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32-Year-Old Female, 47 kg – 16 Weeks After Fistulotomy with Ongoing Discomfort

7/1/2025, 2:00:48 AMMale25-34

Hello everyone, I’m a 32-year-old woman weighing 47 kg, and it has now been 16 weeks since I underwent a superficial fistulotomy. While the wound appears to be fully closed, I am still experiencing some troubling symptoms, including: - A persistent dull burning or pulling sensation following bowel movements - An uncomfortable prickling or stinging feeling with certain movements or when I cough - Occasional pain in my buttocks and lower back - No visible signs of drainage or infection - An MRI conducted two months ago showed no abnormalities This marks my third episode of discomfort, which tends to occur predominantly after having firm bowel movements. While glyceryl trinitrate (GTN) provides some relief, my colorectal surgeon mentions that my discomfort is due to thin skin and increased sensitivity, but I’m not entirely convinced. Is it typical to still be experiencing these symptoms at this stage? Would it be worthwhile to seek another MRI or possibly a second opinion on my condition? Thank you for any insights you can provide!

Internal MedicineEndocrinologyRheumatology

Answers (1)

Cony

7/1/2025, 2:01:30 AM

OpenHealth AI

It's understandable to feel concerned about ongoing discomfort following a fistulotomy, especially after 16 weeks. Experiencing symptoms like burning, pulling sensations, and prickling pain can be unsettling, but they may not be unusual during the recovery process. Here’s a more detailed look at your situation.

Explanation: After a fistulotomy, it can take time for the tissue to fully heal and for nerve sensitivity to normalize. The symptoms you're describing—dull burning, prickling sensations, and pain during bowel movements—are sometimes associated with the healing process, especially in sensitive areas. Factors such as stool consistency and pelvic floor tension may contribute to these feelings.

The fact that glyceryl trinitrate (GTN) helps suggests that muscle spasm or anal sphincter tension might play a role. Since your MRI was unremarkable, this further supports that your current discomfort is likely related to healing and sensitivity rather than a structural problem.

Next Steps:

  1. Dietary Adjustments: Focus on a high-fiber diet to produce softer stools, which may help reduce the strain during bowel movements. Include fruits, vegetables, whole grains, and possibly consider a fiber supplement if needed.

  2. Hydration: Ensure you are drinking plenty of water daily. Proper hydration can also aid in maintaining softer stools.

  3. Regular Movements: Gentle exercise can help promote regular bowel movements and improve pelvic floor function. Activities such as walking or light stretching might be beneficial.

  4. Warm Sitz Baths: Taking a warm sitz bath can help soothe discomfort and promote relaxation of the anal area, which may alleviate some of the burning sensations.

  5. Follow-Up with Your Surgeon: While it might feel unsettling to still have symptoms after a significant recovery time, it may not be uncommon. Discuss your ongoing symptoms thoroughly with your colorectal surgeon. If necessary, they may recommend further evaluations, which could include a second MRI or alternative imaging if no improvement is noted.

  6. Consider a Pain Management Approach: Discuss different pain management strategies with your doctor, especially if GTN is providing limited relief. They may suggest other topical treatments or therapies designed to ease discomfort.

If symptoms worsen or new issues arise, increasing urgency for further evaluation may be warranted. Keep a symptom diary to track your experiences, as it can provide valuable information during your discussions with healthcare providers. Remember, healing can take time, and it’s important to advocate for your comfort and well-being.

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