This is mainly a post to vent a bit as I've had a bad day. I've used the diltiazem cream for almost three weeks as well as Movicol to keep things soft. I had three or four BMs this morning then after the last one noticed that it felt strange around the anus. I felt a large soft lump when I touched it and booked an appointment with a GP for Tuesday morning. However, I noticed blood in my underwear after lunch and kind of panicked a bit. We went to the walk in centre and got to see a GP after a two hour wait.
He had a quick look and said it's a pile as I suspected. He said that I had to be inserted and that he would try to be gentle due to my fissure. Let's just say that it wasn't pleasant and my poor butt still hurts a lot three hours later. He seemed to think that the hemmie is the urgent issue and I should focus on dealing with that first and the fissure second. He prescribed another cream and instructed me to use it twice a day.

I'm concern d that it's the diltiazem cream that has loosened things up and made the hemmies protrude. I'll still see the GP on Tuesday morning and ask for a referral to a CRS as I'm getting seriously fed up with this now. I was doing slightly better with th fissure and then the hemmies struck and the fissure is back to being super painful again. End of rant!

I'm sorry! I know how frustrating this is, it's not fair anyone should have to deal with this stuff!

For sure see a CRS as you've mentioned - they'll know exactly what's what and what to do.

I can say from personal experience that the hemorrhoids and fissure go hand in hand. Many people with fissures develop hemorrhoids as a second hand problem. I developed a couple external hemorrhoids since dealing with my fissure, but I have to say they didn't bother me much, at least since my LIS.

Does the hemorrhoid seem painful? Do you know if it's the strangulated type - and internal hemorrhoid "hanging out" or is it's base on the outside? That can make a difference on whether or not you should be trying to reinsert it - the CRS will be able to tell you that. You for sure don't want to fiddle too much and injure things further!

Do things feel looser down there with the cream? Or are you still having spasms and tightness? For me, the cream did nothing. And the spasms were part of why I developed hemorrhoids as I had to strain so much to go or even pass gas due to spasm.

Hope you get to see a CRS asap and so sorry you're dealing with this!

It's great to have this forum to vent and get support rather than to go on and on and on about it to my wife. Which I obviously do anyway as my world currently seems centered on th state of my bum.

The GP said it was an internal haemorrhoid and that's why he pushed it back in. He said he could feel one other hemmie too. It's been over four hours now and the fissure is still very painful. The hemmies bleed as well but I guess that isn't surprising given that it's been pushed back in and that ought to agitate it/them. I don't think the hemmie hurts, it felt weird after it had popped out but it didn't hurt as such.

Things do feel looser now that I've used diltiazem for almost three weeks. As in no spasms (until post hemmie adventure today) and basically only pain during the BMs with quick recovery after. It's back to the burning horrid pain now, the pulsating hot iron rod kind of pain.
I hope I manage to find a good CRS. One of my problems is that I don't have great faith in British healthcare. I see a GP privately for something else and even the 'nice' private hospital is not that nice comparatively. I'm aware it looking nice and new and modern doesn't mean the care provided is better but it looks a bit run down messes with my head.

I know what you mean - it's so good to vent here, especially with people who know what it's like. Unless you've had to deal with this, it's hard to understand how hard it can be.

It's good there's no pain - definitely sounds like an internal hem! I would say keep using the cream as prescribed or at least until you see the CRS - it sounds like it's helping and the key to healing is to prevent those awful spasms!

For the pain after today, warm baths, heating pad, or even ice alternated with heat has helped me tremendously, as well as lying on my side or stomach as much as possible.

The good thing is that the internal hems are pretty easy to deal with from what I've heard. They may shrink down once the agitation of the fissure is passed, but if not, from what I know, they're pretty easy to remove (since their base is on the inside - and you don't really have too many nerve receptors there compared to the sensitive part around the sphincter).

Hang in there - it sounds like today was a setback but the fact you're generally not having spasms is a Great sign.

Lying on my side is fairly comfortable now. I'm actually sitting up to type this and I think the pain level is down compared with an hour ago.

I'll keep using the diltiazem cream and the cream the GP at the walk in centre prescribed today. I'll ask for a prescription for Movicol or Laxido on Tuesday when I ask for a referral to a CRS. I've spent far more money than I'd like on rear issues the last month. I don't know where you're located by a 50 pack of Movicol is around half price when you have a prescription compared with buying it OTC.

I'm already worried about my next BM as trying to squeeze the hem back in isn't really something I look forward to. I guess there's a chance it won't come back out but the thought of it is not appealing. I've had little bleeding with my fissure this time and I really don't like the bleeding aspect of the hems.

I hope I can get an appointment with a CRS next week or the week after. I'll probably run out of the diltiazem cream by then and will need more.

Thank you for your support. Fissures are one of those things where people don't understand what it's like to have until they've had one.

Ouf yes I've also spent a fortune - been almost 9 months for me and it's been an unbelievable cost - not to mention I haven't been able to work.

It may be that if you try and reinsert right after a bm it might be easier. The sphincter has to relax to let things out so it may be easier then. Another tip - not the most lovely thing, but if it's not too painful you could try massaging the area, just on the outside, with a bit of Vaseline before reinserting - it can get things to relax a little so it may be easier.

-GG

I spoke too soon earlier. I had a fart on the toilet and part popped out again. It was insanely painful, I'm not sure if it was fissure or hem pain. I've tried to reinsert it but the muscle refuses to relax. It's not as much that's outside now but I don't know whether to go back to the walk in centre and ask for better instructions how to reinsert it or to wait and see if it gets better on its own. It's covered in the new cream I got today at least. I think part of the pain, if not most, is fissure pain as it hurt so much I cried right after and pain doesn't usually make me cry.

I bet it's it the fissure pain - but it can hurt if the hem is stuck out and the blood supply is cut off. Can you try in a warm bath - gently?

If not, I would head back to the clinic or emergency. I've learned one thing in the past few months, it's better to get things look at right away than wait and worry over things tremendously. At the least they can maybe give you some pain relief - it sounds like it's pretty bad right now.

This sucks - again, sorry you're dealing with this. I really hope that things are looking up soon

I think it's fissure pain too. I slept around two and a half hours last night. Let's say it wasn't a good night. I put some diltiazem cream on around 3am and that allowed for almost two hours continuous sleep. It burns if I out the cream on when the area is raw. I had a small BM around two hours ago and the spasms and quite severe pain started almost immediately. The good news is that the big hem that popped out yesterday stayed inside. I'm obviously already very concerned about the next BM. I'll put some diltiazem cream on in an hour or two when the area feels better again.

I do wonder if the GP put things back in that weren't in. The bleeding stopped after the fart incident yesterday and the area feels the same as it has previously. There are skin tags and things and possibly some hems as well but it's hard to tell what it's like as it's not easy to get a good look at what's going on back there.

I'm deeply frustrated that I tried lactulose four weeks ago as I would have been fine had I not as I'd have no problems except a slightly uncomfortable BM or two a year for the last three years until I swapped to Movicol. I checked with the GP yesterday and he said you can stay on one sachet of Movicol forever. Hindsight is 20/20...

Well that's good that the hem stays in - it's possible maybe it was better left out as you say, the CRS will know what's what there.

I'm sorry though that your pain is back up. It's awful to dread the bathroom like that. Do you have a sitz bath? Like one that goes over the toilet? When the pain was really bad for me, I just filled that thing up with warm water and had a bm right inside. It helped relax things during, and is relatively easy to clean after.

Keep us updated, hoping things look up soon