Just a little background- my daughter had to have her colon removed at age 15 on December 9, 2015. She had her take down surgery and pouch construction combined into one surgery on February 22, 2016. She has had several problems with her recovery since the second surgery. She was having some trouble emptying her pouch and we discovered a stricture, which we had dialated last Tuesday. On this past Sunday she started having some pain after she went to the bathroom. It has gotten worse and worse over the week to the point that she takes a hot bath before AND after each time she goes to the bathroom just to relieve the pain and screams every time she goes. Over the past two or three days it has been getting much worse and she has had trouble walking or even moving at all. (She definitely isn't going to school which is a whole other issue.) We went to her surgeons office today and ruled out an anal fissure. He then set us up for an MRI which we went in for a few hours later. After that, the radiologist came out and told us he didn't see an abscess (which is what we were hoping for since the treatment is simply antibiotics) and that nothing else with the scan seemed unusual. He said he would talk to her surgeon and they would make a conclusion. On our way home, the surgeon called with pretty much the same verdict, but decided to prescribe antibiotics anyway. We are told the only way to control her pain is to admit her to the hospital and have her on so much pain killer that she is close to sedation, which of course we don't want. Does anyone know what this pain is? She describes it as quite low down and like someone is stabbing her every time she goes to the bathroom. Thanks so much we deeply appreciate your help.
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Although an Anal fissure has been ruled out, I can't help but believe that's what it is.
From what you've described, it's what I experienced just after my takedown; I had the urge to pass what felt like a golf ball, but there was nothing there; I was in so much pain, it was excruciating.
When your daughter says the pain is low down, I assume she is referring to the rectal area; I must admit, if someone asked me at the time, it would be very difficult to describe.
At the time my Doctors claimed that my pain and discomfort was due to the meeting of two skin types and one not being accustomed to bile acid.
I eventually discovered that during takedown, my Anal canal was dilated and the dilation can cause tears to occur, tears which are essentially similar to a paper cut, otherwise know as fissures.
These fissure, are essentially open wounds and subjected to being engulfed in bile acid during each and every BM; essentially, the equivlent of lemon juice on a paper cut.
During the early stages of takedown, bile acid is more acidic and we appear to produce more of it until our appetite and diet return to normal.
This sure sounds like an anal fissure. What did the surgeon do to rule it out?
In the meantime, try to keep the stool consistency about like pudding, neither formed nor liquid. Have sitz baths been tried?
Sounds like fissure to me too, but if they are absolutely positive it is ruled out, there must be something else. Something is causing painful sphincter spasms. There have been a few here who developed chronic rectal pain from presumed nerve entrapment in scar tissue.
Other options to ask about are B&O suppositories (belladonna and opium) and nerve blocks. An EUA (examination under anesthesia) is also in order.
This sounds pretty intolerable.
Jan 