This will be my second AF. After 2 months of creams i had a chemical sphincterotomy. This made my symptoms worse. My consultant told me that because a had a forceps baby that a sphincterotomy would put me at risk of incontinence. Has anyone on here had this procedure after having forceps baby??
I really can't take much more of the pain. When it starts i can't concentrate, walk, sit or lie down as its really bad.. I do get the odd few hours of pain free but as soon as i have a BM off it goes again.
Please can you help a new member.

Are u seeing a colon rectal specialist sweetie ? Pls read other posts to do the food n water n fiber regime. God bless u sweetie n heal us all

Hi lambertoz,
I had a forceps delivery too (9 years ago). I have an anterior fissure and my doc says he doesn't think LIS would help me, but not because of the episiotomy scar, because it's an anterior fissure. But I will have to ask him when I see him at the end of the month.
by chemical , do you mean botox?
Sounds like you need a second opinion.
I'm going to be getting another referral myself next week, when I see my GP.
have you tried a sitz bath for the spasms? Or sitting on an electric heating pad. Some people here have found some help from muscle relaxants. Without a prescription you could take some magnesium. It is a natural muscle relaxant.
Sure hope you start feeling better soon, you have come to the right place though.

Hi Grannymaria & workingonit
I saw my const last thursday who just said I must fall into the percentage that it doesn't work for. Said I will have to wait till the three months before he can inject it again if I want to go down that line. I am eating loads of fruit & fibre. Taking fibrogel on top. Also started taking magnesium supplements yesterday but I don't know how long they take to get into my system. I have a Epsom salt bath daily. But as soon as I have a BM it kicks off big style.
Nobody has really explained to me what a AF is. Learnt a lot on here. I feel let down by my gp & cons. I had to learn myself that a normal fissure can heal in a few weeks but if it takes longer its graded as a chronic AF. I am trying to get re ref to someone else.
Thanks.

lambertoz,
magnesium works quickly. The rule of thumb is, you are taking too much if your stool loosens, but in our case, that is a good thing.
I take 125mg, but have taken up to 200 in the past as a muscle relaxant. I am 5'8", 140lb. I've heard of 6ft guys taking 400mg.
It is so upsetting how docs don't take the time to explain anything. I always go armed with a load of questions and try to look up as much as I can before I see them now. But still, if you don't know the question to ask, you are unlikely to get the answer. If the first CRS I saw over a year ago had taken the time to explain, I wonder if I wouldn't be in this mess now.
But he was a closed mouthed so-and-so. I had a page of questions for him, but i had no idea about fissures at the time. I thought it was a hemorrhoid and he did not disabuse me of that error.
I wrote a scathing review of him on ratemd.com.
would it be possible for you to get a second opinion. I've heard the uk system is pretty slow.
but anyways, i keep a running list of new questions for my current CRS, that I will bring with me next time I see him, and I am looking to get another referral for a second opinion.
you might ask around about anal dilation. Not the old fashioned kind where they use their fingers, but the new kind that is controlled (aka standardized anal dilation).
I have heard as well, that self dilation done very gently and starting with a very small dilator (even just a cleaned pen) can be helpful for spasms. Almost like a massage or stretching out a charley horse in your leg. I haven't tried this myself, and I don't get spasms (TG!). But I do plan to self dilate when I am healed or if I don't heal, or keep re-tearing.
In the mean time I try to yoga breath and consciously relax those muscles as often as I can. I use lanolin on the fissure itself morning, night and after BMs, and I think it is helping.
Was your doctor talking a bout a full sphincterotomy or a lateral internal sphincterotomy?
Just out of curiosity, is your fissure at the front (anterior) or the back of your anus (posterior) near your bum cheeks?
Hope you have a better day today!
-Tanya

Hi Tanya
Do you know i don't think my crs has told me. Too me it feels to the left at the back. When the pain starts it can shoot to the front. He mentioned a lateral internal sphincterotomy.
Thanks
Zoe

Zoe,
Hmmm, Well if it is at the back it is well away from the episiotomy scar, so I don't see what the problem would be with LIS???
I would think he would need to do more testing before he ruled out LIS anyways. There's a test they can do to determine your resting pressure of your internal sphincter muscles. And then there's a test to determine the strength of your external sphincter muscle. That's the one they worry about. If it is too weak, that's when you can get incontinence from cutting the internal one. It's doing extra work to make up for a weakened external muscle. At least that's what I've made out from my searches and brief articles I've read. I have this on my list to ask my CRS on the 29th.
See if your CRS can explain WHY it makes you more likely to become incontinent. I mean why is it so hard for them to explain it us.... unless they don't really know themselves and don't want to confess their ignorance.
Are you going to get a second opinion? Can you in England?
You should ask him about dilation too. Just to see what he says.
-Tanya

Hi Zoe,
How you doing??
I finally got a second opinion today. Somewhat better than the first guy, but ultimately not much help really.
But anyways, He said that whether you've had babies or forceps delivery or whatever, it matters not, so long as the sphincter muscle still works well.
He tested mine quite simply, by putting his finger up my butt and asking me to squeeze. He said I was fine, and could have LIS fine, but didn't seem to think my case warranted it, which I happen to agree with. but it was nice to know I am have a 'normal' sphincter..... well except the little tear-from-hell in it!!!!
But anyways,
:)
always nice to have a bit of good news!
-Tanya

oH yah,
I asked him about self dilation, and he said it would help with spasms, and might help relax the muscle.
-Tanya

Lambertoz,
If you are eating lots of fruit and fibre then i wouldn't bother with Fybogel as this will just bulk things up and give you gas.
Start using a laxative called Movicol instead (the UK equivalent of Miralax). If you just use one or two sachets per day this will make things softer rather than make you rush for the toilet.
Movicol is available from Boots the Chemist but you will need to ask for it at the pharmacy section (you wont see it on the shelf)
Davo