After 5.5 months of sheer agony I finally see a CRS on Monday. The nurse instructed me to do 2 fleet enemas. I just called and told her that the pain from either the fissure or Sentinel piles or Hems are excruciating. She told me only do it if I can. Well, I do not think I can. I can't even touch the area without hitting the roof. The thing I am concerned about is after all this time, I need the CRS to take a good look. Does anyone have any suggestions to help me. What if I just do not eat for 24 hours? I do not take any fibre supplements as I usually have loose stools. Any ideas for me as I want him to have a really good look at this fiasco invading my rear end?

If she said not to worry, I would not worry. Is this under anesthetic? I have never just gone to see a CRS and had to do an enema. Only when I had a sigmoidoscopy, and then I got the Fleet Naturals on Amazon. Try just eating very lightly for two or three days and taking of Milk of Magnesia. That is what I would do, but don't go totally liquid, as that would not be good for formed BMs.

Thanks SavaIci. No this is not under anesthetic. I think I might be in for some pain from the exam!?!

What is the crs actually planning to do? You only usually get enemas if a camera is going up there quite far. I was booked in for a anoscopy under general anaesthetic and I didn't need an enema for it. Ask if they can do without one. I was given an enema by a nurse in prep for a sigmoidoscope once and it was agony having something shoved up there. If you are in total agony as you say you should ask for any exam to be done under general anaesthetic. I don't think you'll tolerate even a finger if you are in that state. I know because I couldn't either.

When you are asleep they can have a good look and the trauma will be minimised to the fissure because when you are asleep you wont be tensed up so things can be inserted much easier.

If they insist you need to be cleared out ask for the laxative alternative. They usually give you a strong laxative the night before that will make you go big style. Better than having a bottle shoved up there.

I will also say that when I was examined when I was in the most pain ever, I cried and yelled through it all and I have a high tolerance. It was excruiating, I cannot lie. The second time, I saw a CRS, and knowing the agony I was in she did not examine me inside. I just will never let another doctor put his finger or an anoscope inside me without some form of knock out.

The same CRS did my sigmoidoscopy, and she was incredibly gentle. I had that semi-awake anesthesia and all it was was a little uncomfortable going in.

Always be the advocate for your own health. Ask what they are going to do.

It is peculiar because this is my first appointment. I have no idea what he is going to do. Right now I am in a pain spasm of 10 and could not have anything put up there. I am quite scared to tell you the truth.

Then you must tell them when you go to your appointment. There is no reason to put anything inside if you are in severe pain. The doctor can just pull the anus slightly and see if a cut is visible; sometimes it's not.

I am nearly positive that this is an anal fissure as it has all the marks of one. Hemorrhoids and any sentinel pile (skin tag) do not give pain at a level of 10 for an extended period of time. An abscess would, but then you would probably be leaking discharge from this.

Do hope you are soaking in a Sitz bath?

If it's your first time visiting your crs they will want to do a simple digital exam. That is basically them putting a gloved finger up your bum and having a feel around. Takes 2 seconds but it is very painful if you have a fissure. Tell him/her she is permitted to look on the outside but not do a digital exam. They will probably just have a look on the outside and maybe pull your cheeks apart slightly to see if they can spot the fissure.

If they want a full exam (it's likely they'll ask you to have a sigmoidoscopy if you mention you are bleeding) then tell them you wont be able to tolerate the pain and they should offer it to you under a general aneasthetic. It's likely once they've heard how bad your symptoms are they'll suggest botox. If they do you will have to be knocked out to have that done anyway.

Just stand your ground. They wont do anything to you that you don't agree to. Take a friend along for support if you are nervous. My mum usually comes with me.

I can understand your anxiety though.I used to feel like I was going to have a panic attack in the waiting room imagining all sorts of silly things. "what if i tell them no and they say I have no choice in the matter. What kind of horrible thing are they going to probe me with against my will" such silly thoughts but you can't help thinking them as you associate anything that disturbs the fissure as a form of torture and your mind runs wild.

The first meeting will be a quick look (without insertion if you ask them not to) and a chat. My CRS was a very understanding guy.

I am very certain that I have inflamed sentinel pile or inflamed external hems with fissure. This inflammation is right on top of where I think the fissure is. The "what ever they are" hurt to the touch and there is some bleeding along with "water like" substance after BM's.I can feel them when in the sitz--the place that I live, most days. It has been almost 10 hours since BM and I am still in spasm. I have been living like this for a very long time. The other thing i was told by the receptionist is that he wants me to immediately have a colonoscopy and book it now. I told her that was impossible. I can barely walk from the pain most days. I do the cowboy walk most of the time. I really am terrified and appreciate everyone's input.

SavaIci yes, I am in epson and baking soda sitz 4-6 times a day and at other times just plain warm water. I know exactly how many tiles are on my bathroom wall! Counting tiles to pass the time!