Apes,
The one major thing I've learnt is that in the situation you describe above, do NOT continue to try to go, even if you feel you need to!! This is a tough one because there is such a sense of relief after having a BM that you just want it to happen and get it out of the way for a few hours! It was a big mistake for me because this is what prevents you from possibly healing more quickly & sets you back a little again.
Internal piles do not help at all because they can increase the rectal pressure and make you feel you need to go, especially if your bowels are more sensitive as mine are. They can also make you feel (when aggravated) that you haven't completely evacuated and then we get that urge to push a little more again after we've actually expelled all we need to at that time. It's really important to truly recognise your body and the sensations that go on in your bowels so you can determine when you do actually need to go properly. This isn't easy though but comes with time. As we cant physically see the internal hems, it's hard to judge the impact they have on our BM's & bottoms but they do have an impact! so just be aware of them.
I have read a lot about these urges and the sensation that your bottom feels like it's going to "fall out" after Botox and would say have a look for the Botox diaries - there are many and these might help reassure you that what you're going through is pretty normal stuff! :)

ETO, your the best. Since my first post in this thread, everything you said is spot on. I have learned a lot about the feelings and how I need to react. These days when I have to go, it's almost coming out already as opposed to the " feeling" of I need to go. And yes it feels like I have not emptied all the time, but I know that this is the internals screwing with me. I have adjusted my behavior and have been doing really good the last week. I wish everybody here can heal and have relief of this horrible affliction.

Thanks Apes! :) I think it's having had to deal with this for so long, you do learn some really important things about your body and your BMs....Just like you, I'm the same! I "go" when it's there and ready, not necessarily when I feel just an "urge" - which can sometimes be an IBS reaction or a hormone surge or even trapped gas. I've really had to learn to distinguish what a proper urge is and one that isn't! I'm convinced prior to my fissure, I spent so many times just sitting on the loo trying to force something out, when I didn't actually need to empty my bowels at all! I've found this quite difficult to deal with but feeling much more confident these days. "Internal screwing" is a good description!! This has really helped me an awful lot in my recovery - Reducing the stress that goes with it all is key for me - if I'm calm, relaxed and focused elsewhere - I don't even think about a BM until I get a proper need to go - This is proven by times I've gone away on holiday etc. and been generally having such a great time and distracted elsewhere, that the whole BM thing becomes relatively minor and I just go when I need to and that's that. Back home, I can become far too focused on the whole routine again and that's not good. My heart goes out to anyone suffering this stuff - it's horrible but hopefully, once people find what works or them in terms of medication and life-style adjustments they are able to make good recoveries and are able to start to put this all behind them.

I'm sorry you are going through this, Apes. I hated that awful bottom pain when walking. Blood is scary, but it doesn't seem to indicate bad problems - I think everyone gets a little blood from time to time.

I hope things go better for you today.

last night there was some blood on the toilet paper for the first time in almost a month, do you think ive just undone several weeks of progress? it hurt, but only like usual, the only difference was a gave a little push at the end because i felt i needed to.

A little blood may not be a big deal. Don't push, easier said then done sometimes. If the pain wasn't greater it's probably ok. Remember to eat right in order to have soft BMS. I think everyone here would agree with that.

Hi Apes,

Thanks for the post. I had the same scare as you and am on my way to see my CRS this afternoon I am so freaked out that I retore. I have had the urge to go but had the same thing, only gas. It hasn't happened to me as much recently...1.5 months since I've had the botox but I do know exactly what you are going through. It did lessen for me as time went on.

the pain wasn't greater, but as it is, after i go it hurts so bad i can barely hold myself upright for a minute or so. then i take a bath which helps. ive still been going more often than id like, but it is very soft. I gave in to taking ibuprofen, naproxen might work better. Any tips for keeping my mind off this horrible thing? it hurts to walk sometimes, its kinda taking over my thoughts. I gave in to taking ibuprofen, naproxen might work better. ive been considering using decitin and/or aloe, and even going to an acupuncturist for pain management, any thoughts?

Student, I really think you need to see a CRS, if I recall correctly you have not. They can prescribe either nitro or nifedipine and talk about other options. Remember it can take a very long time to heal. I was incapacitated for over two months, had a BM or 3 in the morning and was in so much pain I couldn't do anything for the next 6 hours. So diet, soft, BM and a CRS are imperative..

Midwestgirl,
Let us know how you make out at your appointment. I'm 22 days into Botox so we are in similar positions. I see my CRS June 13. The last week has been pretty good, minor pain more good days then bad. In fact nothing like before Botox. How have you been feeling? Let's beat this thing together!!!

i went to a crs two weeks ago, at first she gave me suppositories with antibiotics and hydrocortisone. i was allergic to the antibiotics, the hydrocortisone made my chafe, and the suppositories made me spasm. She also told me to take mineral oil, 2 teaspoons in the morning, after a few days of that i had chronic diarrhea, so had to stop the mineral oil. she also told me to take fiber supplements, which i still do. Then she prescribed the nitroglycerin cream, it stops spasms, and some pain. I dont know if its helping me heal tho. Then the crs prescribed me betamethasone - another steroid cream. I have not used out out of fear of chafing again. Im supposed to go back to the crs in a week from now to discuss botox. considering how all the previous went, ive been considering other treatments. My faith was never strong in western medicine to begin with. I called an acupuncturist, and he had dealt with anal fissures before. I am skeptic of botox b/c of plastic surgery, and they are using it to treat migraines now also. i dont like to idea of incontinence. a week after i stopped taking the mineral oil im still not "in control" of my bowels when i have to go.

apes- i go to the bathroom in the middle of the night every other night or so since the mineral oil, and also once or twice during the day still. I get the same pain, so i can definitely sympathize with you