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Hi there, need advice, thanks for reading:

I have a J-pouch for the last 4 years and generally I am functioning very well, although I'm always on antibiotics.

Recently, i have been having very sharp, burning pain in the anal canal region (inside the bum, not the surrounding skin)

The pain comes with defecation
Started a week ago
It's 8/10 intensity pain
Goes away when I'm not defecating

Starts only after 6 PM, and goes away by early morning. During this period, I also get lots of urges, only to poop small quantities. Feel gassy but cant release it.

Amazingly, when I wake up and during the day, I'm completely okay :S

I'm suuuure my fellow pouch goes have experienced this on this forum. Any advice would be helpful! Smiler
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Interesting. Yes, feeling of crushed glass describes it perfectly.

Might i ask which antibiotics u took for those 2 weeks? It must have been written in another thread, but can anyone recommend a name of antibiotics as ive already tried alternating azithromycin and ciprofloxacin.(i wont put any responsibility on the recommender ofc, all at my own risk)
Dort, fissures are best diagnosed by naked eye examination, NOT scopes. The scope quickly slips through the anal canal and lesions there are often missed by scope inspection. So, do not assume that there is nothing to see just because it was not seen on scope. Scoping can even reopen a healing fissure!

Fissures are often diagnosed by description of the symptoms alone.

Jan Smiler
dort have you considered sibo..bacteria overgrowth..antibiotics control was on them 7 years now dr. shen wants me to follow no starchy carb diet,low sugar..i have had all the above issues cut glass feeling,extreme pain when going in rectum,frequency..for the most part the diet seems to be working i have been off antibiotics for first time in 7 years..but i think perhaps i also get anal fissures as described by some others and jan because it will come on at night and last until next day..i think i might have been getting fissures because of the sibo..have been using sitz baths and lomitol to slow down output when i have it...qand dr. shen in past recommended hemoriodal cream to insert when i had burning or itching..

i am thinking if the diet keeps working maybe the fissures will be less often or go away..following scd diet which allows fruit as my only real sugar..might have to back off the amount of fruit i eat however as i think i have too many..
I was recently diagnosed with a fissure and you pretty much described my symptoms. I've probably had them before, but never gave a good description to the doctor. They were missed during scopes because, as pointed out by Jan, scopes don't see them. This time it was easily spotted by the doctor because a sentinel pile had formed. What's a sentinel pile? This site has a description: http://www.gihealth.com/html/e...ion/analFissure.html

Before I could make it to the doctor I was getting relief and some improvement with sitz baths, moist towelettes, and either calmoseptine or preparation H. This was the first time I had used preparation H and it was surprisingly effective at giving relief. My doctor prescribed diltiazem. I've added that to the regimen and its slowly getting better.

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