Ask an Expert: Transanal Resection - Burning with B-Movement

Colorectal Diseases

Transanal Resection - Burning with B-Movement
04/19/2010

Question:

Hello,
I was diagnosed with a well differentiated neuroendocrine tumor in my rectal area after having occasional bleeding for about 9 months. Note that the bleeding was attributed to hemorrhoid which I`ve had for some time now so the tumor discovery was incidental. Further, the tumor was taken out during a colonoscopy and the diagnosis was obtained via tumor biopsy.
About 5 days ago I had a transanal resection to get the sorrounding area of the tumor resected to ensure that the excised tumor didn`t leave any traces. In addition, PET scans have shown negative results.
Now when I have bowel movements, I feel a burning and sharp pain in my anus (after the stool has passed). It rises with intensity and lasts for some time. To alleviate the burning I douse toilet paper in cold water and gently push on my anal area as I find this helps to cool the burning and alleviate the pain. I also take Tylenol 500mg (2 capsules 3 times a day). To better understand what is going on, I used a mirror to look `down there` and I can see the inner linings of the resected area - it is essentially the layer of rectal tissue which has been cut that I think is causing the burning. What I want to know are:
a. Why I don`t feel the burning internally but do so externally? b. How long this burning will last and whether it is expected after a transanal resection c. Whether the resected area will get infected (because it is essentially wounded tissue that gets mixed in with bacteria from the colon/recum along with fecal matter) d. Will bowel movements ever be pain free
My surgeon said, powerful pain killers (narcotics) are a NO-NO because of their propensity to constipate.
By the way, I`m a young man (early 30s), don`t smoke, don`t drink and excercise regularly - I guess you could call me a gym rat :) - but for now, have been ordered off the gym. Because of my condition, I have also been unable to return to work because if I were to have a bowel movement at work, folks would wonder why a man is trying to have a baby in the men`s room - I have to yell out and sigh whenever I have bowel movements because of the burning. It sucks.
I`ve googled my condition but can`t seem to find folks who have the same problem!! I`m also on a high fiber diet. This entire experience has been a learning experience for me.
I look forward to getting a response. Thank you.

Answer:

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