What’s causing this?

So I just moved and along w the move I had a small hernia surgery which they had me on 800mg ibuprofen for 2x a day for about 4-5 days
I also started accutane 25mg a week ago been having what started with painful bms to now a mini flare. I think the flare is under control but every bm there is some pain beyond the hemorrhoid pain like hurts when things are exiting and pretty messy too. Any ideas folks? Is it the ibuprofen? I stopped both 2 days ago

Ibuprofen and Accutane both can cause UC inflammation and flares...both are pretty much no, nos for us.

UC flares with bad rectal-inflammation can give us razor-blade-poops. Where it feels like you're pooping out razor blades, shards of broken glass, or something equally awful. Essentially, you are healed higher up which enables formed stool to be present, and when that hits the inflamed rectum it causes pain (narrow inside diameter, raw and bleeding tissue).

You might need some rectal-route steroids( a steroid suppository, foam, or enema) to heal that bad rectal inflammation. In the mean time, try to limit your bulking fiber intake.