Hi everyone,

I wanted to come to share my story.
In Dec 2021 I first started suffering with the awful pain of CAF. It literally dominated every facet of my life throughout 2022. I visited a consultant who performed Botox but that only worked for two months and I was in worse pain than ever. It was truly awful. I’m usually a happy person but could not think about anything else.

As 2022 drew to an end, I was so desperate, constantly searching the internet (and this forum) for a cure. As I’m a young (29y/o) female, the first consultant would not consider surgery. He pretty much told me to live with the pain, it wouldn’t kill me.

In January 2023, I visited a new consultant. She tested me properly and found that my pelvic floor resting pressure was twice what it should be. She said it could just be my anatomy alongside habits like shallow breathing. No chronic diseases as the first consultant initially thought!

I started pelvic floor physio and started taking fybogel (psyllium husks). I also spoke to the second consultant who said she would be willing to consider surgery if nothing else worked. Even the possibility of a solution helped me so much.

Now it’s May and I’m so much better. I still get slight bleeding every few weeks but almost no pain and I feel more in control. I feel like me again. Do not underestimate the hardship of this hidden condition.

Not everyone can afford the physio so the main trick is to breathe deeply while pooping. Long breath in to fill your tummy and then blow out like your blowing bubbles. Take the fybogel and drink lots of water (2 litres per day).

They are simple things, unlike some of the advice you get which I could never follow.

Also try deep breathing throughout the day and make sure you’re not holding in your tummy trying to look thin!

My consultant said these techniques solve 80% + of cases - I was unconvinced something so simple could work but she was right.

I had tried all the medicines and nothing. I had three CAFs and really was a bad case so… if it worked for me, it might help you.

I hope this post helps someone because having CAFs was the worst thing that I ever suffered so I know it’s very difficult. Of course I know that I might have flare-ups again but am hopeful that it will never be so bad.

Take care and best of luck with your recovery.

Thank you for your uplifting post. It’s great that you are feeling better. I am trying to breath more deeply and definitely while having a BM - I continue to hope I get some relief too soon!

Hi Poopinpeace,

I share your thoughts exactly! simple things I never noticed before about breathing; I been doing it all wrong for decades and cost me now later in mid-life:( Agree physio was expensive and hard to find good experienced pelvic floor therapist. It helped me start my healing but don't think it is a must if you can learn do yourself. I only had few sessions scheduled bi-weekly which is better than nothing but therapy needs to be daily in order to break bad breathing habits! It is like most physio for other muscles; therapist can only do so much in a single appointment and you have to go home and do exercises stretches yourself.

Hi Poopinpeace,

Thank you very much for your post. I am very happy that your 3 CAF have resolved themselves. I have had the same timeline and treatment as you (except the pelvic floor physio).

Could I ask if you developed (what appears to me, inflammed) skin tags? Mine started to swell post-Botox and have not subsided although now 4 months have gone by since the Botox. My consultant does not seem to think anything of them other than to say that they should not be removed as they are likely to cause more fissures.

My CRS has not said anything about seeing a pelvic floor physio either so I was wondering if you could share what exercises you were given / what the physio did?

Thank you again!!

Hi AF3!

Yes, I have skin tags… they are ugly but to be honest I don’t care very much! My partner says he doesn’t notice and when I mentioned it to my CRS she said she’d seen a lot of bums and I’d be surprised how weird they often look! Now that I’m feeling good, I don’t give it much thought and wouldn’t risk having them removed because, as you say, it could create more fissures… I think mine are the cause of itching sometimes but I use aloe Vera gel which helps.

Regarding the physio, the key thing was to belly breathe, whenever you think of it during the day. The other vital thing is that when you’re pooping, you need slow, deliberate breaths, expanding your tummy. Then breathe out slowly like your blowing bubbles. I’ve others describe ‘big belly, hard belly’ for how those two steps feel. It did not work for me for a good few months because it was hard to break the pain cycle. I thought it would be impossible because how can you relax your muscles when you’re in horrible pain… but somehow I got there.

In my experience, movicol did not help. Fibogel instead is what I take now and it really helps.

I also tried some pelvic floor relax videos on YouTube - helps you feel like you’re doing something more to help.

Best of luck!

Hi Poopinpeace,

Thank you very much for your reply. I really appreciate you coming back to post on this forum even though you are well on your healing pathway. I have realized that deep breathing is the key (while on the loo) and finding ways to relax mentally throughout the day (challenging but I guess that’s the point) so that it somehow translates to a more relaxed internal sphincter / muscle.

What drives me mad right now are the skin tangs that swell after a BM, which are more disruptive than the fissure. Whilst they are swollen, I have to lie down. When they do subside towards afternoon, they aren’t always small enough to make long walks (forget running) possible. That has been one of the worst impacts of the tags, my inability to exercise (I used to hike, bike and run regularly and they have all ground to a halt and I’ve gained a lot of weight). I’m just desperate to break this series of negative cycles and a lot of the time it feels like it’s out of my hands - in calmer moments, I know that’s not entirely true and that I can be the mistress of my own fate but it’s very hard to maintain optimism.

It’s perfectly natural to tense up at the worst possible moment due to anticipation of pain, fear and it took me months to battle against that instinct.

This whole AF experience has been eye-opening for me in terms of how anxiety and stress have been driving me for too long (I have IBS too) and in large part, not acknowledging it/dealing with it appropriately has played a large part in me being where I am. It’s just the worst time to try and reduce anxiety during a time where anxiety is heightened due to the CAF but for me, that’s my greatest challenge.

I’m going to look up pelvic floor exercises as well.

Thank you again for your reply.

Hi AF3
I too have had my exercise regime and main hobby that I love completely destroyed. I don’t think I’ll ever road bike again now as the tags (which originally I tried to have removed which led to the fissure) are still there (not as many) but I have two significant ones so I’ll never find a bike seat easy even if this fissure pain would resolve. So I understand your frustration. I’ve been devastated by this. I am able to walk and run a little though but I suspect many wouldn’t in my condition…. I also weight train but mostly with light weights and body weight exercises which don’t cause any issues. my brain can’t handle no exercise especially with the stress of an AF. I am belly breathing like crazy and it helps on the toilet altho nothing seems to resolve it. I just pray that one day it will all get better xx