I want to 1st take the time to thank everyone here at this site or that has contributed to it!

I've had a chronic AF since 2008. I got another tare in August 2015, but it came with a vengeance. It has never given me this much trouble till this time. The spasms are/were terrible! I have been SLOWLY getting better and feeling better (THANK GOD). I went back to the 1st CRS (because he was the closest to me) and he said that it is healed over and to continue with whatever I was doing. I told him that I was still having the spasms and he seem to think they would go away. Since the tare I have seen a PCP, 2 CRS's and a Pelvic Floor Therapist (PFT) and will comment on that below.

I have been experimenting with several things in the past 8 months and have narrowed down things that have helped. I wanted to take the time to explain and comment on what's worked for me and hopefully it may help others:

WATER, WATER, WATER...Most docs or other health professionals will say, "half your body weight in OZ's" if you are sedentary, but I started there and felt that I need a bit more.

Bath soaks: 20-30min. post BM's. I don't know why, but I didn't/don't spasm on the 1st BM, it was the 2nd or 3rd that caused the MAJOR spasms. Maybe I'm weird..LOL

Vitamin's/supplements: I take vitamin E, Zink, Cod Liver Oil, Magnesium Citrate Gel caps (fast absorbing & loosens the stools), Vitamin A, and a GOOD probiotic.

Pelvic Floor Therapist (PFT): My spasms are my problem now. I've only been to one session, but it has already help me tremendously! I asked the PFT if she felt she could help me and she said, "ABSOLUTELY!" She also said that she NEVER gets to see AF's BEFORE Sx and that she always see's them AFTER. I asked for what and she said incontinence, spasms etc... She was REALLY excited that I had found her before...I was too!!!

I would have never known about a PFT if it wasn't for this site!! Thanks

Dilate, dilate, dilate... I started doing self dilation in December, but had no idea that's what I was doing, until I found this site and read all of the posts pertaining to it. Persistence and experimenting paid off.. and I am getting much relief from the spasms by doing it. My PFT is also an advocate for it.

Nifedipine VS. Diltiazm/Neosporin: I used Nifedipine mixed with 2% Lido that the one CRS prescribed from a compound pharmacy. I applied it, just like he said too, for 4 months with little efficacy. So I went off of it and started applying Neosporin instead and that's when I start self dilation as well. I immediately started feeling better, but couldn't figure out why. I thought that it was the Lido in it and that I may have a "caine" sensitivity, but the CRS said no way. I called an uncle of mine who is a retired GI doc and he said that when he practiced he saw a LOT of "caine" sensitivity topically. SO BEWARE OF THAT! Needless to say the CRS wouldn't change the prescription. LOL no surprise!!

I went to see another CRS for a second opinion and he like the other said I needed LIS. He said he prescribes Diltiazm, but felt it was a mood point to prescribe it. I asked for it anyway...three weeks of using it and I am feeling the difference! You see the both are calcium channel blockers (CCB) that interact with our bodies differently. I have a mother in law that was on a CCB that made her cough. She went back and got on another CCB and she doesn't cough anymore and her BP is lowered! These are our doctors...Ikorumba!

I love Neosporin and NOW think that this is what added tremendously in my healing of the fissure. After using it and doing some form of dilation I went back to the 1st doc in January and he cleared me and said it was closed and healing up. He was absolutely surprised and asked what I had been doing. I told him I started using Neosporin and he asked why. I said to aid in healing and use it for lubrication. Our cells in our anus are the same as on our lips. So I felt you could treat them the same....


Basic trial and error I guess...Einstein once wrote: Doing the same thing over and over again and expecting different results is called insanity!

Well I am by no means out of the woods yet, but can see the forest through the trees though. I could go on but I thought that I would start with these items and leave anything up for comments/discussion...Glad to expound upon anything as well. I didn't want this to be toooooo long! LOL

Great post! and

Just an update...

I've been to see a pelvic floor therapist (PFT) twice now and she's help me a ton! Here's a couple of tips that she has given me that have helped:

1. "drop eggs" to relax the internal anal sphincter. DON'T push like you were going to have a BM. It's a subtle drop you can feel. You don't want to contract the sphincter ("kegel"), especially if you have had spasms for as long as I have. It's actually was a bit painful to do contracting for me anyway in the beginning;

2. If you are dilating you want to leave the dilator in for 15 minutes if you can. She said you can leave it in for longer, but most research has shown no more benefit for longer. She also noted that one time per day is enough.

Personally, I've lost all trust and respect for ANY CRS! Not a one had made the suggestion to go see a PFT for my spasms!! NOT ONE!! They make you feel hopeless/helpless so you go through the sx. It should be REQUIRED for them to suggest a PFT in order to get us out of spasms/pain! They obviously DON'T want you to get better unless you do the sx. That is NOT good patient care...period!

For the past 10 days I'm feeling MUCH better!! There's been a great reduction in frequency and intensity of my post BM spasms..

Dilation for me was the straw that broke the camels back, but in a good way. It was amazing when one day I realised that the dreaded spasms had gone! Was as gradual as that. I am so glad I persevered

Spot on! I have only dilated for about a week and they're now so faint. The last two days I've had one faint spasm! I've had these dreaded spasms for 7+ months... WOW! It's soooo amazing!

It ain't easy to dilate... well for me anyway. Preservation was a mind-set for me though. I tell EVERYONE, "Once you go under the knife, it's there for life!" I worked in the medical industry for years in a level one trauma center (in a US city with over 4 million people) and can tell you first hand that there are ALWAYS risks in sx, period! Nosocomial infections still rank one of the highest risks and under reported; not to mention, LIS is a "feeling" sx. Meaning it's NOT precise, but a cut made by the surgeon by feeling it. HHHHMMMMM??

Savaici- After you stopped dilating, do you still do a "routine dilation"? If so, how often? Has there been any research showing the "optimal" size that you need to dilate to? I'm not sure, but I'd suspect that men and women may vary... I don't have another PFT apt. till late next month, but will ask her that as well.

I am not dilating now. Fibre works to keep thing moving through for me

I can't remember what I went up to, but think it was 15mm. What a relief it was for me when the bloody spasms stopped!!

Keep at it

Dilating has also worked wonders for me! It takes a while to get comfortable with it but it's so worth it. No more spasms for me!