So I went to the doctor today regarding the pain I posted about previously and he said it could be pouchitis and put me on Flagyl.
While there, he said he wanted to take a look at things and feel for a stricture. He just put a finger in the pouch and I came off the table it hurt so badly. That can't be right. I'm not superwoman or anything but I don't think I'm a wimp; it hurt!

It's been a while since I had a routine exam like that but I don't remember it hurting like that. He said it wasn't normal but didn't have any suggestions for what was causing it. He said I didn't have a stricture. He did say I had some inflamation inside the pouch but that shouldn't cause pain like I had should it?

The one good thing is he didn't charge me for the visit; he must have felt badly for making me cry
Any clues, anyone???

What you describe sounds like a fissure and you can't see that with a finger. He would have had to spread your anus with both hands while looking with his eyes. The finger would easily diagnose or rule out an anal stricture. Cuffitis can be felt with the finger too. It can be touchy, especially if the inflammation comes down into the anal canal.

Jan

I do have a couple of fissures but he put lidocane (spelling?) on them to numb them before doing the exam. The intial entry hurt but it hurt the worst the deeper he got inside.
Do you usually just treat fissures with a cream? He sent me home with a prescription for a cream but didn't tell me what it was for and I was crying and breathing to hard to have clarity of mind to ask him what it was for.

The lidocaine could easily not have gotten to other areas of fissure or anal irritation, thus your pain. Fissures are usually treated with lidocaine and/or a drug that will increase circulation to the area- such as nitroglycerine, nifedipine, or isorsorbide (all of which can cause headaches). Also, sitz baths are an important component of fissue treatment. Laying in the bathtub and spreading your cheeks, and avulsing your anus somewhat may be even better than a sitz bath.

You should also try to get your stools at a soft, semi-formed consistency. This will do two things, reduce the number of bowel movements that contribute to your pain, and reduce the caustic quality of the stools.

Jan

I to had fissures even with the numbing cream I came off the table so could be very well the fissure doing it man do them hurt.

Okay so is it normal for fissures to only hurt when having an exam? I haven't had pain with them on a daily basis and they don't bother me when passing stool.
So could it be fissures causing the pain? I thought they were supposed to hurt continually or at least when I would have a BM.
The doc gave me this cream to use and when I asked the pharmasist about it they said it was usually for hemmorroids but could be used for fissures I guess. Hopefully this doctor knows what he's doing...

Generally fissures hurt with each BM. However, if yours were healing and he reopened them with a digital exam, WHAM, brand new pain. The hemorrhoid cream probably has anesthetic and hydrocortisone, it should be fine.

Jan

I always had pain every bm but more so when they would do an exam. what is the cream ?

JeffM, the cream they gave me is Analpram HC. I guess that's why I'm so confused about everything...if the fissures don't hurt all the time was it the fissures that hurt me during the exam? I'm not sure. I know my pouch itself was sore and felt inflamed but I don't think that would cause so much pain either.
I have to go back on the 22nd and I'm terrified he'll do another exam

Yes, analpram HC has hydrocortisone and anesthetic. It reduces inflammation and blocks the pain. I think you had some internal fissuring or inflammation that was set off by being stretched, which does not occur during passage of soft or semiformed stool. Plus, I bet your doc has big fingers!

Jan

lol jan ya big fingers would do it but I know for me atleast mine hurt all the time but more so when I got exam and it didn't matter how big there fingers where I would go flying but then again mine where bad ones the doc said .


Also olive oil does it feel like your tail bone hurts or felt like someone kicked ya in the butt?

Yes, I've had this achey, sore type pain in the pouch that I just attributed to inflamation. And it felt (I write felt because this seems to be clearing up) more pronounced when I would stand up. I wouldn't say the actual tail bone hurt but inside the pouch it did sort of feel like someone kicked me.
Umm, yes, his fingers are quite large
I hope the inflamation has gone down by the next encounter.

ya The reason I ask, if it feels.... like your tail bone but we know its not prolly pouch area is what I was trying to say because off and on since after step 1 I had this and was never pouchtis .

I was checked for pouchtis when the pain did happen and the doctor never gave me a real answer I could'nt never sit or walk it hurt so bad and after step 2 it came back fro a month but asked him again she said he dunno.

About a month gone by and pain was gone so it may be just your nerves in that area growing back and all that trama in that area so I was told but never got a straight answer it just disappered. But ya I had my sure of fissures and these "tail bone " pains .

I know for sure that was 2 separate problems I did myself have it happen so by what your saying it may be the same thing .

Well anyways good luck hope you get rid of that pain and get better .