AF caused by diarrhea...LIS...Tag removal?

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AF caused by diarrhea...LIS...Tag removal?

Postby Starlit » 28 Sep 2012, 08:30

Hi, everyone! I’m having LIS in 4 days, and I’m looking for any words of advice from anyone who has perhaps been in a similar situation.  To quickly sum up, I believe I have the AF as a result of chronic diarrhea.  That is a different experience than all the stories I have read, but I’m hoping someone here has some experience they can share.  I do not currently have diarrhea because the spasms keep everything inside until it’s not so runny.  (Gross, I know. . . Sorry!)  I am afraid, however, that once things are loosened up, and after my *special* pre-op diet, that as soon as I eat something post-op I’m going to have diarrhea that is going to burn like nothing else. 
 
This will be long, but to provide more details, here is my story. . . . I had my gall bladder removed in 1996 and have suffered from diarrhea ever since. At its worst, the diarrhea was 12-15 times a day. I was miserable, but learned ways to cope. The family doctor never offered any help. Anyway, looking back I think I’ve had a painless fissure for years, or a number of fissures that each healed—whatever the case. When the diarrhea was at its worst, I’d have some bleeding and intense itching after a bowel movement and would often wake up in the middle of the night itching. I always chalked it up to a raw butt from the diarrhea and never sought any help. In more recent years the diarrhea had slowed to a more manageable 4-6 times a day. On the rare occasions through the years that I had a formed stool, it was extremely skinny—I guess because the sphincter was so tight.  The only time I ever had constipation was Christmas time when I would have too much cheese:  cheese balls, cheesecake, cheese dips, cheese platters. . . . you know, all the party foods.  It took me two Christmases to figure it out, so ever since then I’ve been more mindful to not eat too much cheese and diarrhea has prevailed.
 
About a year ago I started making a very conscious effort to eat more whole grains and raw fruits and vegetables. Although I didn’t put the two together for a while, I also noticed that I was often down to 3 bowel movements a day and even though it was extremely soft I had to really push to defecate. About 5 months ago I stepped up my efforts to eat healthy even more, and added a daily serving of nuts and even more raw fruits and veggies, with little to no fat. I was definitely having to push, but was still defecating an average of 3 times a day.  It was almost always so soft that it wasn’t even formed. Again, I don’t know why I didn’t put 2 and 2 together, but about the same time I started having a little bit of rectal pain for a few minutes after each bowel movement. I figured it was the beginning of hemorrhoids, so I started following all the advice: eat MORE fiber, drink more water, use Preparation H ointments/creams/suppositories, wet wipes to clean, ice on my butt, etc. Unfortunately, I just kept getting worse. I’m a school teacher, so I was out of school for the summer, and spent considerable amounts of time doing all the OTC remedies for hemorrhoids and trying to stay comfortable. I had a couple weeks where things were better, with minimal pain, but for the most part I literally cried every time I had to walk into the bathroom. It felt like I was giving birth to a watermelon laced with a thousand razor blades. So many times I would have intense cramping because of the need to poop, but nothing would come out. I rocked, bounced my knees, and sometimes pushed even though I knew I shouldn’t. I would be in razorblade pain because the feces were at the opening—I could wipe and get SOFT fecal matter—but it wouldn’t come out! I would go for a walk, get on the treadmill, jump around, move around, and try to come back in a little while. Sometimes I went through several rounds of trying (crying the whole time) and exercising, just to defecate. At its worst, when the sphincter would finally let loose (or the poop push forward. . . . whatever the case was) it would be like an explosion—so much force that everything would be out of me. . . literally. . . in a SPLIT second, and the pressure was so great that it would force my bladder to expel as well. Because of my tendency for very frequent bowel movements, I went through this agony 3-5 times a day. Sorry for the graphic detail.
 
Anyway, this continued for a good while—me eating more and more fiber because that’s what they say to do—and the pain steadily getting worse. I began having very sleepless nights, about the time school started back, where I was in so much pain that I literally would be awake the entire night. Try teaching school with no sleep! Aaaggghhh!!!! I was in pain during the day, but not near as intense as I was at night. One night, the worst I’ve ever had, I finally got a couple brain cells to rub together and realized. . . . I must not be in as much pain during the day because I’m moving around. What other explanation could there be? So, with tears streaming down my face, I got on the treadmill at 2am. (Good thing my DH is a heavy sleeper.) The pain worsened the first 5 minutes of walking, but I felt like there had to be something to my thought process. Sure enough, about the 6th minute the pain began working in waves, where at least it wasn’t solid intense the whole time. The waves grew further apart, and by about 15 minutes the sharp intensity was gone. I wasn’t pain free, and hadn’t been in many weeks, but the sharpness was gone and I finally managed a little sleep. And, thus ensued my nightly walks on the treadmill. . . 2. . . 3. . . 4. . . sometimes 5 times a night. EXHAUSTED!!!!!
 
I finally decided I couldn’t take it anymore, I sucked up my embarrassment, and made an appointment with my family doctor for “Hemorrhoids”. I told him my story, and he said it sounded more like a fissure to him. “What’s a fissure?” I thought! He examined me for all of about 5 seconds because I couldn’t take any more. He said he didn’t see or feel any hemorrhoids, and didn’t see a fissure, but still suspected that’s what it was. He gave me proctofoam (HUGE mistake—caused immense pain) and set up an appointment for me with a colorectal surgeon a couple days later. The surgeon looked for about 2 seconds (thank goodness he didn’t poke around too much!) and said “Definitely an anal fissure. I’ve seen a few of them before.” His dry attempt at a joke. Anyway, he gave me nifedipene ointment and said to come back in two months, BUT if after two weeks I wasn’t satisfied that I was well on the road to recovery, to come back and he would set up LIS surgery. After asking lots of questions, I learned that the years of diarrhea had made my sphincter very, very tight. Eating more fiber gave more bulk, which was having a difficult time passing through. Add in the resulting fissure, and voila!
 
After my appointment with the surgeon, I decided maybe what I should do is try to eat LESS fiber. Wow! It really helped! I know it’s not the answer for everyone—obviously—because it seems most everyone got their fissure from constipation. But, in my case, it has been a short-term answer to preserve my sanity. Like others on here, there was a time just before I went to the doctor, that if I had been a suicidal person I wouldn’t be here today. My husband thought I was just dramatizing when I told him that, and that the butt pain was RUINING my life! LOL. J When I cut out the nuts, and raw fruits and veggies, the razor blades left! I no longer cry at the thought of going to the bathroom. Yay!!! “But you said you were having LIS in 4 days,” you’re thinking. Yep. The razorblades are gone, but the fissure is still there. I still hurt, I still have some difficulty defecating, I still have sharp pains, and I still have to make some nighttime walks on the treadmill. The nifedipene helped, and the lower fiber helped, but they have only made life more tolerable—not painless and not cured.
SOOOO, here goes LIS in a few days and I’m scared to death. Everyone seems to have constipation issues. I won’t go so far as to say it’s not a concern for me—especially given the pain meds I will be on—but I am just as, if not more, afraid of possible diarrhea. With everything loosened up again, I may be looking at a lot of toilet time. So, I’m looking for advice. The doctor wants me on a fiber supplement and a laxative post-op, but I really don’t know what to expect from MY body.  It just seems that my experience is different than most people’s.  My surgeon is, by the way, going to help me get the diarrhea because of no gall bladder situation sorted out. . . . but we’ve got to get things back to normal first. 
 
One more question. . . . Skin tags.  Remove them or not?  My CRS didn’t say anything one way or the other, and I forgot to ask.  When I talked to the nurse who was scheduling my surgery she put it on my paperwork as a possibility.  I figure if he thought they were big/bad enough he would have mentioned removing them when I came in to discuss surgery.  Does anyone have any thoughts or opinions on the matter?
 
Thanks in advance for any advice!
Starlit
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Re: AF caused by diarrhea...LIS...Tag removal?

Postby jr2 » 29 Sep 2012, 22:35

Starlit,
Has no doctor ever recommended to you the use of cholestyramine or Colestipol for your diarrhea following gallbladder removal? Bile acid diarrhea is a very common after effect of having the gallbladder removed, and tbese medications are very effective for this type of diarrhea because they bind to the bile acids and prevent the diarrhea from happening. It's hard to imagine a doctor not prescribing this for you after all this time?
Fiber... Everyone is so different. My fissures are always worse with a high fiber diet. I focus on a more moderate level of fiber with an emphasis on soluble fiber because I find insoluble fiber to be too bulky and irritating.
Different dictors have different opinions about skin tags, so it's tough to advise on that. Some doctors think removing rhem is a good idea to promote the healing of the fissure. Other doctors feel it presents more problems and the skin tags are better left alone.
Wishing you all the very best!
jr2
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Re: AF caused by diarrhea...LIS...Tag removal?

Postby Starlit » 30 Sep 2012, 06:30

Thanks, jr2!
That's exactly what my CRS and everyone I've talked to at his office has asked me. In all fairness to my current family doctor, I never asked him for anything. Prior to moving where I live now (and plan to stay), I had moved three times in about 8 years, therefore changing doctors as often. I DID discuss the problem with them, and they all gave me the same answer: there is nothing we can do, so eat more fiber. That's why I didn't even bother asking my current doctor. Given the current state of affairs with the AF that won't heal, my CRS wants to wait until after surgery and postoperative healing before prescribing Colestipol. Right now, because of the never-ending spasms, I do not have diarrhea.
I wish I had read a few months ago that fiber, or insoluble fiber, may not necessarily be the answer. Everything I found, and even my family doctor and CRS told me MORE fiber. Had I not been so embarrassed and gone to the doctor sooner, and learned I had an AF instead of hemorrhoids, I might not have suffered so much. After my first visit with the CRS and googling general info about AFs, I finally googled AF too much fiber, and did find a couple things that were helpful. I was in so much pain at that point that I had eaten only one very tiny (but full of fiber) meal per day for over a week because I was trying to limit my toilet time. After much thought and research, I decided to try a low fiber diet. I have not had a single watermelon with razor blades experience since. After about a week of almost no fiber, I started incorporating soft, way over-cooked (in my opinion) vegetables, with no ill effects. I've braved a few well-cooked apples and some canned peaches, but sparingly because I am deathly afraid of the razor blade pain. I hate the diet I'm on, but know that it is short-term. As soon as I heal from my surgery I am going to start incorporating a little more fiber at a time until I figure out what my body can handle. I am, however, still concerned that my diarrhea will return post-op since the spasms will be no more.
I wish I had asked my CRS about the skin tags, but I guess I'll do that just before surgery Tuesday. I have read the healing time for LIS is longer with skin tag removal. I also find varying opinions from AF sufferers about having skin tag removal. It's all a bit confusing. :-). I'll just go with whatever my CRS recommends, I guess.
Thanks for your reply and words of encouragement!
Starlit
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