Hi Everyone,
I was diagnosed with an AF one week ago by my GI doctor. This forum has been extremely helpful with gaining a lot of knowledge about this problem. Thanks a lot to everyone who contributes to this forum! You guys are amazing!!

A little bit about what happened to me
I have been a life long vegetarian, but not exactly eating healthy. About 3 months ago I joined a fitness and nutrition program, during which I changed my diet drastically.For the last 2 months or so I have been doing carbohydrate cycling. Basically avoiding carbs on one day and no fats the other day. Also I stopped all unhealthy carbs, no sugar, portion control, etc. I lost about 30 pounds in the 3 months. My stools are generally soft, but I noticed that my stools were slowly beginning to get a sharp edge to start off. After the initial start it remained the usual soft consistency. Then about 9 days ago I noticed a slight bleeding on the toilet paper and some burning sensation. I did not worry too much about it because I have seen something like this before and it has generally resolved itself within a day. But this time it was different. The pain after BM increased day over day. Then I started exhibiting classic AF symptoms (didn't know then) including severe pain about 30 minutes after BM, smeared blood in toilet paper, lot of pressure in the anus, itching, etc. Then I visited the GI doctor who did a digital exam which was quite painful and he said that I have an anal fissure and prescribed me 0.4% Rectiv.I have been using that 2 times a day for the last 5 days
1) Pain and Work
I experience severe pain, burning, itching, etc around 30 minutes after a BM. It lasts for 3 to 5 hours. The pain is quite severe if I try to move and brings me to tears . It becomes a little bearable and starts subsiding if I lie down on my side. The moment I try to move the pain starts off badly again. The evenings have been fine. Due to this I have taken off work for the last 4 days. I see a lot of people go to work with this. I simply amazed how people are able to go into work with this pain. Am I over reacting and taking days off? My pain says no, but I want to get a feel for what others think here.
2) Diet
I have given up on the carb cycling and have started following a lot of the recommendations on this board
- oat meal, brown rice, fruits and veggies, beans and lentils
- lots of water 3+ liters per day
- no spicy or fried foods at all
- about 2 teaspoons of coconut oil orally
- everything cooked in extra virgin olive oil
- eating 5 prunes a day
3) Stool softening plan
This has been the most tricky thing. I have been taking the maximum allowed dose of colace 1x100mg pill 3 times a day. I still have not been able to take off the sharp edge to my stools while starting off (super soft after the start). Still see some small amount of blood in the stools. I think this is preventing me from healing. Is it ok to combine miralax and colace? If yes what would be the recommended dosage?
4) Sitz bath/Showers
Once before BM and once after and 2 or 3 more times during the day with coconut oil in the water. And one hot shower.
5) My GI asked me to follow up after 6 weeks and he said he is fairly confident it should heal by then. I am not sure if my symptoms have improved much at all. So I am wondering if I should visit a CRS to get an expert opinion or wait and watch to see if this thing heals on it's own as the GI doctor said?
Thanks a lot of reading through my super long post!

Hi sorry to hear your suffering
I can totally relate to the pain you are describing, mine would start about 20 mins after a BM and last for 6/10 hours....quite frankly it was hell. The spasms are the worst pain I have ever felt, labour, crohns, dislocated joints all pale into insignificance compared to the agony of a spasm.
I took 8 weeks off work when it was the worst but the GTN (rectogesic) made my life so much more liveable yes I still had a lot of pain and burning but it helped the spasms. I was on 4x a day for most of the time as it was so bad. Keep up with the baths they help with the pain and the healing
Most people do heal fairly quickly from an AF it's just they few unlucky ones that need an op.
I'm assuming your not wiping with TP anymore as that is really bad and can irritate an AF. Cleaning with a shower head is great as is a potable bidet or wet TP.
Sorry I can't help with the BMs as I have crohns so don't have much experience of trying to keep a BM soft.
The best thing is to try and stay positive you will heal and the pain will get better. If you do need more treatment CRS's do tend to have more experience Of fissures than a GI but if your happy with your doc than there is no reason to change.

Just to add to mbp's reply - maybe try a glycerin suppository to soften up the "start" of the bms. It draws water in but can act more locally (rectal) than the oral stool softners. They can also help lubricate things during a bm. They may be a little painful to insert with the fissure, so I would apply lots of Vaseline before, and maybe try the smaller children's size, at least to start.

For me, the pain was that bad, and had me in emergency several times. This is one of the most painful things to deal with, and the pain can vary greatly among individuals (depending on severity, location, etc). Listen to your body and don't be afraid to rest if you can.

Hope that helps, sorry you're going through this but it sounds like you're doing everything right. Hang in there.

Thanks a lot Mypootbutt and GilmoreGirl for the great advice.

I am not using a toilet paper anymore. As disgusting as it may sound I take a sitz bath right after the BM to soothe and clean out. Then I use a single baby wipe to clean out what is left. If I am not too much in pain I take a shower right after. I unfortunately do not have a moveable shower head. Any suggestions for a portable bidet?

GilmoreGirl
Today the BM was pretty bad. Instead of the tip the 1st 1/4th of the BM was sharp and long. The rest was like mush. Would like to make the whole thing like mush and not go through the agony. I am starting on Miralax today. I will also get some glycerin suppositories today. I am thinking of starting with the child ones (2 - 6 years old) just to make sure I am not trying something too strong.

Thanks a for all the advice. Will update this thread as to what is happening.

That sounds like you're continuing to do everything right! The miralax will likely work for you, it does for most! My doctor recommended it in combination with Metamucil. The Metamucil bothered my ibs, but it worked great for bms with the miralax. I'd have a smoothie with some banana and other fruit, and blend the miralax and Metamucil right in. Bms were soft but formed - which for most is the easiest to deal with.

The glycerine suppositories are fairly gentle, mostly just lubricate things - and that does make a world of difference with a more solid bm.

Really hope this clears up for you soon!

That sounds like you're continuing to do everything right! The miralax will likely work for you, it does for most! My doctor recommended it in combination with Metamucil. The Metamucil bothered my ibs, but it worked great for bms with the miralax. I'd have a smoothie with some banana and other fruit, and blend the miralax and Metamucil right in. Bms were soft but formed - which for most is the easiest to deal with.

The glycerine suppositories are fairly gentle, mostly just lubricate things - and that does make a world of difference with a more solid bm.

Really hope this clears up for you soon!

That sounds like you're continuing to do everything right! The miralax will likely work for you, it does for most! My doctor recommended it in combination with Metamucil. The Metamucil bothered my ibs, but it worked great for bms with the miralax. I'd have a smoothie with some banana and other fruit, and blend the miralax and Metamucil right in. Bms were soft but formed - which for most is the easiest to deal with.

The glycerine suppositories are fairly gentle, mostly just lubricate things - and that does make a world of difference with a more solid bm.

Really hope this clears up for you soon!

That sounds like you're continuing to do everything right! The miralax will likely work for you, it does for most! My doctor recommended it in combination with Metamucil. The Metamucil bothered my ibs, but it worked great for bms with the miralax. I'd have a smoothie with some banana and other fruit, and blend the miralax and Metamucil right in. Bms were soft but formed - which for most is the easiest to deal with.

The glycerine suppositories are fairly gentle, mostly just lubricate things - and that does make a world of difference with a more solid bm.

Really hope this clears up for you soon!

Wow sorry I don't know why that posted a million times! My bad!

GilmoreGirl wrote:That sounds like you're continuing to do everything right! The miralax will likely work for you, it does for most! My doctor recommended it in combination with Metamucil. The Metamucil bothered my ibs, but it worked great for bms with the miralax. I'd have a smoothie with some banana and other fruit, and blend the miralax and Metamucil right in. Bms were soft but formed - which for most is the easiest to deal with.

The glycerine suppositories are fairly gentle, mostly just lubricate things - and that does make a world of difference with a more solid bm.

Really hope this clears up for you soon!

When do you take the Miralax? I am planning on taking it at night before sleep. Is that the right time? Also I am worried about taking Metamucil as a lot of people here mention that it has the chance to bulk it up too much. Since all my meals are already fiber filled. But would it help to soften it I wonder. Maybe I will try a small dose of Metamucil as well.

Also I poo once per day in the morning. I wonder if the food I eat in the morning staying in GI tract for so long is causing the hardness. Too many variables