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Bowel Disorders Message Board

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I'm currently recovering from a stapled hemarroidectomy and have found threads like these a mine of helpful information and reassurance, so I thought I'd share my experience over the last 6 days.

I'm a 34 year old male from the UK and generally in fine health. Since I was a child I've always spent far longer than I should sitting on the toilet completing a BM, straining away for 15-25 minutes, and even then I usually don't feel completely evacuated. As with many guys I always take a book with me to the bathroom, and a BM has never been a quick in-and-out (I am still a little awestruck by those who can have a BM and be done in less than a minute!) process. As a result, over the years my pelvic floor has become weakened to the extent that in recent years it looks and feels like I am pushing out some of my own rectum in the effort to empty my bowel.

Initially the protruding inch of pink raw flesh receded of its own accord after a BM; lately however I've been having to push everything 'back up inside' manually whilst in the shower immediately following a BM. This has impacted on my life in many ways... the 'outie' nature of my anus means wiping is ineffectual at cleaning the area, and also painful causing chafing and frequent bleeding from the prolapsed tissue. Therefore I have to take a shower straight away, meaning I don't like taking a BM anywhere but my own home. Also when standing or walking for long periods the effect of gravity is such to cause partial prolapse even without a BM, so I find myself having to visit a bathroom to painfully re-insert things several times during my work day.

I can now only sleep in one position in bed due to the feeling of bloatedness in my rectal area and can no longer fall asleep with my arms wrapped around my girlfriend. My ass causes me low background pain for much of my day; for the rest of the time I am in mere discomfort, and constantly 'aware' of my butt and its condition in a way I'd rather not be.

I go to great lengths to prevent even my g/f from seeing my prolapse and am very anxious about her even touching my butt. I have to close my legs and clench my outer (voluntary) anal sphincter when I laugh, cough or sneeze to stop me prolapsing worse or even losing control over my bowel. I can never trust a fart and have occasional underwear soilage from my loose sphincter.
Medical intervention[/B]
So given all the above impact on my life, I finally got round to seeking medical attention around 18 months ago. After a series of highly degrading medical evaluations (eg having a BM into a little cardboard pot whilst sat in a confined X-Ray machine in a ward with 3 technicians watching and giving instructions) I was finally ushered into the anaesthesia dept at 7am last Thursday for a stapled hemarroidectomy. I had followed a normal diet until midnight the night before, and just had some water and coffee before 6am on the day of the operation. I took some herbal senna the night before and gave myself a laxative enema in the morning to ensure I was empty and clean as possible. As usual, even after such a complete evacuation it still felt like I had a golf-ball-sized object lodged just inside my anus.

I was asleep by 9am and woken by 11. It took me a while to come round from the G.A. and I wasn’t allowed to leave until I had urinated (this was a great deal more effort than expected, as the local anaesthetic in my abdomen meant my msucles and nerves weren’t responding normally, plus I didn’t want to ‘push’ given the staples etc.). I remember feeling quite a lot of pain (or so I perceived at the time, but I was so innocent then!) on the ward and feeling the nurses weren’t taking my distress seriously.

My g/f Liz picked me up, opened up the Futon in our living room and made me comfortable. I was only sent home with paracetemol and an NSAID to reduce inflammation, which together gave me a couple of hours of mild pain relief (not ideal as I had to wait 5 hours between doses). Unfortunately my nausea from the G.A. stopped me from keeping my pills down so pain management was tricky. Again, little did I know that later I would be begging for a return to the pain levels on the afternoon of the procedure!
All afternoon and night I felt the need for a BM but just couldn’t go – firstly as the muscles and nerves hadn’t returned to normal and I couldn’t quite co-ordinate any kind of ‘push’… but also because I was absolutely terrified of the anticipated pain – especially after reading some accounts on this board and others! I was also conscious that I didn’t want to get constipated as this would only push the problem down the road, and I had to have a BM at some point!

I decided to sleep on the futon as it was most practical for finding different comfortable positions, along with not wanting to keep Liz up all night and the slight fear of an 'accident' in bed.

[B]Days 2-6 [/B]
Day 2 started like the afternoon of day 1 - fairly heavy pain that was only partially relieved by the paracetemol/NSAID combination. Liz called my GP and he prescribed some Codeine (opiate based) analgesic which mostly did the trick. I had my first BM that evening - insubstantial and pretty painful, but relief from the bloating and reassurance that things were starting to work again. I slept on the futon again for convenience.

Having pooped a couple more times in the night, I woke at 4am on day 3 with intense pain in my rectum and pelvic floor... I downed my pain meds but an hour later I still had no relief. I have never experienced pain quite like it... both incredibly intense and relentless. I cried as quietly as I could for the next couple of hours until Liz awoke and found me wracked in agony on the futon. Nothing - the meds, the sitz bath, the hot water bottle or ice packs - helped at all and I wondered how much more I could take. For the first time in my life I understood the meaning of 'delirious with pain'... I couldn't speak coherent sentences nor focus my attention for any period; my head was filled with rushing, tumultous thoughts and semi-hallucinations; I scratched at my own flesh in an attempt to divert attention from my butt. I bawled my eyes out for a couple of hours straight. Liz finally called the emergency doctor who prescribed some oral morphine solution ie the 'nuclear option'.

This finally made all the difference and I was able to cope again... but ever since I've focused on avoiding a repeat of that pain!
Now on day 6, things have begun to return to normal. I still use a hot water bottle/ice pack and am continuing my med regimen, but background pain has much diminished and BMs are far more comfortable.
Tips/lessons learned[/B]
Sitz bath/portable bidet – I'm incredibly grateful that I’d discovered and purchased a Sitz bath (basically a plastic bowl that sits on your toilet, that you fill with warm water and use for intimate washing). Wiping after a BM would have been very uncomfortable; instead I would dab gently with a wet wipe, before filling the sitz bath with as warm water and using gentle soap to clean up.
It was equally valuable to provide some relief when my whole perineal area was ridden with cramps and spasms – the most painful aspect of the week. Just sitting there with my sore butt in the hottest water I could take was absolute bliss!

Laxatives/fibre/stool softener – I often have hard, massive BMs that really stretch and scrape the inside my anal canal when I push… I can’t even imagine trying to pass one of those whilst recovering from this procedure… the pain would be unbearable. I made sure that from day 1 I was using milk of magnesia, a powder-based stool softener, some senna tablets and lots of fibre.
An average day’s diet consisted of: porridge oats with a handful of sultanas; bananas, dried figs, dried apricots; multi-grain wholewheat bread; lots of water & fruit juice; Fish and chicken (no red meat).
I’ve resolved after this episode to eat more fibre and less processed food (my diet is pretty good anyway).

Hold/cold packs - I’ve been alternating between sandwiching an ice pack between my buttocks (to sooth pain and reduce inflammation) and holding a hot water bottle against the area (to promote healing and relieve painful spasms). Couldn’t have managed without them!

Someone to look after you - I would have had real difficulties coping by myself for the first three days, and even on days 4-6 it was helpful having Liz around to fetch things rather than get up myself. Whether it was to collect the extra meds from the pharmacy, or merely hold my hand as I cried through the pain... well, the word 'thank you' lost all meaning.

Overall I'm pretty satisfied with how things are going, and everything will hopefully be back to normal in a couple of weeks. My BMs are becoming more regular and normal in quantity and consistency. I am having BMs without great pain and without the help of enemas. I am sleeping for longer periods at night, and feel more able to move around the house etc. My diet is pretty much normal and pain slowly subsiding - I'm not counting down the minutes until my next pain meds any longer! And finally my anus looks 'normal' again, the typical 'puckered starfish' with no protusions or raw chafed areas.

I have one major remaining concern: I have unusual & slightly unpleasant sensations in my penis, as if nerve endings from my penis and butt have somehow been swapped around. I haven't experienced an erection in the 6 days since the op - although sex has been the last things on my mind. Hopefully I'll be more in the mood in the next few days and things will respond as usual!

I wish the hospital had prepared me better for the pain (but then again might have decided against the surgery) and also sent me home with the pain meds I needed rather than the ineffectual paracetemol.

Hope this is helpful to someone!

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