# Please can some one help me?



## alpha66 (May 19, 2011)

Hi. I just signed up for this forum to get some help with my ongoing problem. ** I no more have urge to defecate. **Here is my story. A bit long, so please bear with me.I am a male in mid-40 and have been having mild constipation through out my whole life. My poop has been soft usually but in many occasions, I have rather hard stool. Say 70% soft, 30% hard (But not seriously hard). Like that through out my whole life. I usually go everyday, at the same time like a clock. Pretty much no problem with bowel movement until....I quit smoking in March 2010. Then gained a lot of weight so started exercising in Sept 2010 and started taking some vitamins including some glucosamin pills. Then one day in Oct 2010, suddenly, I had a real big- hard stool (never had this kind of stool in my life before. I had to push real hard to get this out) and some rectal pain started. My PCP told me that it is hemorrhoid so prescribed docusate. I took docusate for over a month but nothing got better. So this time, I went to see a rectal-colon surgeon. He told me that I don't have hemorrhoid but it's anal fissure. He told me to keep taking docusate and gave me some ointments (verapamil and hydrocortisone acdetate 2.4% - Paramoxine HCI 1% cream) to apply to the wound. Also he found some polyps in my colon. So in Dec 2010, I had a colonoscopy to remove these polyps.In March 2011, Doctor told me that my anal fissure is healed so I can stop taking docusate and using ointments. So I did.Then that huge hard stool, (the same kind of stool that gave me the fissure at first place) came right back, resulting come back of fissure.Then I thought those vitamins that I was taking since Sept. 2010, could be the reason. So I stopped them. No more huge hard stools. But....Around this time, I started to sense that the urge to defecate was getting weaker. If I take enough prune juice, I can feel the urge but without prune juice, no urge.Thesedays, I sense the bloating feeling around my lower abdomen when it's time to go. (Usually at 9:00-10:00 am everyday) But just no urge. (The signal from the rectal area is missing.)If I go to toilet when I have this bloating feeling, I can poop, by using abdominal pressure (straining) and the stool is soft which implies that the stool is moving at normal speed in my body.To help you guys to understand better, here is the time table of my history.03/2010 - quit smoking.09/2010 - started exercising and taking various vitamins.10/2010 - real big-hard stool, anal fissure. Started taking docusate (2-250mg / day) and some psyllium husk pills.12/2010 - Started applying verapamil ointment to anal area for the fissure. colonoscopy was done to remove polyps in the colon.02/2011 - Started to notice that the urge is getting weaker.03/2011 - fissure healed. Stopped using docusate and verapamil ointment and hydrocortisone ointment. The huge hard stool came back, fissure came back. Urge to defecate is completely gone.04/2011 - Started taking prune juice only. (No docusate, no fiber pill), Stopped all vitamins. Stool became soft and urge came back.05/2011 - Stopped taking prune juice. Stool still soft but urge is gone without prune juice.06/2011 - surgery for the fissure is scheduled.Like I said, I still get the signal to poop from my lower abdomen every morning. But just no sensation from anal sphincters. So I have to strain to get it out.Can some one tell me why I lost this urge? Yes, I can feel the urge if I drink some prune juice. But I want to go back to normal life when I was moving bowel fine without drinking prune juice or whatsoever everyday. I mean I don't want band-aid fix to this problem but want to know the real reason behind it so that I can try to fix it from the source.I am so stressed out with my current situation. I just can't stop thinking about constipation. I am obsessed with constipation now I guess. I fall a sleep while thinking about constipation in the night and as soon as I get up in the morning, I start to think about constipation in the bed. I spend a lot of time reading about constipation on the internet everyday. I am also so scare of the upcoming surgery. This is just eating up my life and I want my life back badly. Am I begging for IBS-C here??? Sometimes, I feel like I better end my life rather than living while being constipated. That is how much I am stressed out.My doctors are not really being a big help. All they say is taking more fruits and exercise more, take more fiber etc.... which I already know. They just can't answer why I lost that urge.Am I ever going to be able to get the urge back and my normal life back? Or am I stuck with prune juice through the rest of my life?Can someone please help me?


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## enoughalready! (Apr 21, 2011)

You get urge when you use prune juice??!! You are lucky then, so what's the problem?? just use plenty of prune juice! It's cheap, harmless and if it works then problem solved. You could also use psyllium which is very helpful for many people. You don't mention your diet at all, but you do say you have been reading a lot about constipation, so you will know what foods to eat, and to drink plenty of water. If you are a big meat eater, cut right down, or give it up, meat is one of the worst things for constipation. Movicol (Miralax) works well to move things along. You have been well checked out by the docs, had the colonoscopy etc so you just need to stop worrying and get into a regular good diet plan, eating all the recommended foods, water and exercise, plus your prune juice, Metamucil (start slowly with that), and if still no luck, Miralax. That's my advice, anyhow. Good luck!


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## alpha66 (May 19, 2011)

enoughalready! said:


> You get urge when you use prune juice??!! You are lucky then, so what's the problem?? just use plenty of prune juice! It's cheap, harmless and if it works then problem solved. You could also use psyllium which is very helpful for many people. You don't mention your diet at all, but you do say you have been reading a lot about constipation, so you will know what foods to eat, and to drink plenty of water. If you are a big meat eater, cut right down, or give it up, meat is one of the worst things for constipation. Movicol (Miralax) works well to move things along. You have been well checked out by the docs, had the colonoscopy etc so you just need to stop worrying and get into a regular good diet plan, eating all the recommended foods, water and exercise, plus your prune juice, Metamucil (start slowly with that), and if still no luck, Miralax. That's my advice, anyhow. Good luck!


Thanks. But as I mentioned, I want to know the source of the missing urge. Simply put, I've been fine without taking prune juice for over 40 years until recently. But why suddenly am I not able to go without prune juice or other laxatives?? That's my question. I am eating as I've been eating in the past when all was good plus more water, fruits and more exercise. I don't eat meat much. But some fish I eat. My main food is rice which I've been eating for 40 years as that's the main food in my culture.I just want to go back to where I had no problem without taking any laxatives like prune juice.I know there are a lot of people on this board who have a lot worse symptom than mine so I feel kinda sorry to them for making such a big issue out of nothing (but still something to me).BTW, why do you recommend start slow with metamucil? What do you mean exactly by "start slow"??? When is the most efficient time to take metamucil? before eat or after eat etc????


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## enoughalready! (Apr 21, 2011)

Who knows why this has happened to you?! The same thing happened to me. You have eliminated the worst-case scenarios like cancer and organic disease, so you are probably looking at a "functional" disorder now, (like IBS). There are probably many reasons why this could have happened, anything from a virus to stress - honestly, it could be anything. I do know that once you are over 40 stuff happens (or is more likely to happen). And it's worse over 50! lol. Just be glad you don't have colon cancer, drink your prune juice and stop thinking about it. I actually think that the more you think and obsess about the bowel the worse it gets (I should know because I obsess about mine all the time). The metamucil might help you, but I say start slowly with it because otherwise you can get bloated and gassy with it. Start with 1 teaspoon a day for a week then increase to two and so on. I know you have eaten rice all your life, but you know that (white) rice is binding?I really hope you can find an answer to your problem, I know how frustrating it is. Just experiment with different fruits, the psyllium and anything else you can find that helps, until you find a system that works for you. It can take quite a long time. Maybe try Miralax once a day and see if that helps. I also had NO URGE. Even though I have had IBS constipation on and off for many years, I used to get an urge eventually, even if it wasn't as often as I wished. However, since january this year, I have had no urge at all. I take psyllium and Movicol (Miralax) to keep things very soft and moving along, but I still don't get an urge. I just go and sit and push till it comes out. Still no urge to go. One doctor told me it's a functional disorder due to a problem with the nerves that create the muscle movements in the colon. He had no explanation of WHY this had suddenly happened.


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## BQ (May 22, 2000)

Sometimes, for many of us, knowing why isn't as important as feeling good and being able to function fairly "normally" everyday. And to be honest.. you may NEVER find out the "why". But if I were you I would be grateful that you found something (prune juice) to help you! So what! if you have to use something everyday! At least you found something to use! No one's body is perfect.... all bodies have weaknesses of one sort or another. I really wouldn't worry too much about it. But if it is beyond irking you.. by all means... ask one of your Dr's.


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## em_t (Jun 8, 2010)

I have read about other people with anal fissures having this problem as well even when the fissure has cleared up. What happens with the fissure is that is that it sends the anal sphincter into spasm which in turn prevents you from relaxing it properly in order to have a bowel movement. I'm not sure what surgery you're having done but many people have reported better symptom relief after a lateral internal sphincterectomy, where they make a small nick in the sphincter muscle. With anal fissures you should never stop taking your stool softeners as one large stool can reopen your the fissure as you found out. Instead of docusate I would take Miralax to prevent reopening the fissure, it generally works much better. I wouldn't worry about having to rely on prune juice as this is likely to improve once you have had your operation. All the best - hang in there!


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## alpha66 (May 19, 2011)

enoughalready! said:


> Who knows why this has happened to you?! The same thing happened to me. You have eliminated the worst-case scenarios like cancer and organic disease, so you are probably looking at a "functional" disorder now, (like IBS). There are probably many reasons why this could have happened, anything from a virus to stress - honestly, it could be anything. I do know that once you are over 40 stuff happens (or is more likely to happen). And it's worse over 50! lol. Just be glad you don't have colon cancer, drink your prune juice and stop thinking about it. I actually think that the more you think and obsess about the bowel the worse it gets (I should know because I obsess about mine all the time). The metamucil might help you, but I say start slowly with it because otherwise you can get bloated and gassy with it. Start with 1 teaspoon a day for a week then increase to two and so on. I know you have eaten rice all your life, but you know that (white) rice is binding?I really hope you can find an answer to your problem, I know how frustrating it is. Just experiment with different fruits, the psyllium and anything else you can find that helps, until you find a system that works for you. It can take quite a long time. Maybe try Miralax once a day and see if that helps. I also had NO URGE. Even though I have had IBS constipation on and off for many years, I used to get an urge eventually, even if it wasn't as often as I wished. However, since january this year, I have had no urge at all. I take psyllium and Movicol (Miralax) to keep things very soft and moving along, but I still don't get an urge. I just go and sit and push till it comes out. Still no urge to go. One doctor told me it's a functional disorder due to a problem with the nerves that create the muscle movements in the colon. He had no explanation of WHY this had suddenly happened.


Yeah I was very lucky to find out about the polyp. It was found during the exam for fissure. If I had no fissure, it could have gotten worse because later they found out that those polyps I had was cancerous. I told about this to my sister so he took colonoscopy too. And they also found cacerous polyp in her!!! So this fissure pretty much saved me and my sister. A lucky fissure I should call??I know that what I am experiencing is nothing compare to what most of you guys have. I think I am so depressed by the fact that I am getting old and this is the first serious sign of it. That is why I am not trying to accept the fact that I can't live normal like I am young.And exactly that's what I am doing. No urge, so I have to push. But you know that's bad. It could make hemorrhoid to appear. I had very bad hemorrhoid about 20 years ago. The after surgery pain was so bad. Do you do anything to prevent hemorrhoid?


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## alpha66 (May 19, 2011)

em_t said:


> I have read about other people with anal fissures having this problem as well even when the fissure has cleared up. What happens with the fissure is that is that it sends the anal sphincter into spasm which in turn prevents you from relaxing it properly in order to have a bowel movement. I'm not sure what surgery you're having done but many people have reported better symptom relief after a lateral internal sphincterectomy, where they make a small nick in the sphincter muscle. With anal fissures you should never stop taking your stool softeners as one large stool can reopen your the fissure as you found out. Instead of docusate I would take Miralax to prevent reopening the fissure, it generally works much better. I wouldn't worry about having to rely on prune juice as this is likely to improve once you have had your operation. All the best - hang in there!


Very interesting. Maybe the most hopeful information I've found from anywhere. Yes I am getting LIS procedure along with fissurectomy. Where can I find more about this?So you saying, I am not feeling any urge because my sphincter can not relax?BTW. miralax or docusate, are these drugs safe to take everyday for many many years like rest of my life????


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## em_t (Jun 8, 2010)

There's an anal fissure support group online and that's where I found out all the information from as well as researching myself because I had one a while ago. Miralax can be taken for the rest of your life as it is not absorbed by the body, which is why even pregnant women and mothers who are breastfeeding can take it. I'm not so sure about docusate, I think its fairly benign but if you were taking it all the time it might lead to electrolyte imbalances but generally that only happens when you have fairly bad diarrhoea. Here's the link to the support group:Anal fissure support group


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## alpha66 (May 19, 2011)

em_t said:


> There's an anal fissure support group online and that's where I found out all the information from as well as researching myself because I had one a while ago. Miralax can be taken for the rest of your life as it is not absorbed by the body, which is why even pregnant women and mothers who are breastfeeding can take it. I'm not so sure about docusate, I think its fairly benign but if you were taking it all the time it might lead to electrolyte imbalances but generally that only happens when you have fairly bad diarrhoea. Here's the link to the support group:Anal fissure support group


Thank you. I will check out that site. BTW prune juice VS miralax??? Which would you take if you were me???


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## alpha66 (May 19, 2011)

BTW, Do I have IBS-C?Every morning, I feel bloated over abdomen. It becomes a lot better after bowel move.If I don't go because of constipation, this bloating feel gets worse and it last until late afternoon.Only way to relieve it is moving bowel.What other symptoms indicates IBD-C? I heard that abdominal pain is a sign. Is this like a sharp pain? I don't have any such pain. It's just bloating.I've been having this constipation problem for several months. (at least 5 months) Is this also enough to say that I have a chronic constipation?Can this be temporary thing or will this last for the rest of my life???


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