Finally Seeking Advice

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Finally Seeking Advice

Postby itcouldbeworse » 03 Jan 2013, 18:34

Hello everyone,
I'm an early-twenties male who recently moved to NYC and have been dealing with an AF for some time. My stubbornness can no longer compete with my need to seek some help and advice. Some background:
- I had constipation issues during my teen years, and was prescribed laxatives by a doctor for some time, but was more regular in college and did not require any more medication.
- One year ago I visited a developing country for two weeks and came down with dysentery and indigestion, at times causing me to have diarrhea upwards of six times a day. It was not fun, to say the least. At several points, I was not sure whether I had actually had gotten to the bucket in time (no power or flush :/ ). I was prescribed an antibiotic, pedialyte, and a few other medications that were temporary and were not fully explained to me due to the language barrier.
- When I returned, I got better and then immediately resumed a typically unhealthy American diet (pasta, meat, etc) and was greeted with instant constipation. One week after my return, I felt an odd itching during a difficult BM. I thought nothing of it, but it became worse over the course of days, usually after I had a BM. Finally one day I was walking down the sidewalk when the itch became unbearable. I scratched fairly vigorously, way past the point of caring how I looked, and when I got home to investigate there was blood on the toilet paper.
- A walk-in clinic (had no insurance at the time) doctor took a look/feel and diagnosed a "minor" anal fissure. He prescribed diltiazem ointment to be used 2x per day with proper hygiene, soaking baths, etc. This combination helped, but my problem has recurred almost every other week for the last ten months. I stopped eating meat and have since eaten primarily whole grains, nuts, yogurt, quinoa, beans, spinach, and other healthier foods. My fiber intake is upwards of 20g on most days (sometimes much higher). I use wet wipes or my hand with water (obviously wash my hands after) to clean after BMs, and often shower/bathe after.
- I have mostly soft bowel movements, which I actually can't stand; they do not "pinch off" cleanly and no matter how well I clean I will have an absolutely unbearable itch and burn whenever I move an inch. If I return to the bathroom to clean more, there is always more stool around the rectum where I had cleaned.
- Sometimes I go a week with normal-consistency, clean BMs with little to no itch and requiring no cleanup. Then (this often correlates with minor anxiety or a simple change in my routine like vacation, etc.) I will have a BM that feels hot, too soft, and does not have a clear "end". When I wipe and see stool on the wipe, this means that I am in for days of itching and burning, and holding-back of BMs when I am running around at work (can't deal with the itch afterward is I go at work).
This was a very long post, and even I am not sure what I'm asking here. I'm really at a loss. Do I go straight to a CRS? Is this even possible? I have just started applying petroleum jelly before BMs but can already feel that it is not helping much with messy BMs. I haven't seen blood since I swore off toilet paper and started only sporadically using wet wipes (About a month ago), but I just had a whole vacation ruined and feel like "crap".
Ugh. Sorry if this was too long, and thanks for your time.
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Re: Finally Seeking Advice

Postby marg6043 » 04 Jan 2013, 08:05

Welcome to the forums, itcouldbeworse, your post read almost like mine in the sense that my fissure is a result of constant diarrhea after suffering with gallbladder surgery last year.
Like you I had constant diarrhea all day long, like you my BMs were uncomfortable and I blamed on hemorrhoids.
You already have the cream, I see, it works for some but no for others, I also was diagnosed with mild fissure, but I know that after 5 months of discomfort it have nothing mild on it.
If you have insurance now I recommend that you see a Gastro surgeon he will be able to give you a better diagnostic of your condition, I will warn you that is not easy in my case it was very painful as any manipulation of the area will open up a healing fissure specially if a sentinel pile is present, they actually form after the fissure has become chronic after a long time.
First thing is keep the area well lubricated, I use Vaseline before a bowel movement, take by mouth coconut oil before bedtime and use vitamin E suppositories also before bed.
That is to make sure that you bowels are soft, (yes soft) a hard stool will open up your fissure again. No toilet paper but baby wipes works for me, at the end this fissures are usually something we either live with it or get surgery to cure them.
It works for some wonderfully but not for others, I am now dealing with mine before taking the big step.
I hope you find something that works for you we all do in one way or other.
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Re: Finally Seeking Advice

Postby itcouldbeworse » 04 Jan 2013, 19:25

Thank you very much for your comments and kind words. I can't imagine how awful it was to go from one surgery to a complication like this.
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Re: Finally Seeking Advice

Postby itcouldbeworse » 04 Jan 2013, 20:00

I'd actually like to see a colorectal surgeon, because I don't know how much the problem has worsened or whether anything I'm doing/eating is having an effect.
So, how does one go about getting a referral? I don't have a primary care physician, because I get annual physicals through my employer. Do I just pick a primary care physician at random and make it clear that a referral is my reason for showing up? I wish I could get by without wasting money on that.
I'm obviously woefully underinformed about this.
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Re: Finally Seeking Advice

Postby marg6043 » 05 Jan 2013, 09:30

You have to ask for a referral, because you don't have a primary care physician you will have to follow whatever rules your employer have when it comes to extended health care, hopefully your employer have the procedures to make this fast and easy for you.
Meanwhile just keep reading the forums while you wait for you appointment so you can find something that will work for your discomfort.
We here know very well how difficult is to deal with this painful problem.
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Re: Finally Seeking Advice

Postby itcouldbeworse » 07 Jan 2013, 18:51

Thank you so much for your help! I'm calling the insurance company tomorrow!
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