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Hi,I thought I was getting better, but still struggling with constipation issues. I think it's structural, and not slow transit.I have a history of straining, and anal fissure. For a few months I've had to squat, or at work raise one of my legs to contract the abdomen to have a good BM.Now I have a reduced urge to defecate. Also, I had a couple particularly hard straining episodes - the push-as-hard-as-you can - without realising how bad it was. In hindsight, I probably should have ran out and got glycerin suppository. But I forced out some hard stool.Last week I had a sigmoidoscopy prep and now I have this problem, every night like clockwork I get this rectal tightness, I look down and see my veins, and the area is red. I also get a little bit of anal twitching. In the morning I have REALLY hard stool, compacted, too large to pass.I got some nifedipine ointment to see if relaxing the fissure will help, but I worry there's rectal nerve ofr muscle damage. Does anyone know a treatment that will help? Some sort of massage? Muscle relaxant med? Biofeedback?Ack, this is really ruining my health.
 

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The first step is probably to get some testing of the pelvic floor (can be embarrassing but usually not painful) to see if there really is something going on down there that keeps you from passing stool normally.They usually require that before starting biofeedback or doing any other treatment (like I think sometimes they can do some botox down there to relax the right things or other types of treatments like that).
 

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Discussion Starter · #3 ·
So the "butt doc" wants me to do the defecography test for this pelvic floor dysfunction thing. He has to convince my HMO to cover it.I don't think it's the problem though. I had a fissure, and told him so (too bad it was with my previous doctor, who has the history), but he looked at my anus and said it's healed. However, I know it's tighter down there than it used to be, and it might have fibrosed. Plus, I have these episodes every other day or so that last a few hours where the whole rectal and anal region cramp up. I think it's big trouble and I'd like to go straight to anal mamometry, but it's expensive and won't be covered. Sigh.
 

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sorry you're having these problems--i really hope that you can find some relief soon. and i also hope your doc is successful in convincing your hmo to pay for the defecography! i find it really frustrating that so many of these insurance companies won't pay for the tests, treatments and meds we need. my hmo will pay for neither the defecography nor the anal mamometry and they also won't pay for biofeedback, cbt or phisiotherapy for constipation --they consider those treatments "experimental". so i've never been tested for pfd--even if they'd pay for the tests, i wouldn't be able to get the treatment. my hubby and i are both retired--no way can we afford to pay out-of-pocket. and at this point we can't afford to switch insurances either.it drives me crazy that some of these insurance companies refuse to take constipation problems seriously. when zelnorm was available i had to fight them to get them to pay for it. they covered me for about a year and then refused to pay for it any more and told me i didn't need zelnorm i could just take laxatives instead. good luck! hope you can get the defecography and the treatment you need.
 
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Hi, we have simalar issues. A few things have helped me. Fiber drink 1-2 per day, drink more water, lots of cooked veggies and water veggies like celery and cucumbers, no wheat, white rice, corn or dairy. Botok injections for fissure (ive had 3 this year) and a squirt of mineral oil in my rectum when i have the urge to go makes things slide right out and it has stopped my spastic colon.You may also want to try miralax to safely flush things out, take it on a friday and make no plans for saturday incase you are on the pot a lot or you have pain. good luckthea
Hi,I thought I was getting better, but still struggling with constipation issues. I think it's structural, and not slow transit.I have a history of straining, and anal fissure. For a few months I've had to squat, or at work raise one of my legs to contract the abdomen to have a good BM.Now I have a reduced urge to defecate. Also, I had a couple particularly hard straining episodes - the push-as-hard-as-you can - without realising how bad it was. In hindsight, I probably should have ran out and got glycerin suppository. But I forced out some hard stool.Last week I had a sigmoidoscopy prep and now I have this problem, every night like clockwork I get this rectal tightness, I look down and see my veins, and the area is red. I also get a little bit of anal twitching. In the morning I have REALLY hard stool, compacted, too large to pass.I got some nifedipine ointment to see if relaxing the fissure will help, but I worry there's rectal nerve ofr muscle damage. Does anyone know a treatment that will help? Some sort of massage? Muscle relaxant med? Biofeedback?Ack, this is really ruining my health.
 

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Discussion Starter · #7 ·
Thanks for the comments. Right now I am getting my BMs by using a glycerin suppository in the morning. I gave up on stool softeners because it felt like stuff was sliding right through my large intestine all day. I am not backed up, I just have difficulty getting poop out, so to speak.I still have problems passing gas and it feels like I have to push the farts out. I feel like I have anal narrowing or a skin tag. I am pushing my insurance to approve a colorectal surgeon.
 

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Have you had any pelvic floor testing. Sometimes the feeback between the sphincter and the nervous systems gets messed up and it starts to tighten up when you try to go rather than relax to let things out. That can be retrained with biofeedback and there are some non surgical options depending on the problem so that may be something else to push for, or make sure the surgeon is going to have you tested rather that cut first and see what happens rather than see what all the options are before doing something permanent.
 
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