Hello - new here and looking for some advice

Think I have a AF but not sure

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Hello - new here and looking for some advice

Postby Halloween67 » 14 Nov 2014, 07:31

In March 2014, I underwent IRC for internal hemorrhoids. I was symptom free for about 3 months, when I went back - at the time, my doctor told me that I had some more small hemorrhoids, but that they should not be causing any pain. Over the next 3-4 months, I had pain 3-5 days each week - always after a BM. Sometimes I would have a little pain during BM, but always would have itching to burning pain afterwards. Finally, in September I underwent IRC again. At the time, I asked the doctor about anal fissure, and he dismissed it, saying that they only cause pain during BM not afterwards. For the first week after IRC, I had minor itching and pain, but it seemed to be getting better. But, about 10 days afterwards, I started to get intense pain - much worse than I ever had, during and after BM. I called doctor after two weeks and went in. The doctor saw one small hemorrhoid and believed that what I had was a spasm, as the area around the hemorrhoid was very inflamed. In all of these visual inspections, the doctors have never seen a fissure, which is of concern. I just want the pain to go away, but cannot figure out what is causing it, and the doctor seems to be of little help. I scheduled an appointment with a second gastro doctor, but he cannot see me until January. So, I have been searching the Internet when I found this board. I was hoping someone here could help me to narrow down what I may have.

The symptoms - minor to sharp pain during BM (depends on softness of BM), burning pain about 15-45 minutes afterwards (sometimes very painful, sometimes not so much), pain when sitting on hard seats (my butt is on fire after 5 minutes driving my car), walking and/or laying down helps. If I walk on the treadmill, I will start to get some pain about 20-30 minutes in, which eventually turns into intense pain (I stopped doing this, but is not helping with my waistline). I do not have any bleeding (never did with hemorrhoids either), and all pain (burning) is isolated in the butt region. Although not officially diagnosed, I believe that I have IBS too, which is definitely not helping with the situation. Frequent diarrhea, bloating, and lots of gas may be a factor in irritating the region.

So, does this sound like an AF? It does to me based on my research, but because doctors never found one, I am wondering if it might be something else? In terms of trying to treat it, I am using Witch Hazel after each BM. I bought some organic AF oil, which I apply 2-3 a day (for about a week now), and am trying to increase fiber and just started taking stool softeners. I was researching to see if I could find a good suppository for the burning pain, as nothing else seems to help with this, and this is what is most creating havoc in my life. Luckily I work from home, but I cannot keep taking 1-2 lay downs each day when I have a flare up.

Thanks in advance for any help/advice.
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Re: Hello - new here and looking for some advice

Postby Scientist2516 » 14 Nov 2014, 11:46

Hi Halloween,
It does sound like a fissure. The doctor who told you that pain is only during the BM was wrong, wrong, wrong. If he did not see a fissure, maybe that's because he was so sure you did not have one.

If it is a fissure, you need the proper medications right away. Nifedipine, diltiazem or nitroglycerine are the drugs for AF. They relax the internal anal sphincter, helping the spasms, and also relax the walls of the blood vessels supplying the area, which improves healing. I don't think you should accept that you can't be seen until January. Try calling and seeing if you can get a cancellation, or if there is someone else who will see you. It doesn't even need to be a CRS, since a GP can prescribe those medications. If they won't see you, make a fuss! Tell them you are in agony (which you are). Or go to the ER.

In the meantime, try gentle heat to the area. I know you have a burning pain, and heat probably sounds bad. But the pain is most likely from spasming muscles, and heat really relaxes muscles, just like the drugs do. A heat pad or warm hot water bottle (don't put very much water in it, since you will be sitting on it!) can be really soothing and helpful. I had a hot water bottle to sit on all day every day, and tucked it under my bottom at night too. It was a big factor in my healing. You can actually microwave them (2 minutes or so) which is easier than heating up kettles.
Try ibuprofen to reduce inflammation.

If these things don't help you, there are lots of other things to try, and people here will help you with advice and tips. For advice on IBS, try the subforum crohn-s-colitis-ibs-f30.html

All the best - keep us posted!
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: Hello - new here and looking for some advice

Postby Halloween67 » 15 Nov 2014, 19:48

Scientist - thanks. I never even thought about a GP - I can definitely head into Urgent Care tomorrow morning, and get them to proscribe some new meds. I was trying to work with my Gastro doctor as he has been treating my hemorrhoids, and thought it would be faster or better to continue to work with him - however, as the months of pain has gone by, I have completely lost faith.

I will also try a heating pad. That is a good suggestions - I did notice that sometimes, when I was in a little pain, turning on my heated seats in the car helped make my bottom feel better. If the pain is really intense, then nothing seems to help except laying down.

I will keep you posted on how things go - thanks again for the quick response!
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