I live in London UK. I had surgery for an AF last year but ended up having to go to NYC as the various CRS i tried here in London were not very sympathetic or helpful. Unfortunately the US is currently closed to european visitors so I can't go back to the doctor I saw there and am having to try another CRS here in London. He is trying his best and has carried out an MRI and ultrasound which appeared to suggest a perianal abscess and an ulcer which he treated with Metronidazole antibiotics. He now insists that the abscess has drained, the ulcer is not an issue and will heal and there is not a fissure. Despite all this, the pain is still unbearable. He is at a loss as to what to suggest moving forward as nothing is showing up and everything appears OK .
Has anyone had anything like a similar experience and have any suggestions for me as the situation with the intolerable pain is beginning to affect my mental health. Also if anyone is in London and can suggest another CRS for a second opinion I will be really grateful.
Any advice will be really appreciated

Hi bdfguy, I wish I had more help for you but I'm replying not to leave you hanging with so much pain. I fully appreciate the life-limiting suffering. I'm in the US. I don't think the doctors are any better here, overall, but you do come here, the best care is at a teaching hospital with teaching doctor. Try to get the head of the department. You Will have to wait for this.
It sounds like a fissure, but to check, do you feel something sharp defecating (Typically at 12 o'clock location)? The pain mostly goes away for about 30 minutes then starts feeling like an infected wound continuously for 4-10 hours. It should then subside until next bowel movement or tear of the area.

hi there holyhell :)
Thanks for your message. As I mentioned in my post, I did have surgery for a fissure last year but on the basis of the MRI and scan which I have had carried out here the CRS is saying that whilst there is the remnant of a fissure scar, there isn't actually a fissure present at the moment. I'm going back to see him tomorrow so let's see what he suggests moving forward. Thanks again