and "quick to get me out the door" but he is very good at the actual surgery and diagnosis, so I suppose I need to be straight to the point with him haha
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Re: Sharp pain during BM after fistulotomy has healed

Postby msimon » 08 May 2015, 01:53

Oh I hate it when they go to run out the door before you feel like your issues have been addressed. I guess you'll have to be ready and armed with your questions.

I have started using coconut and vitamin e oil on my incision area as I find that it starts to feel really 'weird' when I haven't moisturized it for a while (like half a day) or when I bathe too often or in too warm of a bath. It almost feels like it's tight and pulling. I think the tissue gets dry and is more vulnerable to splitting then. I wonder if applying something like oil, especially before a BM, would help soften the tissue and prevent it from cracking. Alternatively, you could just use petroleum jelly. Many on here are big fans of coconut oil though.

Hopefully your CRS will be of some help. I think they can be too quick to dismiss themselves from our care when they see the wound is 'healed' and don't really want to hear you are still in pain. At least, that's a lot of what I hear. I haven't reached that stage yet myself.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Sharp pain during BM after fistulotomy has healed

Postby Cporosus1 » 08 May 2015, 02:04

Thanks msimon

I've been using the PH witchhazel wipes and the PH suppositories. They help a bit (the witchhazel seems to make the pain less sharp and the suppositories make the BMs smooth and they don't hurt), but I think I need something specialized for the scar tissue itself. Coconut oil sounds great, I will ask my surgeon about that.
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Re: Sharp pain during BM after fistulotomy has healed

Postby chachacha » 08 May 2015, 09:02

My friend did her thesis on IQ's, and determined that once an IQ exceeds 125, the EQ (EQ=emotional intelligence=people skills) starts to drop. And since 140 is the average IQ of a surgeon, it makes sense that their bedside manner isn't always the best. It's always a tough call to go with one who is not overly communicative, but that may be in your best interest on the skill front though.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
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Re: Sharp pain during BM after fistulotomy has healed

Postby msimon » 08 May 2015, 10:39

lol Chacha! That's funny but I would have to say also true. Many of the professors I met when I was in University fit that description as well. I think it is even a stereotype of them.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Sharp pain during BM after fistulotomy has healed

Postby Cporosus1 » 09 May 2015, 03:40

Update- I started using the fractionated coconut oil this afternoon and it already appears to be working wonders. Granted, I've only had one BM, but it's made the area seem much less tender and I can barely feel it now. Hopefully this continues to work!
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Re: Sharp pain during BM after fistulotomy has healed

Postby msimon » 09 May 2015, 12:58

So glad you have had a good result! Many on here swear by it. I have been using it myself recently. As for the witch hazel, it can be drying (especially if it contains alcohol) as it is an astringent. It works great for swelling but maybe not best for new skin, IMO.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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