Hi all,
Thank you very much everyone for being part of this only active AF support forum online. I have been reading stories here over the last 2 days and all the questions and answers have been so helpful. Looking forward to learn and gain confidence in managing my AF (not yet sure if mine is chronic or acute).
Quick Intro:
I am a 30year male who has been suffering from bouts of bleeding and pain during and after BM over the last 8 months (since Oct 2020). Just realized that the accompanying pressure has also been intense after reading some posts on related topics here. The following are the events that IMO led to these events.
AF Journey so far:
E1. Prolonged Constipation, Lack of exercise (i used to run almost thrice a week before and post lockdown, but had switched to strength and conditioning exercises which somehow seem to have led to the 1st event. -> Cured with Nifedipine + Lidocaine ointment, PEG laxative and SOS painkillers in almost 2 weeks.
E2. Had got my wisdom tooth extracted and was on antibiotics. Towards the 5th day, constipation led to bleeding and severe pain. -> Stopped antibiotics, took IBP to reduce pain and took some OTC probiotics to reduce inflammation (was trying to be my own doc). It somehow helped
E3. Severe S&C exercises with a really heavy weight for my body weight (including squats, lunges), coupled with some really spicy Indian gravies -> Led to the most bloody episode byfar. -> Got a telemedicine appointment, was recommended Nifedipine + Lidocaine, SoS painkillers, and laxatives. (I am based in India and here Nitroglycerin is not the SoC here, quite strange). Personal experience - PEG based stimulant laxatives somehow work better for me than osmotic laxatives like milk of magnesia which often causes diarrhea.
E4. Drank close to 1l of beer. Found it difficult, but somehow recovered by modifying diet in the next few days.
E5. (Current) - Had a spicy Indian garlic gravy after months of comfort and safe food and this led to the latest event. Apart from the blood loss which was traumatic, the pain was so severe afterward, i had to take my SoS painkiller. This happened just yesterday.
Here are some of my questions to members here:
1. Given these episodes - do you think my condition is chronic or acute? How does one know beyond the regular <> 6 weeks formula? My doc's diagnosis says "Anterior chronic AF with skin tag and sphincter spasm (this was after a painful anal examination by one of the renowned CRS in my side of the country). But not sure if this was real or because he was trying to push me for an LIS right after the 1st consult.
2. How frequently can one take painkillers and laxatives after these painful episodes? How long (days/weeks)? Are there any long term consequences?
3. Does sitting in the chair for a long time exacerbate problems for people with AF?
4. Are irregular sleep (i often sleep around 12am-1pm daily since i work with folks in the US/UK)/stress/anxiety other risk factors for AF episodes? Has changing these habits helped you?

Eagerly awaiting your responses,
Arun

Hi there, so sorry you are suffering with this awful condition. To answer your questions:
1) 8 months of pain meets the criteria for chronic anal fissure.
2) Non-stimulating laxatives like miralax are ok to take long term. Don't take stimulants like senna for long periods, that can mess up your normal function. Painkillers are ok as long as they are not affecting other things adversely. For eg, long term use of ibuprofen or opioids can be very bad for you.
3) Yes, because of additional pressure on an area that's trying to heal. Get a standing desk so you can alternate sitting and standing. Avoid donut cushions which won't help. Instead look into maybe getting a tailbone cushion when sitting. If you have to sit, a warm compress on the area might help with pain relief.
4) Yes, stress and anxiety affect muscle tension and bowel movements, in turn increasing the chances of an AF occuring. Poor sleep cycles also affect healing.

@patience_and_healing: Thank you for your quick response to all my questions and the suggestions regarding nonstimulant laxatives, standing desk and tailbone cushions. These are quite helpful!