I understand why you are frightened after undergoing so many procedures and losing significant weight. Based on the symptoms you describeâincomplete evacuation, cramping, difficulty relaxing the anal sphincter despite repeated surgery and prolonged laxative useâa non-relaxing pelvic floor / dyssynergic defecation is an important possibility. This means the pelvic-floor and anal sphincter muscles may tighten instead of relaxing properly during bowel movement. Your habit of half-squatting while urinating for several years is very unlikely to have permanently damaged or âdisorientedâ these muscles. More commonly, repeated painful bowel movements, surgery and fear of pain can reinforce an involuntary guarding/tightening pattern.
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Health Tips
The fact that Cremaffin Plus is causing nightly cramps and diarrhoea is important. Don't keep increasing or changing laxatives yourself simply because evacuation feels incomplete; some laxatives can produce abdominal cramping and diarrhoea, and long-term laxative use should be reviewed by the treating physician. For bowel retraining, sit comfortably on the toilet with the feet supported on a small footstool, knees slightly above the hips, abdomen relaxed and breathing slowly. Avoid forceful pushing and repeated attempts. Warm sitz baths may help relaxation if they have previously given you relief. Do not start Kegel exercises on your own if the problem is excessive pelvic-floor tightness, because strengthening an already overactive pelvic floor may make evacuation more difficult. Most importantly, you have not necessarily lost the ability to relax these muscles permanently. Pelvic-floor coordination can be retrained, and biofeedback has shown meaningful benefit in people with confirmed dyssynergic defecation. Given your major weight loss, weakness, repeated operations and ongoing inability to sleep because of cramps, I would not treat this as simply âordinary constipationâ or assume that another operation is automatically the answer. Confirm the functional problem first, then decide whether surgery is genuinely necessary. Thank you