Butt Pain Question (Morning vs. Evening)

Hello All;

Quick question (truly).  I'm trying to be patient with healing this fissure and while I'm making progress, I'm still dealing with a lot of pain in the morning hours and then almost nothing by day's end.

Fissure experts (by knowledge or experience) . . . is this normal?

My normal bathroom time is early morning (usually around 5am) and while I have just a small amount of stinging pain during and immediately after and during my treatment (soak, wash, ointment, etc.) once I'm up for the morning (about an hour later) it's really tight a painful after about 5 minutes standing or sitting up right.

So far, I'm trying to tell myself that it's caused by just the fact that my body is now pressing down on it just due to gravity and pressing on any wound is GOING to make it hurt.  Usually by noon to 1pm, though, the pain is less and by late afternoon, it's very minor.  But it all starts again in the morning.

I even find that on the rare occassion that I have a pm movement (has happened a couple of times this week), I still never experience the same pain that I do after my morning elimination.  Is there a difference in the two?

I'm not sure if your pain issues are normal, but in my personal experience I can say that has happened to me.  I think it is because overnight we continue to have "peristalis"  (where the smooth muscles actively work to push things out/digestion).  By the time morning comes (or routine) so much is waiting it built up pressure on your already inflammed and injured area.   Again in my experience, subsequent bowel movements later in the day are not as uncomfortable as the first, unless it is before the pain from the initial bowel movement has subsided.  

Also are your bowel movements "different" when you go?  Prolonged sitting, variations from diarrhea to constipation (and straining) can aggravate it.  

Since I've had the DS (still very new) I've noticed I have to be even more aggressive with my hygiene or I get flare ups.  I'm not sure if this is true to everyone and this is very embarrassing...but since I do not absorb fats the same I occassionally leak grease (especially if I happen to pass gas).  Also if I am not careful which kind of wipes I use, I can get more irritated.  My "flare ups" have only happened twice post op, but I know to be on top of it after living with this for almost 11 years since the birth of my daughter.  I swear by homeopathic remedies as well and take them at the first sign of any irritation.  I refuse to go through being in so much pain again that it hurt no matter how I tried to position myself...for weeks/months!  Out of desperation, I tried the homeopathics and I have never regretted it since. 

Sorry it's taken me so long to reply.  Sometimes it's hard to find my posts and see what others have said and last week was opening week for the symphony, so very busy.  I think you're right.  While I'm still healing, and notice small but definite improvement each day, I have noticed the length of pain has shortened in the mornings.  Yesterday was a trying day.  I've also come to the conclusion that I have "borderline" internal hemorrhoids.  Borderline meaning, they have not passed the opening, but I believe are close enough, right at the cusp, as to cause pain (from what I've read, you cannot feel pain from internal ones).

I believe in natural healing, but medicine is so prevalent (sp?) today that I've gotten used to it.  I'm going back to basics with this fissure and I think it is helping.  I found a wonderful cream for healing cuts, burns, etc. that has chamomile, golden seal, cocunut oil and calendula root in it.  I've been using it liberally since Saturday and I notice a marked improvement.  I have no pain whatsoever now when I apply it and as recently as Sunday morning, I could still feel a white hot "sensitivity" go through me when I touched the actual fissure in the process of applying the ointment.  I did add some additional golden seal powder for extra strength since the cut I'm trying to heal is under pressure.  In fact, it's also supposed to be good for hemorrhoids.

I'm still using the muscle relaxer to prevent spasm (especially in the mornings) and warm water soaks.  I also found what appears to be a good personal or "travel" bidet by Washmate on Amazon and I'm gonna order 2 so I can have one at work. 

I stopped using toilet paper back there immediately after surgery because the stools were already different - more like what you'd find in a baby's diaper - and I wanted to be sure I was clean.  I've been using the Pampers Sensitive moist wipes.  At work I was using Charmin flushable wipes, but they have perfume and my rear has felt better since I stopped using them.

I would love to talk to you about the homeopathic remedies you use.  I've been using Yellow Root to make mouthwash since childhood.  At the first sign of oral irritation, it comes out.  I keep a bundle in my fridge and now I will be keeping this ointment on hand always.  I plan to at least be using it daily til year end, though my goal is to heal this darn thing completely by the end of October (my colo-rectal follow up).  It will be a part of my daily bathroom ritual though and will be stepped up at the slightest indication of irritation.

I think modern medicine is great, but there are remedies and healing agents that have been out there since the beginning of time - they should not be discounted.  So far, I've been very happy just with the changes I've made so far.  Yes, there have been difficult days (yesterday was one), but you have to recognize that as miraculous as the body is, it has needs and the best thing for healing is time.  We want a quick fix and you can't always get it.  I was hoping for a relatively quick healing early on, but I've gotten to the point now that I'm in no hurry.  I see the progress and am content to be patient for the full healing.

I believe this is completely normal and part of the healing process.  I have just got past this part of the process and couldn't be happier.  Once I got rid of the shards of glass pain I had just what you are talking about for about 1 month longer and then one day I realize there was no pain.  Try to take extra Magnesium as this helps with spasms which is the pain you feel after a BM. 

Keep up your routine and especially the soaking part even if there is no pain.  I still do that nightly just as a precaution plus it's getting cold here so I need to keep warm

I would rather go through my surgery plus all the complications I had rather then deal with a fissure again. 

Kathy

You KNOW It!!  Yes, I'm taking Magnesium with each calcium dose - started increasing that this week too - and still using the Nitro compound muscle relaxer the doctor prescribed.  I normally do a soak after my first bathroom appointment which is around 3am.  At my 6am appointment I usually just use the handheld with comfortably ho****er on it for a bit.  Then I soak again when I get home.  On the weekends, I'm free to soak three times per day.

Thanks so much for your reply.

May I ask?

What is a fissure )as it pertains to DS)?  I don't see the fissure threads often but it seems to be related to recovery from the DS....is this a possible side effect?

Thanks!

A fissure, specifically an Anal Fissure, is a tear in the sphinter muscle of the anus.  It is quite common in the general population from any age, including babies, but is slightly more common with the elderly.  The tear can occur from passing hard stools, unchecked constipation or it can occur from chronic diahrrea because the toxicity of the liquid stools can irritate and weaken the skin the eventually result in a tear.

It is something that CAN happen with anyone who experiences constipation/diahrrea, but as it relates to DS . . . .  as you may already know, the calcium we take is constipating to varying degrees regardless of what form you take.  Most everyone has developed a regimen of water, fiber and aids like stool softeners/miralax daily to combat the constipation inherent with taking the doses of calcium that we have to take.  There are a few fortunate souls who do not experience it quite as much and can handle it with sufficient liquid and fiber in their diet, but for most of us, that's not the case.

Because that area is literally just delicate skin, muscle and nerve endings, a fissure is quite possibly the worst pain imaginable.  Some have said it is like passing shards of cut glass, which is an accurate description.  It is also difficult to heal because it's not like a cut or scrape on your arm where you can apply something topical and protect it with a band-aid.  An anal fissure is going to be contaminated with waste everytime you have a bowel movement - no getting around that, plus being on a sphincter muscle, it is constantly under pressure.  That makes healing a fissure very tricky.

Trust me, it is much easier do prevent a fissure than to heal one.  I've been trying to heal this one for just over two months now.  I'm making progress, but it is a painful business.  There is an outpatient surgery that some have said is quite successful, others have said it's the worst experience they have had.  If it can heal naturally, I have no desire to have surgery . . . not an option right now anyway since I'm on Coumadin . . . my colo-rectal guy won't even discuss it which is fine with me.  Others will tell you that healing a fissure is possible with patience and determination, but it is not a quick process.

With me what happened was I had gotten off of my supplements and was a little to gung-ho getting back on the wagon back in June.  I should have done what I'm doing now and started with one calcium dose, observing how my body reacted and making the necessary dietary adjustments to soften stool, then added a dose, slowly.  But, like you, I honestly don't recall seeing many posts about terrible constipation and fissures until it happened to me.  It's not that they weren't there, just wasn't a part of my consciousness, I guess.  While I have no regrets about having the DS almost six years ago, what I wouldn't give to go back to June and and have a do-over of the last three months.  But, I can appreciate all that I am learning as a result and I am pretty confident that once I get this thing healed and continue with everything I have learned, I should have no more problems in the future.