Help!!! My ass is causing unending AGONY!

on 12/10/11 4:48 am - Portland, OR
Last spring my ass was burning.  I had seen a post about fissures and thought I might have one.  I went to see a colorectal surgeon and he said I had perianal dermititis.  I got calmoseptine and balneol and starting taking sitz baths.  The pain went away. 

I started having similar pain the Sunday after Thanksgiving.  I thought it was because I had overdone the carbs.  I have pretty much not eaten a simple carb since that day.  The pain starts in the morning about 15 minutes after I poop.  It usually lasts about two hours and then I'm fine until the next day when I poop again.  The pain has gotten progressively worse and there are many days that I am in pain for 8 or 10 hours.  I have had many telephone conversations with the colorectal surgeon who says he doesn't need to see me.  He said it sounds like I just have a bad case of the dermititis. 

I talked to my DS surgeon, Dr. Keshishian on Wednesday.  He said it sounds like a fissure or a fistula.  I have an appointment Monday morning with the colorectal surgeon.

I got a prescription for lidocaine which is supposed to numb my rear-end.  I would say that with 8 hours of pain a day, it's not working.  On Thursday the C.S. called in a prescription for Diltiazem (used for fissures) even though I haven't been seen or diagnosed.

Walking seems to help, while I'm walking.  And the sitz bath helps, while I'm in the water.  I have been taking some of my daughters left over vicodan, but it's not a very strong prescription. 

I have only been eating one meal or less each day and drinking 3 protein shakes.  I am determined not to eat until I'm seen on Monday.  Even with as little as Im eating I still manage to have 1 or 2 bowel movements a day.

Should I go to the emergency room?  I don't want to go because it will be expensive and painful and I don't think they'll be able to help me.  If I go I will insist on seeing a gastro-enterologist, but Dr. K says I need to be examined by a C.S. and I have an appointment on Monday.

Help!  Any suggestions, advice, similar experiences?
Blank Out
on 12/10/11 5:59 am
DS on 05/24/10 with
 In the meantime, are you taking an acid reducer?  I have found this to help!  Also, don't underestimate witchhazel on your bottom every time after you poop!  It is so soothing!  Just a couple ideas until you get into the doc...
HW/ 302  SW/287  CW/140  GW/135

(deactivated member)
on 12/10/11 7:36 am
Definitely keep the appointment with the colorectal surgeon on Monday for a physical exam.  Telephone diagnoses are notoriously inaccurate.  Hopefully, the surgeon will have some definitive answers and a treatment plan for you.  In the meantime, continue what you're doing.  

Avoid straining with bowel movements and avoid spreading your butt cheeks far apart which can tear potential fissures and make a bad situation worse by increasing their size.  Are you on an acid blocker such as Prilosec?  Sometimes when stomach acid goes straight thru it can burn the skin.  Moisture barriers help.  Applying Maalox topically will also neutralize any acid on irritated skin.  

I hope you feel better soon. 
on 12/10/11 11:22 am - Portland, OR
Thanks for the information about the acid blocker.  The doctor has never mentioned that.  I ran right out and bought some.  I will keep the Monday appointment and hopefully be properly diagnosed.
on 12/10/11 8:46 am
So this reply is going to be TMI for those who don't suffer.  Look away if you must, LOL! 

I have had simpy horrible butt-pain recently.  I went on Amazon, looked up Preparation H and started reading comments from other users.  Many recommended this stuff, so I bought it: ils

It's probably the best thing I've found for soothing/cooling my poor butt.  It has a kind-of minty effect somehow.  That plus some witch hazel, which I gently apply beforehand, with a baby wipe.  (Preparation H sells wipes that already have witch hazel, and I bought those too, but they don't have enough, IMO.)  People on Amazon recommended some kind of pill to go with the ointment, and I bought that but it made my GERD flare up (I do take an Rx PPI twice a day), so I quit taking them.  The ointment plus an analgesic like Tylenol helped me get to sleep.

I also tried the Lidocaine - I agree, it wears off after about 5 minutes.  Other people have recommended Desitin, but haven't tried that yet, and of course good ole Prep H.

This is a seriously life-affecting issue, believe me I know.  I hope your C.S. can help you, and I hope these recommendations help in the meantime.

What finally helped was cutting back on the Miralax.  You know, this hi-protein diet that VSG-ers are supposed to be on, even with high fat, you have to do SOMETHING to get things moving.  But I was taking Miralax every day, and my "movements" were so loose they were making my hemmorhoids so much worse!  I now take the Miralax every other day, which is MUCH better, it produces a more normal bowel movement.  So I now have to use the witch hazel / ointment occasionally.

Something else occurred to me, that a probiotic might help you.  If it's some kind of bacteria that's creating the dermatitis, perhaps a more beneficial bacterial mix would help?

Good luck!

Height 5' 7"   High Wt 268 / Consult Wt 246 / Surgery Wt 241 / Goal Wt 150 / Happy place 135-137 / Current Wt 143
Tracker starts at consult weight       
In maintenance since December 2011.

Lisa A.
on 12/10/11 11:16 am - Windsor, NY
Oh I know this story all too well. Just make sure you stay away from sauces and spicy foods. Another thing that helped me alot was taking 3 advil every morning. This has really helped reduce the inflammation. I also have a fissure and see a colorectal surgeon.
on 12/10/11 11:39 am
Dianna Cox managed a fistula, or a fissure ( sorry not sure which) without surgery. She has a treatment method down pat, I believe with the help of a doctor, but the mix of treatments seem to be mostly trial and error.
In the end ( yeah pun!) her rear was healed and so were some others who followed the protocal.
Please contact her.
Best wishes.
on 12/10/11 10:03 pm
 I had a fissure repaired surgically, recovered in a few days, and have never had any issues since.  I saw no reason to suffer needlessly. 
on 12/11/11 12:53 am - Portland, OR
Did you have the fissure surgery before or after your DS?  Some people worry about incontinence.  I am not trying to brave my way through this.  The problem is the doctor keeps diagnosing me (perhaps incorrectly) over the phone!  I really don't do pain well!  I would get loaded to zone out, but I'm coming up on 10 years of recovery.
on 12/11/11 1:56 am, edited 12/11/11 1:57 am
 I had it after my DS.  I have had zero issues since,  of any kind.  

You need a good colorectal surgeon.  And not somebody who diagnoses over the phone.

The risk of incontinence is small,  and it also depends on the size and nature of the tear.  It's obviously extremely important to have the procedure done by a colorectal surgeon who has done lots and lots of fissure repairs.
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