Hi all
Glad to see a whole forum dedicated to AF! Hope I can get some help and also help others.
My problem - 7 weeks bleeding when making BM (bright red blood sharp pain) absolute AGONY all day,( I thought it was hemmies as ive had in the past but thought maybe i had a bad case this time.) later at night pain eases off, then next morning BM and SAME VICIOUS CYCLE! :( this all began after a really hard poop 7 weeks ago.
Went to see GP last week and has referred me to colonrectal surgeon - got appointment in 1 month. H
GP noticed 2 external hemmies and prescribed scherproct cream, didnt help. also, referred to specialist. I was confused by how bad the pain was and concerned as it didnt feel like typical hemmies pain. I looked on interent and my symptoms pointed direct to AF.
I called my GP and he also agreed it could be AF, and prescribed Fybogel & PROCTOFOAM - Stings like crazy and really hurts when I insert the applicator in my bum! :( Not really helping.
The fybogel is making my poo really big and uncomfortable to pass, my stools are much fuller now and thinking of just taking Senokot instead.
Im a little confused as most peoples AF are visible around the anus, I cant see anything and the pain is defo coming from inside.
I cant explain how bad the pain is!!!!! What makes things worse is Im a Driving Instructor and sitting for many hours in the same position with the pain "drives" me mad!
I find the pain during a BM not too bad - sharp but not agonizing. When I wipe its bright red blood with a few what look like small darker red clots. Then about 20min later the pain really does get intense and lasts all day (in waves) Im having as many sitz baths as possible - very soothing but 10 minutes later im in pain again.
went to Chinese herbalist and got something called "may yoing long musk" onitment WOW!! super cooling! defo worth a try,but doesnt cure!
Im drinking as much water as possible and changed my diet. Hopefully things will get better. I just hate that feeling knowing that if i take a trip to the loo my whole day is destroyed!
Would love to hear how my colonrectal specialist will diagnose my fissure? I cant
bear to let him put his finger up there! - does it hurt? (Im outta there if he gets the Proctoscope out! )
If you can give me some tips and how to make the pain easier that would be great! Just feel like starving myself so i dont have to poo for a week or so and give the AF time to heel! :(
Look forward to your advice
Paul

Hi Paul,
So sorry to hear that your going through the acute, painful cycle of the fissure but glad to hear you've now got a CRS on your case and things are moving towards treatment.
My initial consultation with a CRS was not that eventful. He tried to examine me but the minute he got anywhere near the area, I yelped and he then recommended an EUA (Examination under General Anaesthetic) which means they can have a good luck without you even being aware. Very simple process. Like you, my fissure was internal and nothing was visible just by looking.
Following the diagnosis of the fissure under the EUA, they gave me Diltizam, which worked wonders, provided much pain relief and I believe it contributed greatly to the healing of my fissure. My suggestion would be to you that if the Proctofoam is not really working and causing you pain, then to go back to your GP and ask for Diltizam or Rectogesic as these appear to be more common/ and both can really assist healing. I struggled with the head pain the Recto gave me and then switched to Diltizam, which was fantastic. Applied internally twice daily.
I too experimented for a while to get the perfect diet for the perfect Mr Whippy BM!! - I immediately started on the Fibogel but actually stopped it, realising I was already actually getting a good amount of fibre intake and I believe the Fibogel just increased the bulk of my stools and also made them larger to pass.
I just ensure I eat lots of beans, cooked veggies, fruits and everything brown (rice/ pasta/ bread) and not too much bread, potatoes or bran as this can make things bulkier too. Needless to say, LOADS of water after eating.
I would just say be careful with Sennacot as it can be quite harsh. I think Movical or Lactulose are probably better options as stool softeners and one great tip I've learned is a tablespoon of extra virgin olive oil every night before bed!! It helps lubricate that early morning BM and I would never do without it now.....
It's tough dealing with that pain on a day to day basis, drove me to depression, but I found pure aloe vera, witch hazel, vaseline and sudocrem really helpful as short-term pain relief methods plus Ibruprofen if it got too unbearable and of course, lots of hot baths as you know.
There is so much great advice on this site and so many wonderful people able to offer you support.....Just devour it...and try suggestions from others too to see if they help. I forgot to add that I also regularly take Vit C, Zinc, a multi-vit & fish oils...........
Truly all the best in your healing but please think about trying another of the creams out there. They may help you far more than the Proctofoam?
Good luck with it all & hope that all goes well with your CRS appointment. :)

Some good advice there from ETO! I ws examined in my first consultation, first they inserted a finger (eurgh gross I know!), then they use an anuscope. Some CRSs may not do this though if it is too painful. I too had a EUA when having botox so it may be possible to do that. I would get on the rectogesic asap!! You are doing all the right things. Its good you have got in so quickly to see a CRS, it can take ages on the NHS! I ended up going private in the end (after alot of saving!). Good luck, keep us updated! :)

Thanks ETO! As Sue says really good advice there.
Just an update - Im no longer bleeding after BM as the Senekot is really helping soften the stools. I agree with what you say about Senekot though, can I buy any of those stool softeners over the counter>
I have noticed that I have developed 2 more external hemmies, they are much smaller than the other two. Im now beginning to think it hemmies that are causing the problems. Suppose I wont know until I see CRS.
I think I will opt for EUA I really couldnt bare to let him insert his finger...its bad enough inserting a small suppository.
Again thanks you both for you advice, I shall certainly follow it. Will keep you updated....

Just another update.... Pain has been horrendous today so Called NHS and they have made me an appointment at The Urgent Care Centre at A&E. Hopefully this will get fixed now!
Will update you when im outta there...

How did it go?

Hey Comfortably Numb....
How did it go?
I also got straight in for a EUA after seeing my CRS because as I said my pain was so bad, they just told me to come back into hospital the day after I saw my CRS, for the procedure.
Hoping by now, you will know exactly what is going on, which will provide you with lots of reassurance.....
You can get both Movicol and Lactulose over any pharmacy counter and do not need a prescription for it.......I will continue to take Lactulose until I feel it is no longer needed!
Those external hemmies are horrid!! I never realised I have 3 or 4 until all this bum stuff happened. They've always probably been there but just became more noticeable, swollen and painful after my op, although they do shrink pretty quickly so don't bother me generally, unless I have a bout of diahrroea and then one might maybe reappear for a short while. They really don't help though do they???? but at least (touch wood) mine do shrink and then I forget they are there....
Hope you are feeling OK and you now have some pain relief. Pls update when you can :)

Hope all went well, at least you will get to see someone quickly. I got admitted to hospital and was in 2 days, followed by an MRI 2 weeks later and an appointment 3 days later when they found the fissure. It was after this the delays started! I hope you got something done!

Hi Guys,
Sorry for late reply. I went to Urgent Medical centre at my A&E as I was in immense pain, he pain got so bad I was actually crying on my bed, Sobbing to myself... "why wont it go away"
Enough is enough I thought and dialled NHS 111 and they booked me into UMC asap.
Got to see a lovely chap at UMC who listened to my complaint. (severe pain in my ar*se radiating down the leg and only occurring 20 min after BM and lasting for 6-8 hours)
He examined my bum - didn't stick finger up, phew :)
Said i had a large swollen external hemmie at a 7O'clock position. I asked did i have a fissure and he said no.
As he didnt perform DRE we couldnt rule out an internal AF.
He prescribed me Schiroproct suppositories which my GP previously gave me but in the cream version, I pointed this out and he said the suppositories will work much better, he also gave me Lactulose.
So I started taking the suppositories on Saturday and seemed all seemed to be fine, Hemmie still external, will go up when I insert a suppository but a few minutes later out it pops to say hello! :(
I didnt have a BM until today, Lactulose - LOVELY! nice and soft whippy poos :) Felt okay after BM then 1 hour later BOOOOOOOOM! The pain starts, despite inserting TWO Schiroproct suppositories!
As stated earlier Im a driving instructor and my diary was pretty full today, couldnt afford to cancel anymore lessons so had to power through the agony, my pupils where saying "your very fidgety today" I replied "yes I have a bad back" LOL...all i was dreaming about was a sitz bath!
about 7pm the pain subsided, clearly the meds aint working niether is having Mr. Whippys! To be honest im not 100% sure its a fissure as when im in pain my hemmie is very large and the pain does seem to be coming from hemmie. Although symptoms are very similar to AF.
I suppose I will know more when CRS takes a look on 22nd August, Im so fed up with this!! I must confess that I done something silly today and had 2 cocodomol :( I couldnt bare the pain so had to take something to ease it, I cant take Ibroufen and paracetomol doesnt touch it. Hopefully the lactulose will still make me Whippy! :)
Anyway..thats the update. Im going to call CRS tomorrow to see if I can get an appointment earlier, another month of this and I will seriously go mental!
Thanks for your support above Guys! Means alot!
Paul