Does this sound like an AF?

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Does this sound like an AF?

Postby MyNameHere » 22 May 2014, 07:07

Hi all,

I have been suffering from what my doctor thinks is an anal fissure for about 6 months now. I'm thinking about going back to see if I can get a colonoscopy to see if it's anything more serious. I want to know whether my symptoms sound like and AF to you:

I wake up around 8 each morning an feel absolutely fine.

I have a bowel movement once a day, every day before 10. The BM itself is completely painless. For the next hour or two I don't have any symptoms.

I then begin to get sharp, intense pain in my anus. The pain is shooting and comes and goes. I presume this is caused my muscle spasms that everyone here talks about. It's sometimes quite itchy. A bath helps to relieve the intensity of these sharp pains. It's not as bad when sitting/lying down.

The pain is at its worst around lunchtime but slowly begins to dissipate over the late afternoon. By the evening time the sharp pain has normally disappeared although I'm sometimes left with more of a dull ache. This ache feels to be more to my left hand side of my anus, radiating outward so I can sometimes feel it down my groin/back of leg.

By morning time this sharp pain/dull ache is completely gone and I feel 100 % again. After my BM, the whole process is repeated.

There has been blood 3 time but non in the last 3 months. Each time this happened, I had particular intense pain a number of hours after my BM and had to wipe with tissue to relieve the itchiness/pain. There was a slight bit of light red blood on the tissue.

I've been given a second does of rectogesic but the headaches can be as bad as the anal pain.
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Re: Does this sound like an AF?

Postby Scientist2516 » 22 May 2014, 08:24

Welcome to the forum, MyNameHere!

Well, it does sound a bit like a fissure, in that your pain patterns are very similar to what mine were. Except my BMs were rarely painless. It's more usual to have excruciating BMs.
That said, after the initial phase of my fissure, the BM pain was less, and it was the after pains that were terrible. So not too different from what you have.

Pain delayed for around an hour after BM - check
Better when sitting and lying - check
Dissipating in the afternoon - check
Radiating down the leg sometimes - check
Painfree in the morning - check

So, could be a fissure I guess.
Also, check out levator ani syndrome on the web and see if any of that sounds familiar.

I don't think a colonoscopy will help. You can ask your CRS, but I don't think fissures are generally visible in a colonoscopy, where they are looking higher up.

Good luck!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Does this sound like an AF?

Postby MyNameHere » 22 May 2014, 08:58

Thanks, that's reassured me

I was considering asking for a colonoscopy just to make sure it wasn't something more serious further up my colon/rectum that was causing the pain
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Re: Does this sound like an AF?

Postby Apes » 22 May 2014, 11:02

Your CRS. Should be able to look for a fissure. When I was told I had a fissure the CRS called the spasm I was having levator ani syndrome as scientist suggested. Apparently it is a muscle that wraps around a lot of things down there. My pain went from my tailbone to testicle. I had a lot of pain in my left cheek.
If it is determined to be a fissure I would ask your CRS what the next step is. Probably Botox or LIS.
GOOD LUCK.
Fissure 2/13/14 from Colonoscopy
Nitro no help
Nifedipine no help
Botox 5/5/2014 work in progress
HEALED 10/2014
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Re: Does this sound like an AF?

Postby MyNameHere » 22 May 2014, 11:08

Interesting. Levator ani syndrome does tick a lot of the boxes but I don't see anything about bleeding. As I mentioned I had some blood on 3 different occasions. The second and third time there as blood I knew before touching with tissue as the anal pain was so sharp/intense
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Re: Does this sound like an AF?

Postby Apes » 22 May 2014, 12:21

The fissure can cause the levator spasm. The fissure can also bleed. It's also possible you have internal hemaeroids that can bleed.
Fissure 2/13/14 from Colonoscopy
Nitro no help
Nifedipine no help
Botox 5/5/2014 work in progress
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Re: Does this sound like an AF?

Postby MyNameHere » 22 May 2014, 12:53

The original diagnosis was piles and I was given some medication for that but it didn't do any good. That was back in December or January. The doctor couldn't feel any thing during a digital exam. Thanks for the feedback guys
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Re: Does this sound like an AF?

Postby Apes » 22 May 2014, 17:37

It makes sense, the internal piles are usually painless but can bleed, the fissure is the pain.
Fissure 2/13/14 from Colonoscopy
Nitro no help
Nifedipine no help
Botox 5/5/2014 work in progress
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Re: Does this sound like an AF?

Postby Scientist2516 » 22 May 2014, 21:32

Did the digital exam hurt?
If not, maybe it's not a fissure? Most of us can't stand having anything, not even a gloved finger, put up inside.

I've had occasional painless blood for years - just the smallest amount. This was long before the fissure developed.
Never had any blood with the fissure itself. It just goes to show how weird the whole thing is.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Does this sound like an AF?

Postby MyNameHere » 07 Nov 2014, 10:04

I'm bumping my thread from a few months later. Long story short, it was an anal fissure.

As I said, it started at the start of Dec 2013. After initially thinking it was something spicy I ate I decided to go to a doctor before Christmas. They thought it was piles and prescribed me medicine for this. It hadn't cleared up after Christmas and I went back in January. Again I was given medication for piles. I began reading up and an AF sounded like what I was suffering from (or at least hoped, given that some of the other conditions were much more serious).

I was referred on to a specialist by March who said it was an AF and I was given rectogesic for about 2 months. The headaches were pretty bad, in the morning in particular and made my job extremely difficult and my work suffered. I was probably extremely moody as well with my gf as well at the time. This improved my symptoms slightly but not completely. Shortly after my original post here I went back to a different specialist. He booked me in for botox a week later. I was also given a calcium channel blocker (I can't remember the name right now) as the doctor said that patient compliance was better (no headaches). The days following botox were pretty bad. It was a different sort of pain than beforehand but just as bad. Slowly but surely however, the pain went started to subside. This was a very gradual thing however and some days were worse than others. That was the worst part, thinking I had fucked up the progress I had made just because I strained to hard one time.

It's now 4 or so months since the botox and I'm almost completely pain free. Some days I might feel a slight tingle but that's it. I hope somebody out there reads just to see a success story!

PS: I found using sudocrem worked to sooth some of the pain. I don't know if you can get it in your countries. It's an antiseptic cream that has looooads of uses. It does say only for external use but I had read somewhere online that it was good for AF and I was pretty desperate at the time

http://en.wikipedia.org/wiki/Sudocrem
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