So I've had pain after pooping for about 10 months now. 2 months ago I fixed what had caused me constipation. My stool is soft, but the pain and random blood is still there. I had a colonoscopy, showed nothing (and cost me $1500), went to the GI dr for a follow up appt today. He did a digital exam and pushed hard in random directions, and I felt no pain while he was doing it. He said if I had a fissure, it would have been excruciating. I had been under the impression that it's a fissure, but is it? I have no pain while going to the bathroom, I'll clean up in the shower, then lay down, then 20 mins later I get this BURNING pain. It almost feels like my skin is super irritated. Like if your skin gets dry but you keep rubbing it. This lasts for hours sometimes, just a horrid burning. I've been dealing with this for so long now, it's taken over my life.... thoughts?

Hey Treerootz...first of all a warm . Sorry to hear about the pain you are dealing with.

Here are some thoughts --

It could be a fissure, it could be a hemmie, it could be a papilla (less likely) that is irritated and bleeding a bit. Bottom line is I would go see a CRS who will look up there with an anoscope...GPs miss a lot down there.

It is odd that you felt no pain on examination -- i remember when I was examined with my fissure that way...i almost hit the ceiling.

have you tried any of the fissure creams in general to help reduce the resting pressure of the sphincter muscle. The pain may actually be spasms rather than a cut...the blood may be from a hemmie or some other minor irritation.

I would try and use heat compresses before the pain hits...try it out. Perhaps the extra blood flow and relaxing heat will prevent the searing pain...if not, try cold in the area (that used to help me from time to time0.

Hopefully others will chime in with other advice and thoughts.

all best - canadabum

Yeah I thought about doing the CRS. He said he'd refer me. I have little faith he will have anything that can fix this. If it turns out this isn't a fissure that would be great, but until I ACTUALLY find out what's going on, I'm desperate for pain relief. It's odd because 3 days ago I went, had no pain, got in the car to go to work (45 min drive that's excruciating) and only had minor discomfort. Today, no blood, extreme pain. Probably some of the worst I've had. I had recently started taking fiber and the stool is much bigger, but seems to hurt less the last couple days, until today. I'm lucky I had work off today otherwise I would have been DYING at work. Thanks for listening to me, I appreciate the reply. I'll try the heating. I do think I have spasms. I can't fee them necessarily, but the muscle seems REALLY tight for a long time afterwords.

This is exactly my issue right now - I'm recovering from two fissures that are completely healed (my physio can poke around without pain) but the sphincter is constantly extremely tight.

I was told by my surgeon, gastro and pelvic floor physio therapist that this is most likely what's going on:

- the fissures created injury and scar tissue in the area as well as skin tags that can be sensitive
- when I have a bowel movement, the muscle is able to relax a little, a natural response to having a bowel movement
- because there is no acute injury/open sore, it doesn't hurt when I have a bm as the muscle relaxes
- I feel no pain for about 15 min after a bm and then BOOM the burning starts - the muscle at this point is back to squeezing really tightly
- this puts pressure on the sensitive areas and potentially injured nerves at the fissure site
- standing or sitting in certain positions also causes the burning to start, as it increases tension in the pelvic floor
- the pain then causes the muscle to tighten further, protectively

It's a vicious cycle just like when I had an open fissure - so I've been told the best solution would be the LIS surgery, to help lower the resting tone of the muscle.

Because you have bleeding, I would say you either must have a fissure or hem that's bleeding....is it possible you had a fissure at the beginning of this? It may be, like me, a situation of sensitive scar tissue in a cycle of muscle contraction and pain.

Don't know if that helps at all but I've been on a long journey trying to figure out why I still have burning after my fissure has healed!

-GG