4 Weeks After My Hemroidectomy. When will the pain stop? + My Learnings So Far.

How is the pain for you at this point in time?

It's up and down.

Nothing I'd read could prepare me for the first 2 bowel movements (day 4 and 6), that has to rank as the worst pain I've ever experienced, but it's been a gradual improvement since; from a 9-10 (unbearable) down to 6-7 (tolerable) out of 10.

I would say half my problem was psychological and I was prolonging the experience due to fear of the pain, and the other was not squatting.

I would say when the urge comes, let it happen, get in the right position, and breathe deeply through the pain.

I have been having exactly the same experience. But I'm 20 more days ahead than you. The psychological horror was indeed the worst. I did however expect that the pain after 30 days would be less than it is now during BM.

Any thoughts? Are you taking different meds / timing your pain meds before BM?

Before my experience I was taking , paracetamol ibuprofen and codeine on a 3 hour schedule and was barely coping.

Yesterday though, I had my first bowel movement without pain relief and surprisingly without pain as soon as I awoke. I put some water in my sitz bath and placed it on the floor, so i could squat over it.

During the rest of the day I felt like a new person and only took ibuprofen a couple of times and managed to help around the house for the first time since coming home.

Just before bed though I had a slightly painful movement and feel sore this morning. I think this is because I stupidly stopped taking my stool softener (dulcosate).

I'm now convinced the pain is caused by pressure from a build up of stool and gas which squatting helps keep that under control.

I've also restarted my dulcosate and keep having weetabix for breakfast and some Fybogel during the day.

I've also stupidly ignored the no caffeine rule as am a fresh coffee addict.

My squatty potty arrives today and keeping my fingers crossed this wasn't a blip!!

How was the transition into the painless BM? It's supposed to be slightly better each day right?

Would you say that squatting could be better / more beneficial than the squatty potty? I might try that once to compare.

How is caffeine impacting the pain? It doenst right? Caffeine just stimulates BMs. But as long as you only go once per day anyways, a cup of coffee wouldnt hur right?

I went for a checkup to the doctor today. He basically said there were no complications are that I'm just an unlucky case. He said I have a very low pain threshold, which I dont buy based on my medical history.

I had quite a bit of pain again yesterday, but as soon as I gritted my teeth through the pain I realised why; I had another large amount of stool that had built up, and after it was out I felt great again.

I now have the Squatty potty so should be able to report whether i think it's as effective as physically squatting when I'm back at that stage again, which I'm sure i will be 😢

The Squatty potty had definitely helped me with wind which such also adds pressure, but haven't needed to go property again yet after yesterday's release!

I think still softeners are important as i stupidly stopped taking mine after feeling better only to be back to square one again.

I'm surprised at the rapid improvement as my op was quite intensive and lasted 2 hours. They removed 3 extremely large internal hemms via incision and also used THD on some smaller ones. It was an emergency op after going to a and e with severe blood loss. I was in for 5 days and needed 3 blood transfusions whilst waiting for the op.

Thats a good tip on the softeners. I'm actually taking a lot of softeners now. But so far the stool looks okey. I but worried though that my stool will become hard once I stop with it (I have already been using if for a month or so, a bit afraid I'm becoming too dependent on them).

Your op sounds very intense. Definately more intense than mine which was 'planned'. That being said, your recovery seems to be going better than mine (especially considering time past since op, which is >1 month in my case)

I went for a 2nd opinion yesterday and that doctor said that I've got a bit of a vicious cycle going on:

• My wound is not healing properly because I have involuntary muscle/anus constractions (because of the severe pain before probably, that's the body's response apparently)
• These involuntary contractions dont stop, because the pain is still quite serious. And because these dont stop, the wound doesnt heal => etc etc

I'm trying to take more sitz baths now, but apparently there is no real cure to releaving these involuntary contractions (except for stretching the anus, which is going to hurt like hell). The doc also gave me some antibiotics in the hope that it will improve the healing process of the wound.

How has your experience with the Squatty Potty been? Any other tips to eleviate the pain and break this cycle I got going on?

You're experience rings true with mine, in that prior to my large expulsion, I had constant painful involuntary spasms that would make me yelp!

I'm wondering if that intensively painful bowel movement that produced a large volume has stretched things down there as I don't get those painful spasms anymore.

The squatty potty has been AMAZING, I had about 4 productive bowel movements yesterday and whilst they were not pain free, the pain was limited to the moment the stool was exiting and stopped straight after.

Previously that would have built up and caused me lots of pain.

All I can say is the next time you're at maximum pain and think you can't take anymore, stick with it a bit longer and get it out. I know it feels like you're literally going to tear apart, but in reality you don't.

I'm convinced that fear of the pain causes things to retreat and that prolongs the problem. Any stool left in, outs pressure on your wounds longer.

thanks for your response Henrik. Strange indeed that the positive momentum is not continuing. Do you have any tips on how to win this mental game / things that worked for you trying to overcome the fear of having a BM?

Yep, I think so too and as I said, it shouldn't as my stools are still soft and I can poop without hardly any straining etc. Today the "tearing-feeling" was somewhat better but had again some minor bleeding, although not much, but more than the previous weeks and so is the swelling, so something's up. Due to the Corona crisis there is basically no chance for an appointment, I'll maybe have the opportunity to see a private GP in my area in a couple of weeks. Starting to think I may have a fissure going on since the bleeding comes from the inside near the opening.

Well, the only tip I can give is to try to relax the muscles and take your time, one has to poop so there's no other way. Also to keep your discipline regarding food and fluid intake, that's the main thing. What I do is that I eat normally(or under these circumstances, for me, not a lot) if I poop everyday and if it feels that it is starting to build up and going into 1-2 days between BM's I cut down on the food intake and increase my fluid intake combined with an additional dose of Movicol/ fiber supplements, the last thing you want is hard or dry stools and then I basically keep this regimen until BM.

Other than that, just keep going, this is a totally s****y situation but what you gonna do, hopefully there's an end to this somewhere along the road. Never thought that someday my whole life would be revolving around BM's and pooping, anything else at the moment is more or less irrelevant, LOL!

Yeah the corona situation makes it difficult to go see a doctor, I'm experiencing the same. And hemorrhoid for some reason doesn’t sound serious enough. Even you are in serious pain

Have you been taking antibiotics also? I have been for the past couple of days and it gave me diarrhea. And even with this softer stool the pain of a BM (and this morning post-BM) is not what it should be.

I'm a bit wary that the pain will increase once the diarea is over and the stool will become hard again.

Was hoping that the antibiotics would accelerate the healing of the wound, but I don’t believe its contributing much.

Hi again John, forgot to reply to you last time, how are things now? Still pain?

After my surgery i used Flagyl for one week, just to keep any risk of a fungus infection to a minimum, considering the area. Don't think antibiotics per say help with the healing too much.

I'm 3.5 months post-op, things are much better. Had my follow up last week with my surgeon, the outside lumps have reduced in size, don't think they'll shrink any more and the doc confirmed that they are skintags. Overall everything looked good BUT still have some discomfort during BM, some very light bleeding and this is due to a post-op fissure that most likely have healed up pretty good after the op but not completely. Surgeon could see some signs of a fissure but he wasn't sure as it wasn't too obvious so he prescribed cream ointment to try for 30 days. In hindsight, it may very well have been the fissure that caused the most discomfort during my first 3-7 weeks, just goes to show how important it is with follow ups shortly after surgery, not 3 months after, but what you gonna do...Still keeping my diet pretty strict, no white flour, cheese etc, using 1 dose of Movicol and fiber sup. every day.

Hi Henrik,

Good to hear from you. I'm about 2.5 months post op and still have quite some discomfort during BM (and unease after). Not taking any medication anymore (apart from 2 or 3 paracetamol a day).

I have had numerous inspections in the past 10 weeks, even did a second opinion. That doctor didnt see any complications and indeed mentioned that my complaints were fissure like.

Im still a bit afraid it might be a fissure. Is there any way to (visually check) yourself? Or any other tips regarding that?

Diet wise (and stool wise) I think I'm going fine.

Regards,

John

Hi again John, no not really, started using diltiazem cream as treatment for my fissure a couple of days ago since things have gotten worse again due to BM-troubles. Surgeon told me to use it for 30 days. Been having pretty soft stools yet still I have to strain, this has been going on for maybe 1.5 weeks, making things worse again. No changes in diet etc so don't know what the problem is. Just shows how important it is with good and soft BM's. I'm so f'n fed up with this that I'm starting to get "depressed", it never ends.

Hi Henrik,

I have exactly the same problem. I still have blood with BM (also fissure like complaints). Also feel I need to strain a bit more the last few weeks..

It has been 3.5 months, and for some reason it doesnt want to heal. My BMs have been okey I would say, still trying to drink a lot.

Are you following a specific diet to keep you BMs soft? I'm also taking 2 capsules of fishoil and 2 capsules of fiber supplement per day.

Yesterday I even started applying Lignocaine gel again because my pain got worst after I had a checkup at the doctor and he inserted his finger to check for tightness (was appartently needed, because too tight anus can cause other problems..). Hurt like hell again...

Unfortunately I do not have access to a bath, If you do. I think a hot bath will help relax the anus also. I think the muscle spasms (because of the pain) keep it from healing properly, herewith tearing the wounds open again during BM

Hang in there buddy. I'm trying to do the same, but also notice I'm getting anxious again. Def developed a mild form of PTSD or something...

John

Seems like we almost have exactly the same issues because I also felt that things got a bit worse after my follow up, maybe some 3 weeks ago now, because of the legendary man-sized finger(LOL) and Anoscopy-tube, I'm just thankful I don't have any direct pain, just discomfort overall. Have you contacted your surgeon or a GP just to get some cream for your fissure(?) because you probably have one.

Well my diet is mostly made up from fruits and veggies(like pears, strawberrys, broccoli, green beans and spinach), unpeeled potatoes, oatmeal, wholegrain rye bread, basically anything that generally has fiber and is easy to digest. Protein sources are basically from eggs and high calorie whey/casein protein smoothies since I'm back training again since May and have to get my proteins from somewhere. Eating small amounts of meat, some fish and tuna just because I'm afraid that it will make BM's slower. To bump up the calories I'm also using olive oil with my food, some natural peanut butter etc and fiber supplements with Movicol/Lactulose.

Yeah, this definitely affects your mental health, been pretty down on and off for some time but it is what it is, lifecould be a lot worse.

I think diet and exercise wise we are on nearly the same regime. Also trying to complement protein intake with one or two whey shakes per day.

Do you notice any difference from the cream? Also can you visually see the fissure? I think my wound is more inside my anus rather than outside visible.

Hard to say, coming up on 2 weeks now but no noticeable improvement yet but I've read that the cream should be used for at least 4-8 weeks, but yes, I have my doubts...

Nothing visible, the fissure is a few cm inside. The idea of the cream is to relax the sphincter muscle thus allowing better blood flow = better healing.

I would suggest you to do self anal dilation. It helped me greatly tbh. It sucks at first but after that it actually relax the area especially if you have a fissure. And also use fukttu suppositories w put sum diltizam/or/rectogesic ointment on it and put it there. It wouldn't hurt thay much and it will get better trust me.

Hi, well, have to try that as well, nothing to lose at this point lol so I will try everything. Thanks for the advice. I've come to the conclusion that the problem has to be some sort of anal stricture/stenosis since my stool is soft but still I have to push at the start to get things going. Almost feels like there's something blocking the stool at the "bottom" = what I believe is a stricture/narrowing.

omg im having this issue too! im 8 weeks out. my bm were watery for a bit due to bad diet eating milk and cheese (im lactose) but after clearing that out of my system, i got it back to some sort of normal where stool seems soft but is super skinny stringy. and yes..takes some pushing for that to come out and feels like theres something blocking. have u asked your dr if it is the anal stricture/stenosis?