post op problem with duodenal switch

Question
I had the DS procedure about 4 years ago and since then there are periods where I have severe rectal burning, pain, and some bleeding.  I have had myself checked out and there are no hemeroids.
What is the problem and what can I do about it? It is very debilitating

Answer
Hi Mary:

I know you've had yourself checked out, I'm going to assume this was through your PCP.  If it was, please also check with your DS surgeon.  S/he may wish to refer you to a gastroenterologist or a colorectal surgeon.  

You could be suffuring from anal fissures.  It's not unheard of among DS patients.  If you are, many DS patients find relief through nitroglycerine paste.  You need to go through a compounding pharmacy.  A 5% formulation seems to work best. It will help the fissure heal.  You will need to apply a small amount (pea-sized) twice per day after you have a BM.

You can also use a stronger than normal dosage of lidocaine creme (5%) on the fissures to numb them.  Apply it before a bowel movement... sparingly...it will help numb your rectum so you feel less pain.

I hope this helps.  Please do not settle for being told everything is OK, when obviously it is not.  Confirm the anal fissures diagnosis with a physician before beginning treatment.

In the meantime, you can also try to keep a food/symptom diary to see if certain foods exacerbate the problem for you. Experiment with a high-fiber diet and see if that helps. This could be useful information to pass on to your physician.

Kind Regards,
Karla

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