Hard to evacuate. What to do to?

[LuisCMartins]

Hey there.
Besides other regular Crohn's problems and conditions, I have this very specific condition that has been messing with my life for the last years.

It is something that is sure to happen every other day during climate changes (from hot days to cold days, and much more accentuated from cold days to hot days, like the time of the year we are on right now), and on rare random occasions during the rest of the year.
When I have a meal, I feel the need to evacuate (pretty normal so far), but when I sit on the toilet, it doesn't come out that easily. It's like it's stuck. I have to force it a bit and when I'm finally done, the need to evacuate is gone but it feels like not everything has come out. I get out of the bathroom, and for the following minutes I have this very uncomfortable sensation on the anus. After around 20 minutes or so, the desperate need to evacuate comes again. I run to the toilet and nothing comes out. I push and I push but almost everytime never comes out anything, and when it does, its usually just a bit, and it's always in the liquid form. I get out of the toilet again, this time with a even more uncomfortable sensation because of all the pushing and effort done. Even so that my anus is very sore, and I can't walk straight or even sit. Some minutes after, same story, and I end up using the toilet around 5 to 6 times. This can last from 1 hour to some usually painfull 3 hours!!
As you can imagine, this has a great impact on my life. When I'm about to leave home after lunch and this happens, it's impossible for me to leave the house, getting late to college or other commitments. When this happens when I'm not at home, I find myself running to the bathroom often, gathering the attention of people around.
Just this very afernoon, I was at my girlfirend's house and I used her toilet. When I got out we went out for a walk, and we had to stop every twenty minutes to desperately ask at cafes to use their bathroom.
I have an anal fissure that has been healed many times with the use of suppositories, but always ends up ripping up again in these seasons because of all the effort done in the stool because of this condition.

I have been researching this on the internet and found questions in forums of people with very similar conditions, but I never see a straight bullseye answer that seems to really help. It's usually just to get more hidrated or eat smaller meals. However, I don't think this is a solution because I work out and drink plenty of water (1,5 up to 3 liters a day), and altough I confess sometimes I'm not that carefull when it comes to my meals, there seems to be no relation since this happens everytime there are climate changes, regardless of how much and how healthy I eat.

I explained this to my doctor, but she is totally useless, just saying that it happens because I'm probably stressed or nervous, or giving me pills that don't do nothing. I decided to fix things by my own hand by asking others who actually experienced the same, not just by reading some damn book.

Does anyone have the same problem and has actually tried something that worked in order to help it? Please share your knowledge on this with me. I'm tired of missing events and giving up on so many things in life due to this.

Thank you very much.

 

[Lady Organic]

Hi do you have a GI with rectoscopies? Im throwing an hypothesis that could be checked with a rectoscopy : hemmorhoids? : hemmorhoids can be concommitant to IBD. With increased pressure from frequent stool passages, the anal veins can become irritated and therefore become swollen, inside or outside. (its best not to force to evacuate, this can only aggravate the anal veins if H is the issue). People suffering from constipation and who force on the toilet also often get H. The feeling of mild H can be constant pressure in anus, like you feel a small ball stuck inside, itching is another symptom.

 

[LuisCMartins]

I've done several sigmoidoscopies, that's how I found out about the fissure. But I have never been diagnosed with hemmorhoids.

 

[Lady Organic]

have you mentionned these symptoms to the GI who performed the scopes?
to clearly see small hemmorohiods, the GI must make a special reverse maneuver with the camera in the rectum, a manuveuvre which is not normally done if we dont express special problem in the anal region.

 

[UnXmas]

Have you had the nerves and muscles in your rectum and anus assessed? This kind of testing isn't part of colonoscopies and other scopes. Have a look at this page: http://www.bowel-control.co.uk/diagnosis/tests/index.htm

The tests under the "Testing muscles, sensation and nerves" heading in particular may be relevant to diagnosing your problem.

I didn't have your symptoms, mine were quite different in fact, but I had severe rectal and anal problems. These problems were eventually fixed with a permanent ileostomy. The ileostomy ended my rectal problems and I wished I'd had the surgery done years earlier. With rectal and anal problems, you always have that option; with a stoma, and the rectum either removed or not in use, you can't have rectal or anal symptoms.