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Excruciating rectal pain with BMs

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Crohn's Disease
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Posted 5/1/2008 1:55 AM (GMT 0)
Initially, everything was going very smoothly after my resection. However, after 6 days of diarrhea, I have been developing increasingly severe rectal pain with BMs. I kept track yesterday - 10 BMs, diarrhea for the most part. The rectal area must be raw because the pain is excruciating when I have a BM and for about 15 minutes thereafter, with a lower level of pain continuing, until I have another BM and it starts all over again. I went to my colorectal surgeon today (5 days early). I hadn't eaten anything for ~19 hours, to keep the pain level down, so I wasn't crying in pain when I was at his office. He told me to eat small frequent meals, eat binding type food, drink in between meals only and take immodium and Fibercon. I'm really trying, but the pain continues. I'm taking sitz baths after every BM. The immodium hasn't helped and the Fibercon (only took one pill so far) caused cramping and maybe even diarrhea. My husband's trying to get me to eat some rice, but I can't bear the thought of eating, because what goes in must come out. I tried some rectal cream with steroid/lidocaine, but that caused such intense burning, I'm not using it again. This is the worst pain I've ever experienced. I had no idea that recovery would be this horrible.

Has anyone ever experienced this extreme rectal pain related to diarrhea post-resection? I'm ready to go back to the hospital and get an IV, and give my poor gut a rest. Any suggestions?
Posted 5/1/2008 2:22 AM (GMT 0)
did the dr even look at it? i mean he could have used a small scope just to check to see if there was a fissure... which from my experiance feels like ground glass with bits of razor blades coming out. any blood with this painful episodes.?
Posted 5/1/2008 2:51 AM (GMT 0)
Ski Bum, I have had something similar, it turned out to be ulceration in the sigmoid area. I think like Randy says,
maybe best to at least talk to your doctor.

How long ago was your resection?
Posted 5/1/2008 3:03 AM (GMT 0)
I went to the colorectal surgeon today. He asked if I wanted him to examine me. The thought of him sticking anything up there was inconceivable to me, but I guess I probably should have let him take a look. He didn't tell me that he should or that it was necessary, he just asked me if I wanted him to look. Now that I think about it, that was pretty dumb on both of our parts. He's not back in the office until Monday. There is some blood, but I've always had bleeding from hemorrhoids. The blood is kind of different looking though. Surgery was 4/22, just a little over one week ago. I wasn't expecting this kind of pain. What is the treatment for a fissure?

Vicky - If it's ulceration, I hope it's temporary from the diarrhea. If it's from crohns, then I would have never made it to remission after the resection.
Posted 5/1/2008 3:25 AM (GMT 0)
It sounds like a fissure to me. I have never had a resection though, so maybe I am clueless! You need to get it checked out though for sure. They can prescribe some rectal meds that can help a bit, if not more. Also, while you are afraid to eat much, drink something like Ensure. You need the nutrition and it is soft and easy one your body both going down and coming out.
Posted 5/1/2008 3:44 AM (GMT 0)
Ski Bum, my ulceration was at the time caused from constant diarrhea. However at a later scope it was biopsied & dx
as active CD, But it can be caused by just diarrhea.

I'm surprised that your surgeon wasn't more interested than he seemed to show. I think if it continues I would push
the issue, after all YOU know your body best...
Posted 5/1/2008 1:11 PM (GMT 0)
Vicky - what did you do to treat the ulceration?
Posted 5/1/2008 1:25 PM (GMT 0)
Ski Bum - I have had the same problem from having horrible diarrhea. I have found that Desitin diaper rash cream works wonders. I get the cream kind, I think there is an ointment kind also. It truly takes away the pain within 15 minutes. Someone else had suggested it in a different post and at that point I was willing to try anything. Hope you are feeling better soon.
Posted 5/1/2008 2:22 PM (GMT 0)
Ski Bum, I was actually put onto Humira, but then my disease was also active in the ileum as well.

I know lots of people that have success from suppositories, but I'm sorry to say I've forgotten what they are
called. I'll try and find out for you....
Posted 5/1/2008 2:33 PM (GMT 0)
I use hydrocortisone suppositories - they work well but take some time to kick in. I am also on Humira and found that worked well but I am sure you hoping you would not need meds like that right after a resection. MB
Posted 5/2/2008 7:03 AM (GMT 0)
I was going to suggest Diaper rash cream as well. Also, on my little grandaughter when her bum gets really red and bumpy and burns like the dickens(hasn't happened in a long time) the doctor suggested using cream meant for yeast infections like Mycostatin. It worked like a charm.
Posted 5/2/2008 9:04 AM (GMT 0)
I am sorry you are having so much pain.I had a fissure that was painful like that. Did the sitz bath and numerous creams, also. The thing I found that worked best for me was a nitro glycerine cream.Nitro-Bid.. The GI doctor suggested it.Nitro glycerine does give some people headaches. It did me, but it was a trade off I could handle. I really hope you get some relief.

Diagnosed  Crohn's, 1998..Gangrene Small Bowel,1998..Ostomy Take Down,1999..TPN for 5 1/2 months..Adhesion Removal,1999..Abdominal Hernia Repair,2000..Kidney Artery Bypass,2001...MEDS--Lomotil,Purinethol,Folic Acid, Fish Oil,Remicade,Levsin SL,Anamantle Cream,Cortifoam ,Ultram.and many more. 26 meds..

Posted 5/2/2008 9:19 AM (GMT 0)
Thanks everyone for your recommendations. I seem to keep exchanging one set of problems for another. Following my doctor's advice, I took one Imodium 1/2 hour before meals. The rectal pain is still there with BMs, but I haven't had a BM since ~4:00 pm yesterday. I've been up all night with gas, bloating...and worry. So while the "rectal rest" is nice, I've exchanged the rectal pain for something else, which I hope isn't an ileus.
Posted 5/2/2008 12:54 PM (GMT 0)
Hi Ski I had a set back after my syrgery with infection after the 18 staples were removed. I was still on pred. for awhile because I had to wean down from them. Have you looked with a mirror to see what the butt kooks like? How are your lytes? Hang in there and hopefully the Imodium will give you some relief. I agree with the diaper rash cream that's what I used when in the hos. and a few times since I came home. Darn I hope things get better hang in there it takes time to heal. How are you feeling today? lol gail
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