Hi,
I am Greg. I just switched GI doctors and he thinks I have an AF. I had a CT Scan with contrast and iodine and he should have results today. I have suffered for several years and ruled out anything urological. I have been to lots of physical therapy, chiropractors, GP's, spine specialists, etc. I can point to where it hurts but so far no diagnosis. The pain is between the back part of my rectum and sometimes radiates to the perineum area. I had a colonoscopy about 9 months ago with no major problems other than a few HR's that were treated with the CRH O'Reagan system (rubber bands). Doc has started me on Mirilax and nitroglycerine ointment and lots of water. Please let me know if it sounds like I belong here.

HI Greg,
A GI isn't usually the best doc to deal with an AF. Usually it is a CRS (Colorectal surgeon).
AFs are a pretty individual hell. Some people have tiny microscopic ones that cause them great suffering. Others have one almost down to the muscle and go on with their daily lives.
If you look up spasms here using the search engine, you can judge from other's descriptions if it sounds like what is happening to you.
There is also another anal fissure forum on yahoo.
please keep us posted on how the nitro helps you!
For more thorough searches, you can use the portal section (see above next to 'home') . There is a search engine at the bottom on the left side. Choose 'google' and 'posts'. and it will use google to search within posts, not just topic headings.
-Tanya

Hi,
The reason I went to another GI is when I went to to a CRS he didn't offer any help at all. He looked with the scope and said he didn't think he could make my pain any less. He is the only proctologist in Athens, GA. Is a CRS and a proctologist the same thing? Anyway, my CT scan came back normal and the doc has got me doing Mirilax, benefiber, and nitroglycerin ointment 3 times daily. He said it would take 3-6 months to heal. He said if it did not heal in 6 months he would consider sending me to a CRS.

Greg,
I'm not sure if a proctologist in the US is the same as a CRS. I know they call CRSs, 'Proctologists' in England...
If your GI sends you to a CRS, would it be the same guy?
My CRS sounds like your guy. Kinda shrugs his shoulders and starts looking at his watch.
It does take a long time for AFs to heal once they become chronic. I am healing, but it's been over 4 months since i sought help and started to manage my diet etc. better. I figure it will be another month or two before i can say with certainty that I am healed.
If it is muscle spasms causing your pain, you might look into self dilation. Or even Standard Anal Dilation (SAD). Just do a search here and check it out.
Your GI sounds pretty good.
You said you were doing therapy before. Was that Pelvic Floor Therapy? There's some info on the board about that as well.
That's great that your scans are normal. :)
-Tanya

Hi,
At one of the physical therapy places I tried the self dilation. It may have helped a little bit but I don't think it was the major issue. I was willing to try anything. After that I went to try accupressure. Again, I felt better but it did not get to the real issue. My GI doctor now seems to be on the right track. At least he is giving me something to try. He said that he is a little conservative and recommended we try the fiber, nitroglycerine ointment, and Mirilax for 3 or 4 months and if there was no improvement he might send me to a CR doctor. I definitely do not want to go to the last one I tried. Yes, he was the kind you described "shrugged his shoulders and starts looking at his watch". I like that analogy. Thanks for all the information.

HI Greg,
Your most welcome!
I was wondering how long you tried the self dilation and how large a dilator you made it up to?
I know from other's accounts that it can take months. I find it slow going myself, although it's only been a month for me and I am only up to 0.8".
I hope things are starting to improve for you.
-Tanya