Hi

First post on here, been reading various threads and gaining lots of useful information. My story below should give some idea of where I am. I am 40 year old male living in UK, in quite good health.

I was first diagnosed with hemorrhoids in 2000. These were banded successfully and disappeared. Occasionally over next 10 years I suffered occasional flare up but was able to control with suppositories, creams, diet etc. In December 2009 I had another flare up, but this was different to any before. Pain was so bad that I had to go to A & E. There I was diagnosed with anal fissure and given Rectogesic ointment. I got the major headaches but as I was off work sick I was able to perservere with it. However at that time I was worried about the bleeding so I had a colonoscopy done to rule out anything more sinister. Consultant confirmed that there was an Anal Fissure and Hemorrhoids. The Rectogesic seemed to fix the Anal Fissure and I got the Hemorrhoids banded in December 2010. From memory there was still some pain for about 12 months after banding because I still used Proctosedyl suppositories after bowel movements, and also took two Fybogel every day.

Everything was OK until June 2015. Initially I seemed to have flare up of hemorrhoids so I started using suppositories once more. This sort of kept it under control. I was away on holidays in July and had considerable diahorrea. This increased pain considerably. I attended GP regularly and he confirmed presence of hemorrhoids. There was no bleeding however, just intense pain after bowel movement, sometimes lasting up to 10 hours. He did proscribe Rectogesic but because of work pressures I wasn't able to use it properly, as the headaches were debilitating, and I couldn't afford to take time off. I tried to carry on until end of September but things were just getting worse. At this point my GP suggested referral to colorectal consultant. I live in Northern Ireland and NHS waiting lists are horrendous, was looking at 4 month wait just to see specialist. I arranged private consultation and consultant confirmed presence on internal hemorrhoids, and he carried out banding at end of October. However the intense pain hasn't stopped since the banding. I went back to see him in December for a follow up and he said that when he was banding the hemorrhoids my anal sphincter went into spasm, and he thought that this was making things worse. He suggested Rectogesic but i explained about headaches so he prescribed Anoheal (diltiazem). I used it from middle of December but with no huge improvement. After Christmas I suffered from a prolapsed external hemorrhoid. By the time I went back to consultant it had started to heal on its own, but at this point I explained that I thought the banding hadn't worked and there seemed to be something else causing the pain. So he has suggested that he carry out a rectal examination under anaesthetic, should happen in February. I asked what he thought it could be- he was quick to rule out anything major, but only suggested maybe a fissure that he couldn't see under normal examination. He did say that if there was anything he could do to fix whatever is wrong when he is carrying out the examination then he will- he said botox, or maybe further banding. I am using fybogel twice daily and bowel movements are easy enough, but the pain is present whether they are easy or not

This is where I'm at with things. I got some questions though if anyone has any thoughts?

1) If its not hemorrhoids or a fissure what else could it be. Like I said no bleeding just considerable pain after bowel movement. Consultant talked about spasms. If they are burning pains then maybe I'm having them.

2) I'm off work sick now. Was going to try Rectogesic now. Is there any point, considering I've had the same pain for nearly 6 months? The last time I used it the fissure had only happened, whereas this time, if it is a fissure, its been there for 6 months

3) If it is a fissure is botox any good?

4) Lastly GP had given me Methocarbamol for spasms. Is there any point in taking it? I searched on here and there are a couple of people have used it, though its not something normally given. I've thought about trying magnesium tablets. Would they be better.

Apologies for length of post, but any help or thoughts would be much appreciated.

Thanks

In regards to the Botox, I had it 2 weeks and 2 days ago ......so far absolutely no change, still pain, still can't sit down, can't do pretty much even basic tasks and becoming increasingly terrified of BM's.