First, the disclaimer: this post is about a bowl problem, so if you are uncomfortable reading about the details, or you can't contibute in a mature manner, please just move on. This is a 100% serious post...
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If you're still reading... Help please, I don't know what to do...

(This is embarassing to talk about, but I really need the help and this is the best place I could think of short of going to an urgent care or ER, as I don't have a regular doctor I can call...)

Since Last friday, I've been having some difficulty going #2. I don't know what caused it, but its really painful and the times I have managed to get something out I really had to strain to the point where my glut muscles hurt and I almost passed out. I've had one painful bowel movement each day since friday. When I look in the toilet, I'm expecting to see something the size of my fist, but its only about the size of my finger...

Yesterday morning, after straining to pass my third bowel in 3 days, I did 2 things. 1) bought some miralax, as its supposed to act as a stool softener, and I bought some metamucil. I took the miralax in the morning, and the metamucil in the afternoon. I didn't have a bowel movement the rest of the day. Today I took the miralax again this morning, and the metamucil at lunch at work. Around lunch time I felt the need for a bowel movement, but when I tried to go it was too painful and I couldn't pass anything. At lunch, I went out and bought some milk of magnesia and took it probably 45 minutes ago.

What do I do? Do I just have to suck it up and go to urgent care?

...there is more to this story, but I was trying to keep it succinct up until now.

Since September '08, I've lost about 130lbs. Since June of this year, I've been having what I think are hemorrhoid problems. I can trace it back to some cashew butter I had... I love cashews, but everytime I ate them, my anus would itch for days after. Well, same thing happened after I had this cashew butter, and I think while cleaning myself during a bowel movement I created a hemorrhoid. (I haven't eaten cashews since...) On and off since then, I've had some minor irritations on and off. I never had any trouble passing a bowel movement, but I would have some pain now and then, sometimes a little bleeding, and discomfort while sitting or standing. I've been using prepH when needed and it gets rid of the discomfort.

Before this friday, I haven't had any problems in a while. Well, On wednesday or thursday I had a little bit of beeding with a otherwise normal bowel movement. Then I had the painful poo and now all of a sudden all the discomfort is back, and some swelling. I know there is some swelling because, well... I was reading about the tests the doctor would do if I went in about this, and while applying some prepH this weekend with a rubber glove on, I realized I could not insert my finger into my anus. (this is very, very embarassing to talk about...)

Friday was the worst. I travelled out of town after work, sat in my car for 3 hours and then sat out on some bleachers for a football game, and then only relief came from some neosporin... Saturday after I had my painful bowel movement, I was back home so I was able to use the preH. By this morning, the discomfort was gone, but aparently the swelling still remains as evident by my inability to go...

So, idk what to do. I'm sitting here feeling like I have to go. It feels like the poo is right on the verge of passing through. But I can't push it through, and so far the 2 types of laxitives/stool softeners don't seem to be working. And I'm sitting here terrified to go to a doctor because the throught of a rectal exam is giving me extreme anxiety not only because of the embarassment, but because I'm afraid it will be painful.

And for the record, I did visually examine my anus this weekend, and it didn't look red or inflamed or anything...

So please help... I'm extremely embarrassed, and I don't know what to do, so I'm literally throwing myself out there at the mercy of this forum hoping someone can give me some advice.



edit: forgot to mention, I'm 25 years old.

Every now and then - maybe 2x a year I get an episode of constipation that is much like you describe. The last time was maybe a month ago and there was a week where I just couldn't go. I needed to, it hurt, I was miserable, and it just wouldn't GO.

So ... yeah, embarassing to talk about, but I think getting things out in the open is half the battle right?

Here's what works for me. YMMV and all that. When it happens, I immediately start drinking more water. Lots more. I eat prunes (really, it helps). I take a mild over the counter laxative. And I walk. A lot.

It usually takes 3 or 4 days for things to get going again and I'm not goign to lie - it's really really really really uncomfortable until then. But don't strain and don't force it. You can cause more hemorrhoids and small tears if you try to force it.

I'm not saying this will 100% work, but it's what works for me. And until it works, I just live with being uncomfortable.

I would say that if nothing has moved after a week of sticking to this plan, then you should go see a doctor. But mostly if you go now, they're going to give you the same advice - and maybe a slightly stronger laxative.

Thanks for the advice Kara. It makes me feel a little better knowing that this could actually go away on its own and that I'm doing the right things. I've doubled my water intake today, and tonight is bowling night so that could take the place of walking. Just sitting here, I can feel the Milk of Magnesia working its magic over the last half hour or so. The last time I remember not being able to go, I was a kid, and my dad gave me a stool softener and not 2 hours later I was all fine again. I guess thats why its making me freak out a little that 2 days of laxitives haven't seemed to get things moving again yet...

There are over the counter stool softeners that are suppositories and those do sometimes work faster, but you know, when I'm constipated the last thing I want to do is put somethign else up there.

But you might try one if you feel up to the task. *ahem*

Such a difficult topic to talk about publicly, huh?

Yes it is difficult... but the more uncomfortable this becomes, the more willing I'd be to do whatever it takes to make it go away.

I read about the "suppositories", but I just don't think I'd be up to the task as you say... Not to mention, I'd be embarassed enough just buying the stuff... but I'd probably try it myself at home before trying it at the doctors office...

Well... things are moving along today if you know what I mean.

but... I am still having problems.

After the first pass this morning (which I needed to strain, but it just had to come out...), I can tell the laxitives and prune juice has been doing its job if you know what I mean. I've probably gone 5+ times since this morning, but everytime there is pain and burning, even if whats coming out is not much more than water. And the burning isn't really going away, and the prepH isn't soothing today.

I think the research I've been doing is making me think I have a fissure. Actually, I think I've had it for a while and the recent constipation is making it worse.

Is it time to suck it up and go to the doctor, or is the answer to just make sure I'm getting enough fiber and wait for it to heal on its own? My only immediate medical option is to go to an urgent care...

Fissures after straining are pretty normal, as is the burning type pain.

I don't think there's any need to go to urgent care or an emergency room, but maybe make an appt with your regular doctor for whenever you can (I know for my dr. it's usually about a month wait for a non-urgent visit).

(Disclaimer: I'm not a medical professional ... this is my opinon and not to be confused with actual medical advice. )

well... maybe I'll just wait it out and see how I'm feeling tomorrow. I left work early today - couldn't sit at my desk any longer. Lying down seems to be helping, so as long as the constipation doesn't return, I think I might be able to pull through.

Make sure that you are eating at least 25g fibre a day (I have lots more than that). Also make sure that you are having enough water (1 oz for every 2 pounds of your weight). Not getting enough of either can cause constipation. It well worth counting both of these on a daily basis - much as some people just count calories...

It is good that some is coming through - as my mother couldnt go some months ago - and it transpired that her bowel had become twisted and she needed an operation. She was in hospital for a week before they pin-pointed the problem (during which time they gave her lots of laxatives and kept asking whether she had managed to go at all).

Ditto to Kara's disclaimer - I am not a doctor either...

I've had that happens when my diet radically changes. I usually treat myself to a whole (YES WHOLE!!!!) pizza every 2 weeks or so and for a day or so after that happens to me.
A very fast acting solution I found was to chug water like no tomorrow. I usually down two 32 oz bottles in the course of five minutes, then around 15 minutes later I'm all better. I don't know if this is particularly healthy, obviously you shouldn't drink that much if it causes you pain, but in the rare times I have that problem that's what works.