Bowel symptoms - spiralling - how to regain some control?

[stick1974]

I know this is long, but please can anyone help me to cope? I've only slept a couple of hours each night the last few nights, and am waking up and then lying there unable to relax or concentrate on anything so can't get back to sleep. My state of anxiety also has me going to and fro for bms during the night which, given my current symptoms, is another cause for worry

I'm a long term HA sufferer but have been having therapy for anxiety the last few years. I'm just disappointed in myself at not being able to deal with this better. Luckily I had a therapy appointment booked for today and my therapist was really helpful in suggesting practical things I can do to help myself - like make myself eat and drink something, practice good sleep hygiene and not read medical stuff on my phone during the night. It’s just so lonely when I’m awake all night spiralling and not wanting to wake my husband up

I’m 49 and I’ve had IBS for a really long time, but symptoms which come and go and I have had long periods when I’ve been ok (had 2 flexible sigmoidoscopies – most recent at the end of 2016). I’ve also got a history of anal fissure though it’s mostly resolved fairly quickly, and have a sentinel pile/skin tag which has been there since at least 2015

I started to have trouble with a fissure during the Covid lockdowns. I had times when bms would be really painful and sore, and I had occasional bleeding – stripe on poo or spots on toilet paper. I saw my GP in late 2021 and she did a digital rectal exam which was ok and prescribed me GTN ointment (Rectogesic) which I stupidly didn’t take because I was worried about the headaches listed as side effects
About a year ago I became aware of a sensation of rectal/anal pressure – sometimes feeling like I needed to poo, but sometimes it was just pressure in that area. I really started focusing on it and it really bothered me. Sometimes it feels like it is difficult to pass gas or to finish a poo – though sometimes it’s ok

By this time my lovely GP had retired. She was someone who knew me well and could balance my need to resolve my symptoms but also to keep in mind my anxiety. I decided to use the GTN ointment but it was near its expiration date and obviously didn’t work because I didn’t get any headaches
The feeling of pressure and the fissure seemed to calm down a bit and there have been days/weeks when I’m not really aware of those symptoms but then either the fissure plays up or I start focusing on it all again
During the last couple of years my dad has died and my mum has developed dementia so it’s been a difficult time. I’m also quite cautious about Covid and that has been hard

My husband had Covid again recently and that was stressful, though I managed to avoid getting it. Almost as soon as he was testing negative I flipped to being totally anxious about my bowel symptoms and convinced I have something seriously wrong with me. I’ve been checking poo for red flecks which I thought was blood but actually (after reading a comment on here) could be tomato skins and chilli flakes. I even smeared a chilli flake on some kitchen roll to see whether it would mimic the smear I saw on the toilet paper.

I booked to see a private consultant last week about the fissure. I told him my IBS and fissure history and he attempted a digital rectal exam but failed as I was in ‘spasm’ – never had that before. He prescribed GTN ointment again which I am taking, and have the throbbing headaches to prove it. He also looked at the skin tag and wants to excise it as he clearly thinks it looks dodgy. He said it is ‘multifronded’ and has a ‘warty’ appearance. I’ve immediately assumed it’s AIN (I had a LLETZ for CIN3 in 2007) or worse. I didn’t really get the chance to talk to him about my worries that the fissure is masking something more serious, but I’ve got a follow up appointment with him in 8 weeks after the end of the GTN treatment.

Since then I’ve been reading everything I can about fissures, AIN, anal cancer and rectal cancer and I’m convinced it’s more than just a fissure. No one who writes about having fissures really talks about pressure as a symptom, though I suppose it could make sense if I’ve had it for a long time and the muscle/sphincter is very tight or scarred. But I’m adding up the pressure, occasional blood (presumably from the fissure) and my IBS symptoms and coming to a worse conclusion. The best I can think at the moment is that I will need treatment for AIN, and the worst is late stage cancer

My anxiety has triggered my IBS and that’s been difficult to cope with and separate out from what else might be going on
My husband has been amazing at trying to distract me and get me out for walks etc but I can’t wait 8 weeks to see the consultant again and have booked an appointment to see him next week to talk properly about my symptoms and how I feel. Ideally I would like another flexi sigmoidoscopy (though would be terrified). If he’d been able to do a successful digital rectal exam I think I might have been more reassured.

Please, if anyone has been in a similar state before, and found ways of getting some sleep and functioning a bit, I’d be really grateful to know them

I know I shouldn’t ask, but if anyone has had a fissure with feelings of pressure and it was just that I’d also be really grateful to know

[stick1974]

Sorry for such a long post yesterday. I'm just hoping, please, that someone might be able to suggest how I can get some sleep. I only got about an hour's sleep last night and I can't carry on like this. Last time I had anxiety this bad my GP did prescribe a very short course of half dose sleeping pills and a small supply of diazepam. I only ended up using the sleeping pills a couple of times and the diazepam the same - but it took the edge off.

I'm guessing more natural remedies aren't going to work. I think I might have tried valerian supplements as well but not sure they did much. The only other thing I can think of is the anti-histamine that makes you drowsy.

I can probably cope with the nausea and digestive issues for now as long as I can sleep

[Sparkling_Fairy]

Sorry you're going through this. I can't really offer too much. But 2 weeks ago I had a really bad case of constipation that ended me up at the out of hours doctor. I ended up being up all night that night and that sent me through an insomnia phase of 10 days. I started getting increasingly worried about not sleeping, which led me to not being able to sleep. I'm talking alternating nights of 3 hours sleep and no sleep at all, for 10 nights. What helped me get over that, is time. It's always time. I got so tired that I eventually stopped caring. I reached a point where I was like, I can't worry about this anymore. If I die from no sleep, I die. This is no life either. And surprise surprise, the moment I stopped worrying I slept like a baby!
You need to stop worrying about it, but that really only comes with time. The only thing I'll say is you can go without sleep or very little sleep longer than you think. You may feel like a walking zombie, but I've always read your body will sleep when it needs to. And that really is true. You'll reach a point where you're too tired to worry about anything, and then you'll sleep

[Sparkling_Fairy]

And to maybe give you some reassurance about the bowel symptoms too: I've had all of this during the last few years from IBS. I can't say I've had a skin tag, or at least not noticed it.
But I've had anal fissures, a constant pressure like something is about to burst out but nothing comes, and constipation/diarrhea taking turns.
When I went to the out of doctors with my constipation, I hadn't gone in 6 days. And at that stage it had gotten too big to come out. I felt a constant pressure down there, but just couldn't get anything out. Eventually he helped me and it worked, but I had that pressure feeling for 3 days. And an anal fissure to go with it.
HA just sucks man. I'm either worried about my bowels, or my heart, or the vertigo i'm dealing with. Something always takes over and pushes the rest away. And then the other one takes over, but we always find something to worry about. And sadly that affects our sleep. But again, sleep will come when you get too tired to care

[stick1974]

Thank you so, so much *Sparkling_Fairy*
I was wondering how long I could go with the level of sleep I'm getting at the moment - 3 hours broken the last two nights and then 1 hour only last night. I can get to sleep ok but wake after 1 or 2 hours. Last night I was really good and tried not to go on my phone but then I just lay there not being able to relax and thoughts spinning round in my head, music ear worms, all sorts. I think I may have dozed slightly as I had thoughts that weren't conscious, but I didn't ever go back to sleep. I tried using a Headspace meditation, then a sleep story, then some sleep music - none of which helped. I'm dreading tonight. It's reassuring in a way that eventually you just got through the insomnia. I've been working from home today and yesterday which has meant i don't have to interact with people much. I'm supposed to be in the office the rest of the week and I'm not sure how well I can function there. I have a very supportive and kind colleague who knows me well and will cover for me as much as possible, but not sure how it's going to go

I really don't feel like eating but have forced myself to eat small meals. My therapist explained that my body is in fight or flight and is reacting to a perceived threat, but it's really horrible

Thank you also for your comments and reassurance about the bowel symptoms. It does help. I should have done this before, but I actually looked back at a post I'd made here in 2016 which mentions a lot of the same symptoms I'm having now (apart from all the fissure related ones), which has also helped a little but not enough to get me out of this spiral and conviction that there is something seriously wrong

[Sparkling_Fairy]

Trying all the different ways to get you to sleep, is actually keeping you awake. I watched a great video on YouTube about this, that said when constantly trying to make it easier for you to sleep, you're in the background worrying that you're not sleeping. And that will keep you awake.
So I stopped doing all of that, and just said ok: if I sleep, I sleep. If I don't, I don't. I can handle the tiredness (and I was always able to). And the first few nights I still didn't sleep, until eventually I was too tired to worry about it. So best advice I can give you is don't try too hard to sleep because it's counterproductive. Just go to sleep with the attitude of: either way, it's fine