Feeling hopeless after hemorrhoidectomy

I developed anal stenosis after surgery (December 2012).  Did you have internal or external hemorrhoids removed?  I think stenosis is more common with internal ones.  Some also develop anal spasms, which also results in small diameter BMs but are treated completely differently from stenosis.  I had 2 large internal and 1 large external removed.  I had trouble with my BMs from the beginning.  I never got the tearing feeling you described, just an unbearable need to strain in order to have a BM.  But I never let it get hard because I could tell something wasn't right.

Keep your BMs soft for now -- not liquid, just soft.  Miralax works great for me.  One dose every day and I'm usually fine.  Have your doctor check you out.  Give him details on how it feels.  I didn't push the issue with mine and didn't get a physical exam until 6 weeks later.  By then he could only examine me with his pinky finger and that was excrutiating for me.  My proof (and reason for even getting that third exam) is that I couldn't insert a suppository.

Get answers from your doctor.  Don't try to self-diagnose or self-treat.  Don't accept an answer of "just give it time".  And insist on a physical exam.  It will hurt, but that's the only way to know if it's stenosis or not.

Good luck!

Hello,

Do you know when you developed anal stenosis? was it very soon after surgery? I wonder, did you find it got tighter as time wore on, or was it like that from day one?

I'm 9 days post-op. One internal, and one external pile.

I am having difficulty getting my stools right. I am an IBS sufferer, a big indicator in my needing this surgery in the first place. I had my piles for a long time and had gotten fed up with them. Surgery was offered to me a few years back when my son was about 3 years old. I have to say, I am so glad I chose to wait! He is living with his dad right now, and it's a relief because I feel crappy, excuse the pun!
I have been able to insert an index finger, although it was not at all comfortable. I doubt I could have attempted that last Tuesday, that was the day from Hell! (Lactulose solution gave me the runs - and I reckon there was still some enema messing around, judging by the noise in my stomach the night of the operation and the next morning!)

Although I've avoided constipation through careful diet and lots of liquids, I am finding that my slow bowels, coupled with a rectocele, make it impossible for me to empty in just one action - although pre-op I would on occasion have the perfect b.m. (oh how I hope I can do that again one day!) So I am keeping everything soft by doing the following:

I am in bed much of the day. Lack of exercise means that I have little appetite. I have been experiencing stomach pains - also period pains started two days after surgery, (what great timing that was!) So I am eating very small meals.

I am intolerant to Lactose (Why oh why did the hospital give me lactulose solution???) but can eat live yoghurt so am eating that for breakfast with melon. I hope the friendly bacteria will sort out my stomach pains, in case the flora of the gut has been disturbed following the enema and use of Movicol and lactulose solution.

Movicol is an osmotic laxative. I have extreme sensitivity to laxatives and have found this one suits me, although I am wondering if fybogel might be a better product for me to use?

Diet: I will only eat chicken or fish, I'm avoiding dairy, also bread and pasta, and I am eating lots of vegetables and two portions of fruit a day (plus dried fruits and seeds to snack on). I am drinking 2 litres of water a day and only one cup of normal tea in the morning. There has to be something from 'normal life' I can cling on to!

Any advice would be greatly appreciated.

Hi MandyPandy365. While I have no proof, I think my surgeon made my anal canal smaller when he removed my hemorrhoids. I think this because I had trouble having a BM from the start after surgery. It just wouldn't come out. It felt so unnatural. Then the scar tissue made it smaller and smaller.

I just went back to my new doctor last week after having another colonoscopy 2 weeks before that. He says I'm all better and there's no more restriction. So I asked why I still can't poop without taking something to soften it. He said to give it time for the muscles to remember how they're supposed to work.

It is much better, but now I'm worried it's a mental thing now. After 11 months of daily worry about my BM it wouldn't surprise me. I was tasking Miralax daily. Now I'm back on magnesium supplements and have justed started adding fiber supplements to add more bulk. Hopefully it will be much better when I see him again in 6 months.

Hi tb1,

Thanks for your reply.

It's interesting that your doctor said the muscles need to remember how to work. Can I ask, have you ever heard of the squatty potty? Google it! Basically, it is to do with correct posture on the loo and helps a person empty their bowels without straining. I don't have one, I use a stool, but I find it definitely helps me. I do believe that everybody who has this surgery (and the other one you mention) should have better advice on how to get the diet right, how to use the loo properly etc... there just isn't enough helpful information! Also it would be so helpful to know the 'danger signs' like you say how you just can't go, etc... It is very worrying when you can't even comfortably insert a pessary!

I rang my surgery today and I am hoping to see my Doctor tomorrow; I intend to ask her to give me a proper examination to check that I don't have a narrowing anal canal. All I know is, it still hurts so much after I go that I'm in bed for hours, and that is no way to live.

I took some fybogel this evening, it's a product that naturally bulks the stool but doesn't stimulate the bowel. I hate laxatives, I think they are responsible for many of my problems!

Did you have to pay to have your colonoscopy? I live in the U.K. and getting those kinds of tests is hard work on the NHS!

Amanda

I thought you weren't in the U.S. based on the names of what you take. My insurance mostly covers 1 colonoscopy every 10 years for screening. I've had 2 this year but since I've already paid my deductible (about $2500) I only had to pay about $200 myself.

I had heard about squatting, but it doesn't work well for me. I don't know how to say this without being gross, so apologies in advance. I often have gas when I start my BM. When I tried the squatting, I ended up spraying poop all over because bits shot out. Maybe it will work better as I get it bulked up.

yeah, I am thinking that too many laxatives make it all too watery, and can give you terrible gas, too! That is how I was last Tuesday morning, just 16 hours after my op. I was told I probably wouldn't go to the loo for 2 or 3 days, which allows some healing to take place. I suspect the lactulose solution was responsible.
The problem is definitely a mental one, because the fear of a painful B.M. is terrible. I will wait to see how I poop tomorrow and if the fybogel is better than the macrogol then I shall stick with that. I do also think that the lack of exercise is a big part of the problem. The bowel needs regular exercise. I can't even walk round to the corner shop!

Give yourself time to heal. I was starting to feel much better pain-wise after 2 weeks. I don't have pain any more, though it does get sore if I have a firmer BM and need to give myself an enema. It's just a sensation of a large t**d that won't come out, but I don't have any choice but to strain to try. I used to occasionally get constipated (thus the hemorrhoids), but this is different. It's very hard to describe. I'm just hoping it will improve over the winter.

Hi Amanda. I came upon our previous chat when looking for info on rectoceles. How are you doing? I'm still struggling. This past spring when I told my doctor I still needed to use laxatives or stool softeners every day, he had me take a bunch of tests. Most of the tests checked how my muscles worked but one test looked to see if I had a rectocele. And I do! This summer and fall I had physical therapy using biofeedback to build up the strength in my pelvic floor and relearn how to poop. It is better, but I think the rectocele is my biggest problem. My doctor said he could do surgery, but I don't want any more surgery unless it's absolutely necessary.

I think I'll probably just be taking something every day for the rest of my life. Not knowing how difficult my morning BM is going to be like keeps me from wanting to do so many things. I know many people have worse problems, but this is so depressing at times.

I hope things are going better for you.