It hurts to do number 2

February 5, 2010 12:59 PM

What can I do when it hurts to do number two?

Long story short, I have herpes that flare up mostly in the anus region. But I'm also prone to fine tears and probably even hemmorhoids. The thing is I don't know when it's my herpes or hemmorhoids. It hurts for my feces to pass in a particular area and I don't know what I can do. The last time I've seen a doctor she told me I had anal tears. Nothing we could do about that. The last time I checked my anal area, which was many months ago. I notice a wart around the area. My feces looks fine upon toilet inspection, so I see this as an outer skin problem. I need options and opinions please!

posted by anonymous to health & fitness (22 answers total)

Do you eat a healthy diet that facilitates good pooping? Seriously, if you are straining to go to the bathroom (which I'm assuming you are by the fine tears and hemorrhoids comments) then you are not helping yourself at all. Maybe you could try to incorporate some oatmeal/flax seed/fruit/veggies into your routine?

I don't know anything about the herpes possibility, just that when I got hemorrhoids while healing after surgery I had to completely change my diet around and then the pain/icky elements went away and never returned.
posted by sickinthehead at 1:03 PM on February 5, 2010

For a while when I was little, I had to take 2 Tablespoons of mineral oil per day because of anal tears resulting from constipation. I remember it as gross and unpleasant-feeling on its way down, but as advertised, it made a Slip 'n' Slide of my poop chute, and protected the torn skin. Maybe you could take that when you're flaring up, and/or to help any fissures heal, in the short term?

BTW, I recall it taking a few doses before things really got going.
posted by palliser at 1:05 PM on February 5, 2010 [2 favorites]

Oh, and nthing sickinthehead, after finishing with the mineral oil, a bowl of Raisin Bran every morning meant I never had to take it again.
posted by palliser at 1:06 PM on February 5, 2010

The pharmacy sells various stool softner products, they help you pass things easier, with less strain.
posted by digividal at 1:07 PM on February 5, 2010

Drink lots of water. Coffee is also a laxative, as is barley tea. Cut out red meat and cheese.
posted by KokuRyu at 1:10 PM on February 5, 2010

be careful with the mineral oil and never mix it with the stool softeners.

from wiki: Mineral oil is taken orally as a lubricative laxative, and is often prescribed to ease the pain of bowel movements for those who suffer from hemorrhoids and constipation. In Europe the use of mineral oil as laxative is considered obsolete mainly due to its potentially harmful effects on the lungs if accidentally aspirated. Furthermore, the oil may be absorbed to a small percentage into internal tissue and cause adverse reactions to the body. In higher therapeutic dosages loss of bowel control and/or dripping from the rectum has been reported causing temporary stool incontinence. Mineral oil temporarily coats the intestines and prevents the uptake of certain essential vitamins and nutrients. Mineral oil is never to be used in conjunction with other stool softeners as this increases the likelihood of harmful absorption of mineral oil into the body.
posted by nadawi at 1:30 PM on February 5, 2010

Psyllium husks, in capsule form, will help also.

I use a product called Colon Care, (although the one I use is in capsules) which is pretty prevalent in natural food stores. Works good, after 24 hours or so.
posted by Danf at 1:50 PM on February 5, 2010 [1 favorite]

The thing about poop is that it's the output of many inputs - diet, mood, stress, exercise, sleep, breathing. So it can take a while to balance any imbalances; they can be tricky to determine, and changing one thing can affect others.

Take fiber, for instance. There are two main categories - soluble and insoluble fiber (referring to whether it dissolves in water or not.) Increasing the soluble kind can soften stool and relieve constipation; increasing the insoluble fiber can bulk stool up and reduce some digestive symptoms.

So, just add a bunch of soluble fiber when constipated? Not so fast. For one thing, some fiber sources are a mix of both types of fiber. You don't want to eat a bunch of oats, hearing they have lots of soluble fiber, only to realize they actually have an almost equal amount of insoluble fiber. For another, fiber needs to be added to the diet gradually, and in the right form. Too much at once can cause more distress. Look for the best sources of soluble fiber, and use them in moderation.

If there's any problems with gas or bloating, it's recommended that both fruits and vegetables be cooked before eating. This breaks chemical bonds and releases hydrogen gas in the frying pan instead of your digestive tract, reducing the bloat problem. Adding certain spices such as ginger or nutmeg can also reduce bloating (but again with the caveat - ginger can make conditions like GERD worse.)

In general it is best to increase fiber gradually and in tandem with increased liquids. Unprocessed foods are easier for the system to handle. Eat the skins of fruits and vegetables (after thorough washing) and the seeds of fruits like figs and raspberries. Gastro specialists like Gary Gitnick, who wrote the excellent book 'Freedom from Digestive Distress', recommend fiber come from the diet, and not from supplements, to get the most benefit.

Specifically, I would not recommend coffee; it has been known to cause different digestive problems.

Psyllium is an all-round helpful dietary fiber, but use it with care. Too much psyllium at one time, without enough liquid, could cause intestinal obstruction.

And make time to relax. The less stress, the easier things flow, in more ways than one. Or number two.
posted by Hardcore Poser at 2:07 PM on February 5, 2010 [3 favorites]

Consider setting aside a day and doing a fast then a Miralax & Gatorade prep (as you would do to prepare for a colonoscopy) and see if that helps things at all. It might be that you just need to clear out the whole area and let it heal.
posted by theraflu at 2:20 PM on February 5, 2010

Diet is definitely most important. Have you tried the old fashioned grandma remedy of drinking prune juice?

Also...when things are agitated down there, by just about anything, sometimes even toilet paper can make things more painful. Try using baby wipes if you are having any sort of external pain...just don't put them in the toilet...bad for drains!
posted by dawnoftheread at 2:33 PM on February 5, 2010

Lots of water too. I get tears when I am dehydrated; staying hydrated keeps the membranes more supple.
posted by Billegible at 2:36 PM on February 5, 2010

Maybe try a new position
posted by Juicy Avenger at 3:06 PM on February 5, 2010 [2 favorites]

Drinking lots of water and maintaining a good balance of soluble fiber, as mentioned above, will help a lot with consistency and ease of passing.
To help the actual skin tearing though, use baby wipes. I had a situation that was not healing and my PA told me that the dry tissue was causing problems. The dry tissue will irritate and stick to your anal skin. Avoid any scented wipes-- get the kind for sensitive skin.
It felt silly at first but it has made a huge difference.
posted by Librarygeek at 3:22 PM on February 5, 2010

Fleet enemas are in the same aisle of your grocery/drug store as laxatives, usually on a lower shelf. It takes about 2 minutes, and basically liquifies your stool.
posted by Houstonian at 4:44 PM on February 5, 2010

OK this is what I actually use, not the Twin Lab product as I mentioned above.

Hardcore Poser is right. . .plenty of water, with psyllium husks. The purpose of such dietary fiber is to retain more water in the lower intestine, therefore softening the stool.

Good luck.
posted by Danf at 5:14 PM on February 5, 2010

docusate sodium? "stool softener"

This is what I took after I had a baby and had hugantic hemorrhoids and general unhappiness in the region. Makes poop slip right out, but doesn't make it runny like laxatives.
posted by leahwrenn at 6:35 PM on February 5, 2010

There are things you can do for anal fissures, if that's what you have. Medical, perscription things. If you always have pain in the same place, it could be a persistent tear/fissure that's not really healing because of the muscle tension in the sphincter that keeps pulling it open. Meds can help with that. So might be time to try another doctor.
posted by kathrineg at 6:37 PM on February 5, 2010

Something that I have taught people to do (as an RN working in a busy GI practice) is to support the painful area with one or two fingers as the sphincter loosens. That allows the waste to slide past the fingers without touching the open area. It is also a way to gently control the "stretch" at a certain point in the muscle ring, and can prevent reopening or extending a tear or lesion. It goes without saying that the person does a thorough handwashing after.

Most folks initially recoil, but bathroom functions being what they are, sooner or later you get something on your hand. Then you wash even more carefully than usual.

Some people who are exceptionally squeamish put on a disposable glove before doing the sphincter support maneuver. I caution them to use a water-soluble lubricant to protect that sore tissue from the glove material.

Providing support can prevent further tearing and help keep irritation from delaying healing. Placing a fingerpad over the tear can lessen or even prevent pain from irritation by caustic feces.

This is all in addition to eating enough roughage and drinking enough water.
posted by reflecked at 7:17 PM on February 5, 2010 [1 favorite]

The last time I've seen a doctor she told me I had anal tears. Nothing we could do about that.

You know, on further reflection, katherineg is exactly right. It sounds like your doctor is not being very helpful here, and should probably refer you to a specialist.
posted by palliser at 8:12 PM on February 5, 2010

You don't actually specify that you're suffering from constipation. Loose stools can also cause this problem. If you have chronically loose stools, then oddly enough you also need to eat more fiber. (Strange but true!)

I swear by flushable Cottonelle wipes instead of toilet paper. Tender area is tender! They are a godsend when there are "problems," and they can help keep said "problems" from happening in the first place.
posted by ErikaB at 8:39 PM on February 5, 2010

Meet your new best friend. It's a life-changer. I'd beware the flushable moist wipes - those and tampons are pretty much keeping plumbers in business.
posted by Lou Stuells at 6:38 PM on February 6, 2010

If you're of the age (>50) or have a Family history of colon problems, I would push for a colonoscopy.
posted by skepticallypleased at 10:47 PM on February 6, 2010