Rectal pain and diet post right hemicolectomy

Posted by lillyann @lillyann, Jun 3, 2021

I had a right hemicolectomy in mid March not due to cancer but rather a negative outcome of a colonoscopy. I was in perfect health pre this and needless to say it has been traumatic. (I hope it is ok to be in this group.) Because I have no assigned doctor for followup (emergency surgery) I am struggling to get info. The GI specialist that did the procedure called once, changed my diet and set my digestion in a tail spin. He told me to follow the FodMap diet which was so restrictive, I ended up starting to lose weight and have not recovered from this. (I was not being treated for irritable bowel before). I have consulted a dietician, and although not her specialty, we have a rapport. Questions
PREOP I had pelvic pressure and painful internal and external hemorrhoids after a lifting incident. POSTOP I have rectal burning ongoing. It makes life so unpleasant. I was told I had a fissure a few weeks ago but I am not convinced. I was ordered a cream to relax the rectum for the fissure but d/c it as it burns so badly. 1. How can I get through the rectal burning pain: It's been three months of distress? Any ideas? I sitz bath, use breathing exercises etc.
2. Also I have had to take a laxative twice (restoralax) twice in the last two weeks for constipation and sticky stool that seems to sit in rectum. My dietician has has me taking cold milled ground flax daily. I am now at one tablespoon. Is the flax a problem? (I drink an abundance of water daily)

Interested in more discussions like this? Go to the Colorectal Cancer group.

Hi @lillyann, welcome. I've also added your post to the Digestive Health group as well as the Colorectal Cancer group. I'd like to bring in a few other members who have experience with a hemicolectomy, like @maggie12 @maroney @travelgirl @mouse1 @titigiti @tiss @annmac74 and @virgo1952 who can share their experiences with diet and possibly burning rectal pain.

Lilly, do you know what caused the anal fissure? Might it have been straining during bowel movements? I have found CALM magnesium citrate to be helpful with loosening stools.

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Hi@lillyann. I’m sorry to hear about your struggles. I had a colon resection after being diagnosed with colon cancer. Following the surgery, I had c-diff and had a lot of rectal burning from frequent bowel movements. I used an over the counter hydrocortisone cream that helped. It’s been a little over a year and I still take a laxative, stool softener and fiber (Metamucil powder) as a way of staying regular. (nothing before my surgery and infection). The alternative (bowel impaction) was not acceptable. Over time, you will be able to create what works for you to help your body function. Drinking a-lot of fluids is smart. Moving will also help with any constipation. Good luck to you. Glad you found this site 😊 virgo1952

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Thank you for your help

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@colleenyoung

Hi @lillyann, welcome. I've also added your post to the Digestive Health group as well as the Colorectal Cancer group. I'd like to bring in a few other members who have experience with a hemicolectomy, like @maggie12 @maroney @travelgirl @mouse1 @titigiti @tiss @annmac74 and @virgo1952 who can share their experiences with diet and possibly burning rectal pain.

Lilly, do you know what caused the anal fissure? Might it have been straining during bowel movements? I have found CALM magnesium citrate to be helpful with loosening stools.

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I had had some hemorrhoids pre colonoscopy and pelvic floor discomfort from a lifting incident. The surgical intervention after the colonoscopy mishap was slow and by the time the internist found me I was in critical condition. There was no time for a CT scan and the doctor manually had to check my bowel for more tears. I awakened on a ventilator. I struggled with the pain for three months and no one looked to see the rectum until I insisted. An external look showed a pelvic floor Year infection. The burning continued. Finally I saw a surgeon and after a quick rectal she diagnosed a fissure. I thought the diagnosis did not fit the symptoms but soldiered on. I had strained on and off. She ordered dilitiazem cream to relax the sphincter which worsened the burning. I had to stop it. I did have postop hip pain on the right side and when it worsened a trip to the ER was my last resort. I was diagnosed in the ER with bursitis. I just saw a pelvic floor physio and she feels I have pudendol nerve issues and not bursitis. With the spasms and burning, I think she is more accurate. She is starting exercises. I can’t sit at night due to the burning. Any advice or help would be appreciated. I am emotionally struggling as this was just a follow up colonoscopy and I was formerly in perfect health. I am depressed and anxious.

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I was suffering from a lot of pain after passing the stool. 
I endured this horrible pain for over an year.
But 5 months ago, I visited a doctor and he diagnosed (visual inspection) the problem to be of Chronic Fissure.
He gave me a laxative, some antibiotics and anobliss cream and told me to take these for a month.
So here I'm, after 5 months and the pain is still there after passing the stool. and it lasts for many hours the whole day.
After applying the anobliss cream, the pain goes away for a couple of days, but starts again after 3-4 days.
So I guess the fissure is recurring again and again.

I'm 30 years old obese male, always under stress due to various reasons. And this fissure pain is making it worse.
I drink a lot of water (3.5 liter a day)
I take duphalac syrup as well as husk every alternate day, but I still pass hard stools sometimes.
I'm not highly constipated, because I always have atleast one bowel movement every day.
Never in my life of 30 years a day has passed without me having a bowel movement.
So what could be the reason of hard stool?

Most importantly, what am I supposed to do now?
Undergo a lateral sphincterotomy or are there any other magical, non surgical options?

Please help me guys/docs.

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@benett2021

I was suffering from a lot of pain after passing the stool. 
I endured this horrible pain for over an year.
But 5 months ago, I visited a doctor and he diagnosed (visual inspection) the problem to be of Chronic Fissure.
He gave me a laxative, some antibiotics and anobliss cream and told me to take these for a month.
So here I'm, after 5 months and the pain is still there after passing the stool. and it lasts for many hours the whole day.
After applying the anobliss cream, the pain goes away for a couple of days, but starts again after 3-4 days.
So I guess the fissure is recurring again and again.

I'm 30 years old obese male, always under stress due to various reasons. And this fissure pain is making it worse.
I drink a lot of water (3.5 liter a day)
I take duphalac syrup as well as husk every alternate day, but I still pass hard stools sometimes.
I'm not highly constipated, because I always have atleast one bowel movement every day.
Never in my life of 30 years a day has passed without me having a bowel movement.
So what could be the reason of hard stool?

Most importantly, what am I supposed to do now?
Undergo a lateral sphincterotomy or are there any other magical, non surgical options?

Please help me guys/docs.

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Hi @benett2021 and welcome to Mayo Clinic Connect. I wanted to share with you this conversation that was discussing anal pain and possible fissures so that you could connect with other people so I moved your comment to this post as you will see. @lillyann has had similar pains and been through a several month medical history of GI issues like you have.

I see that you are having increased hard stool despite medication. What does your current diet look like? are you consuming a lot of iron?

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I had a cecal volvulus last year and an emergency right hemicolectomy. Within 3 weeks, I was hospitalized again for a small bowel obstruction. Since then I have struggled with lower right pelvic pain and constipation. I have had 2 CT scans and another colonoscopy. I have also had a gastric emptying study. Every thing was normal. I was told that the surgery site is very narrow and at a off angle. They did not find any adhesions. Basically, if I don't eat solids, I do well. When I try to eat normal food, I am good for a couple of days and then the frequent urgent need to have a bowel movement hits. No resolution unless I take laxatives and stool softeners. At one point, I couldn't even pass gas but had terrible intestinal spasms with nausea and sporadic vomiting. The gastric pa told me it was damaged nerves. I eat and think I'm going to be sick so I get sick. I asked how I could be constipated and have diarrhea at the same time. His response was I just think I'm constipated. He did give me some Trulance and after 3 violent bowel movements with chunks, I felt good. I found an herbal tea that keeps me regular and I take stool softeners daily. I do pretty good most of the time but only eat one solid meal a day. I usually have 2 smoothies a day with chia seeds added. Since Thanksgiving, I have had a setback. My lower right intestines are constantly hurting. I think I just ate too much solid food. The pain feels like torn incisions. That is the only way I know to explain it. Sometimes when I bend over, I get a catch down low and have a hard time straightening back up. Feels like something is caught or kinked. I might add that I do alot of manual labor and lift more than half my body weight at times. I'm just worried that something serious might be wrong but I believe the doctors think it is in my head. The gastroenterologist suggested I seek therapy. I'm scared and frustrated. I also might add that the twisted bowel started in 2013 and I finally went to a different hospital in November last year. The previous episodes were diagnosed as IBS-C . After the 2nd colonoscopy and endoscopy, they determined I had esophagitis and bleeding ulcers. As of now, I am off all prescriptions but still struggling with pain.

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@durelle

I had a cecal volvulus last year and an emergency right hemicolectomy. Within 3 weeks, I was hospitalized again for a small bowel obstruction. Since then I have struggled with lower right pelvic pain and constipation. I have had 2 CT scans and another colonoscopy. I have also had a gastric emptying study. Every thing was normal. I was told that the surgery site is very narrow and at a off angle. They did not find any adhesions. Basically, if I don't eat solids, I do well. When I try to eat normal food, I am good for a couple of days and then the frequent urgent need to have a bowel movement hits. No resolution unless I take laxatives and stool softeners. At one point, I couldn't even pass gas but had terrible intestinal spasms with nausea and sporadic vomiting. The gastric pa told me it was damaged nerves. I eat and think I'm going to be sick so I get sick. I asked how I could be constipated and have diarrhea at the same time. His response was I just think I'm constipated. He did give me some Trulance and after 3 violent bowel movements with chunks, I felt good. I found an herbal tea that keeps me regular and I take stool softeners daily. I do pretty good most of the time but only eat one solid meal a day. I usually have 2 smoothies a day with chia seeds added. Since Thanksgiving, I have had a setback. My lower right intestines are constantly hurting. I think I just ate too much solid food. The pain feels like torn incisions. That is the only way I know to explain it. Sometimes when I bend over, I get a catch down low and have a hard time straightening back up. Feels like something is caught or kinked. I might add that I do alot of manual labor and lift more than half my body weight at times. I'm just worried that something serious might be wrong but I believe the doctors think it is in my head. The gastroenterologist suggested I seek therapy. I'm scared and frustrated. I also might add that the twisted bowel started in 2013 and I finally went to a different hospital in November last year. The previous episodes were diagnosed as IBS-C . After the 2nd colonoscopy and endoscopy, they determined I had esophagitis and bleeding ulcers. As of now, I am off all prescriptions but still struggling with pain.

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Welcome, Durelle. What a journey! With the diagnosis of esophagitis and bleeding ulcers, what are the next steps for you?

Are you able to maintain your weight and get enough calories with reducing your solid food intake and smoothies? That must be especially important for someone like you who does manual labor.

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@colleenyoung

Welcome, Durelle. What a journey! With the diagnosis of esophagitis and bleeding ulcers, what are the next steps for you?

Are you able to maintain your weight and get enough calories with reducing your solid food intake and smoothies? That must be especially important for someone like you who does manual labor.

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At my last visit with the Gastroenterology Clinic, the PA suggested I seek therapy. I scheduled with another internal surgeon and he suggested a motility study. I agreed but never heard back from him. My primary suggested I see him. He wanted me to schedule an esophageal widening. When I was in the hospital the 2nd time, I had to stay an extra day due to not being able to swallow. Tests showed food was stopping halfway down my throat. Anyway, I never heard back from him and I have just given up. I saw the internal surgeon twice that did my surgery. No diagnosis. Went back to ER with stomach spasms and vomiting. CT scan was normal. All in all since the surgery, I have been to 4 different doctors and I'm beginning to think maybe it is something that I just will have to live with. I lost almost 20 pounds and have not put it back on. Mainly, I am drinking fruit smoothies with protein powder and chia seeds, Kefir and eating yogurt. The only diagnosis that I've been given is nerve damage and IBS-M. Frustrating because before the cecal volvulus, I was told it was IBS-C. I saw a nutritionist who put me on a diet for IBS-D. That didn't work. Tried the low fodmap diet for awhile but struggled after a couple of days eating solid foods. I am trying to supplement with vitamins. The prescriptions that they prescribed had a side effect of constipation and bone fractures. I took them for a while and was told I could get off of them since I wasn't improving. Right now,
I am just holding out till May when I can retire. Thank you for your response.

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I'm thinking that I suffer from chronic constipation. I added bananas to my smoothies. I have been having multiple muscle spasms and feel like I have tendonitis in my hamstrings. I was diagnosed with degenerative back disease 30 years ago and see a chiropractor weekly. Last year 3 bulging discs, spinal stenosis and sciatica were found on an MRI. Really thought then that was the cause of the pain in my side and why I couldn't walk or sit without pain. Turns out it was the cecal volvulus causing the side pain. Anyway, I decided that maybe I'm lacking potassium. Started adding bananas on Tuesday. I have struggled since the surgery with overflow diarrhea. I didn't realize it until I started researching how I could have diarrhea in the morning and be constipated hard in the afternoon. It still happens. This week I could start out with a normal bowel movement and get stuck in the middle with a hard chunk that is extremely painful to pass and then back to normal after passing it. Normal bowel movement twice Thursday and then yesterday I didn't have one in the morning. By midmorning, the abdominal contractions were nearly doubling me over. Also,the sciatic pain was making it difficult to walk. I tried twice to move my bowels at work but just got small pebbles. When I got home, I tried again and eventually took a suppository. Finally moved a huge
mass out. Thinking that could have also contributed to the back pain. I take MiraLAX, stool softeners and drink a colon cleanse tea daily. I usually drink 32 oz bottle of water at work and refill it at home. 2 cups of coffee in the morning. Water through the day. I've never struggled so much with bowel movements. Before the twisted gut issue, I minimized white bread in my diet. I knew it caused me to back up but I never resorted to laxatives or suppositories. I was able to stay regular by eating a balanced healthy diet that always included high fiber foods. As far as medications go, I take aleve or tylenol alternatively but not every day. I also take trazodone occasionally when I can't get to sleep. I rise weekdays at 3:30 and feel sleep deprivation most days. My stomach pain is much better this morning. I'm trying a different colon cleanse tea this weekend. Reviews were good but recommended being close to bathroom. This morning, I have had 2 normal bowel movements.

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One other question, I was told adhesions caused the small bowel obstruction last December but after the colonoscopy was done in May, no adhesions were found. I have asked 2 doctors if I don't have adhesions what caused the small bowel obstruction? The answer is we don't know what is on the outside of the bowel. Why can't I get resolution? I read high fiber foods can swell up and block the bowels. I am scared to eat anything that may cause another blockage. I've learned since that anything with oatmeal in it causes extreme pain. I tried just a lettuce salad and stomach cramps started the following day. Black olives caused diarrhea and cramps. I passed olives for 3 days. I have eaten small amounts of potatoes, yams and chicken with no problems. Sometimes I can eat eggs and avocados with no issues. I think the fresh fruit salad that I ate at Thanksgiving is what caused the pain in my intestines for days after. Any insight would be great.

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@durelle

One other question, I was told adhesions caused the small bowel obstruction last December but after the colonoscopy was done in May, no adhesions were found. I have asked 2 doctors if I don't have adhesions what caused the small bowel obstruction? The answer is we don't know what is on the outside of the bowel. Why can't I get resolution? I read high fiber foods can swell up and block the bowels. I am scared to eat anything that may cause another blockage. I've learned since that anything with oatmeal in it causes extreme pain. I tried just a lettuce salad and stomach cramps started the following day. Black olives caused diarrhea and cramps. I passed olives for 3 days. I have eaten small amounts of potatoes, yams and chicken with no problems. Sometimes I can eat eggs and avocados with no issues. I think the fresh fruit salad that I ate at Thanksgiving is what caused the pain in my intestines for days after. Any insight would be great.

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Hi Durelle, it sounds like a real trial and error to find what foods work and which ones cause problems. You may also be interested in this related discussion:
– What is a good diet after colon surgery? Are probiotics good? https://connect.mayoclinic.org/discussion/diet-after-total-colectomy/

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