Finally Talking About This

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Finally Talking About This

Postby fissure_be_gone » 29 May 2018, 07:08

Hey all,

I'm a 28 year old male chronic AF sufferer. I've been dealing with this things since my mid-teens. Starting out as acute little 'shits' that came for a couple of days but could be easily dealt with by using your standard OTC hemorrhoid creams, baths and going easy on the paper wiping.

I first went to the GP about my AF when I was about 18 as I started seeing quite a bit of blood with BM's.

The were on and off for the following 9 years, until early last year when I got my first taste of the chronic.

I knew that this time it wasn't healing in the same way, I tried a lot of OTC stuff, kept the stool soft, drank water, exercised, kept it clean, bathed to stop spasm etc. It just wasn't healing - back to the GP this was around January this year (having suffered with this one for around 7 months before going).

This GP was female, very stern and typical of GP. Did give a digital exam but I'd noticed a sort of 'bump' had formed at the opening of the bottom of my anus. I anticipated this was probably a tag or haemorrhoid forming but didn't think to mention it when I was at the appointment.

I was prescribed GTN - was getting headaches but used it for 2 weeks as was determined to heal. Thought I'd healed. Went back to old bad habits, CAF came back around a week later.

Tried GTN again - was getting bad headaches... Didn't stick with it properly.

Went onto a journey into intense stress and anxiety. Started getting anxiety around the prospect of cancer because it wasn't healing and I had this 'bump' that may have been missed.

Tried EVERYTHING I could find online to help healing. Coconut oil (didn't work), expensive suppositories and oils from Amazon (didn't work), bath salts (tend to use these after exercise anyway but don't do anything for AF).

2 things I have found helpful (but not healing) in this time:

1. Buying a heat pad.
2. Raising my knees whilst passing a BM (since doing this I haven't seen blood since). - Would love a squatty potty but family won't have it so I just use a metal bin we have in the bathroom, which is amazingly the right height for me to get my hips properly aligned to not strain.

I've noticed there is a definite connection between the onset of feeling pain/itchness/any sensation and mental prompting. I wake up and it's the first thing on my mind, thus causing tension, thus bringing the AF under tension... If I get a sensation I become obsessive over it and compulsively try to take action to do whatever I can to fix it.

I generally handle 'stress' in what would seem externally well; but internally I have gradually started noticing tensions in my body - and guess where is clearly tense a lot?

Definitely not helpful that I still have the thought lurking in my mind this could be cancer. I'm living my life thinking that when I see the specialist I'm going to be told that it's all over for me.

Since before AF, I'm pretty into meditation and I notice that compulsive trap, but I still find it very difficult to break from it. From what I notice stress/anxiety and AF are best friends.

Regarding BM, never go more than a day without a movement. Pretty healthy stools. Was noticing that stools were quite often hard; have since realised that my body naturally needs to go twice a day to keep stools soft (this is a GAME CHANGER: I've always wondered why my stools are large and hard when I eat fibre, exercise, drink water etc. It's because I'd trained my body to go only once a day, but that meant for me the stools were in the colon too long. Not had a bad stool in any way since going twice a day.)

I went through a stage of taking prescribed laxatives or stools softeners just in case, but as you can probably tell; I really don't need them.

So, I went back to the GP last month. This time I got a male GP I thought was really efficient. He asked me A LOT of questions, did the digital exam, seemed to take his time with it and properly examine the area. I still hadn't mentioned the 'bump' and he didn't either, but when he did the digital he asked where it hurt and I said at the back and he said that was what I said last time too. I can actually feel the fissure running down from the bump when I apply the GTN.

He has referred me to the specialist and said he was going to order I am checked out for inflammation / potential crohn's as I've been suffering with them for so long. He also gave me some more GTN and said to use it as it's the best they can prescribe.

Yesterday was a really bad day on GTN - headache completely took over, probably as it's really humid here at the moment. Have since halved the amount I am applying and no headaches now. Think there's still enough for it to do its job. If this is the case - the recommended dose is a huge overdose!

Specialist appointment is 2nd week of AUGUST (f****** NHS!) And I don't really want to talk with ANYBODY about this, so I'm on the forum - and I'm a very active user of forums so I will ensure I keep my journey updated. I just need to speak with somebody about this now, August is too far away...

"Who alone suffers suffers most i' the mind" - Shakespeare

If this heals, I suppose it's been a great journey of getting to know exactly what my body needs. So, if I heal, I'm kind of grateful for it as it should bring me vitality from what I've learnt... Let's hope!

Current strategy:

- Try not to let myself get into compulsiveness of sensation > attention. Recognise the sensation, let it pass and (for lack of better word:) distract.
- Continue raising knees when moving bowel.
- Continue BM's twice a day when feels like I need to go (seems to be morning - late afternoon).
- Use GTN twice a day with 'pea sized' amount to prevent headaches.

Otherwise practising a healthy diet, drinking water and exercising anyway.
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Re: Finally Talking About This

Postby jn91 » 29 May 2018, 11:05

Just out of curiosity, what is GTN? I don't think I've heard of that before.

I'm also a believer in the squatty potty'esqu sitting. I use an Epsom salt box and I swear it's made things go out quite a bit more smoothly.

I don't really have any helpful feedback but wanted to offer support. I understand the pain of suffering alone. Took me two years but I finally told my parents about my struggles and that was a huge help. They couldn't really help but a little support goes a long way and I don't feel like quite the pariah for my embarrassing problems.
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Re: Finally Talking About This

Postby fissure_be_gone » 29 May 2018, 11:09

Hey jn91,

"Glyceryl trinitrate: 4 mg/g.

One gram of rectal ointment contains 4 mg Glyceryl trinitrate (GTN). The delivered dose from 375 mg of this formulation is approximately 1.5 mg GTN."

GTN is one of the more advanced medical options in the UK. Its branded name is Rectogesic ointment.
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Re: Finally Talking About This

Postby fissure_be_gone » 30 May 2018, 06:09

Update:

The NHS recommends that if the stated dose of GTN is causing headaches you should instead apply a 'pea sized amount' 5-6 times a day.

The pea-sized amount seems to be reducing my headaches drastically. However, I found yesterday that another application within 10 hours brought on the headache massively.

I think a pea-sized amount twice a day is going to be sufficient.

It does seem to be starting to do its job slowly (and painfully - considering the headaches). Pain is less and today's morning BM had no associated pain even though it was a bulky (but quite soft) stools.

I've also noticed the sensation moving to more of an itch than pain, which could indicate healing.

Keen to shift to a more positive outlook on this, try to notice more that I'm not feeling any sensations and accept that as a good thing rather than 'search' for the bad feelings to check if it's still there.
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Re: Finally Talking About This

Postby fissure_be_gone » 20 Jun 2018, 10:17

Update:

All was going well since my last post. Seemed to be healing well and the only occasional problem that occurred was some itching. I guess the fissure may have been healing at this time with the GTN and otherwise good practices.

I went to Belgium two weekends ago and with not being able to raise my knees to defecate, drinking beer and potentially the stress of travel I noticed some blood with a bowel movement over there.

Unfortunately since coming back this has gone downhill further. Several instances of small amounts of 'pink' blood on the paper and some blood on the stool recently too.

More worryingly, I've had some bowel problems too. On two occasions just over a week ago I had some fecal incontinence in the morning after my first bowel movement, when thinking that it was just going to be passing wind. This is the first time I've ever experienced this where I haven't had a dreadful bug.

Since then I found that every morning after my first BM I would get some cramping/bubbling in my guts and would have to follow up with a second loose, watery bowel movement quite urgently.

This has no doubt caused issues with the fissure again.

Thankfully this morning (and today) the bubbling gut and diarrhoea seems to have passed - my first BM today was a hard one (typical). Then this afternoon softer but painful.

This was either caused by stress of having a health concern that it's taking the NHS 3 months to attend to or I do indeed have an inflammation problem. I'm still battling with getting in a rut that it could be cancer and every day I don't heal I'm getting more worried about that and it's turning into depression.

Back on the GTN. Going to try and keep that up until my specialist appointment in August now. I've also started drinking kefir in the mornings to help aid my gut health. I'm going to try and arrange to not have any more stays elsewhere until I'm fully healed. My idea now is that if the GTN heals it to the point where it's not causing pain, as before, I will continue to use coconut oil daily after bathing to help aid the healing.
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Re: Finally Talking About This

Postby loner46 » 15 Aug 2018, 01:52

My situation is very similar to your
I had anal fissure during year 9 in high school after passing big hard stool, but I was young and didn't stress a lot, so it healed itself, until last year when I am in university. The stress from uni assignment probably cause my anal to tense up, felt like a lot of pressure so the fissure came back, I was in a lot of stress and worried a lot, probably when you get older you feel more stressed whenever something bad happen to your health. Then I tried Anusol but didn't help, went to a lot of doctors but they are all unsympathetic, I decided to try anal dilator then surprisingly the fissure went away, no more pressure no more blood for like 1 year?
Until 3 days ago, I am currently in 3rd year of uni and I am dealing with a lot of assignments so I got stressed again and the fissure came back lol. I probably will try to get Rectogesic ointment from the pharmacy today and see if it help or not. I still think that my anus always have a lot of tension that's why it is so easy for anal fissure to occur.
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Re: Finally Talking About This

Postby fissure_be_gone » 16 Aug 2018, 09:06

Hi Loner,

Welcome to the board and thanks for the comment.

It's evident in just looking through posts here or elsewhere on the web, most people who suffer from these have issues with stress management or anxiety - and when we get these issues with fissures that don't heal they turn into major heal anxieties which exacerbates the issue completely.

Unfortunately my fissure is still causing me issues. The hospital rearranged my specialist appointment last minute and I couldn't make the appointment and didn't respond to my email to rearrange a date, so I'm another case stuck in the NHS referral F**k up. - I will definitely be taking health insurance when I am in position to do so.

I found rectogestic too much with the headaches etc. And it doesn't promote healing the way it is supposed to in my experience. The ONLY way I found healing commenced for a long period was when I was taking 2 stool softeners a day. Keeping the stool soft is the only way to heal these things.

I actually thought I was healed as the symptoms went away all through July and into Aug.

However, the prolonged use of a 'laxative' started to concern me and I have been having a lot of issues with gas etc. So I decided to try and stop taking the stool softener - straight back to hard stool and another bleed.

My problem now is, no matter how much soluble fibre I add to my diet and water I drink, I can't seem to keep my stool soft.

I'm back on the stool softener as a dicky gut half the day is better than the fissure pain and alarming bleeds. I've got about half the pack left so I'll take one a day, but have also started taking l-glutamine, probiotic and dietry fibre as supplements in the morning so I'm hoping when the dulcoease runs out these new supplements will help keep me soft. I'm also going to have a smoothie every morning without failure with ground flaxseed in to help keep things gel-like.

As for the dicky guy, I think a lot of that has still been stress. I still haven't managed to get some of my stressors sorted out otherwise...

I think looking after the soft stool is number 1 priority over all else.
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Re: Finally Talking About This

Postby Camry » 16 Aug 2018, 09:43

Do you also feel pain after a bm that lasts for hours and goes away usually when day ends?
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Re: Finally Talking About This

Postby fissure_be_gone » 16 Aug 2018, 10:25

Yep! It's been better lately, but that was definitely something I experienced often.
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Re: Finally Talking About This

Postby Camry » 16 Aug 2018, 11:06

How were you able to manage the pain? Its a bit annoying at times...do you take pain relievers for it?
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