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Newly registered, been reading for a while...

Postby CrackinUp » 30 Jan 2013, 12:56

Guess I don't need to explain why I'm here but here's my story.
I can remember having sharp pains very similar and blood back in my 20's, when to be fair I didn't eat very well and was not regular (once every 3-4 days). So I'm guessing I did some damage then.
I'm 33 now and have been suffering with IBS for the last few years, although my diet is really quite good... perhaps a bit low in fat if there is such a thing. Very low wheat and dairy intake as this used to cause me constipation issues in my 20s. I drink 2-4 litres of water every day, and this is not something I have suddenly started because of the fissure. I'm also regular - like clockwork (almost to the minute!) - normally once each morning. IBS does cause varying consistency though, which I've decided causes the issue. One day watery, the next day hard, even with regular eating, water etc - nothing seems to control it fully.
Around October time I had a pain whilst cycling and though nothing of it until it became apparent there was an issue, as going to the toilet felt like passing something containing a razor blade (yikes!) and there was some bright red blood. I suspected either hemorrhoids or a fissure, got some Anusol suppositories and followed the weeks course - job done!
Then during my vacation in December I started to get similar pains but on a much milder scale. Tried to watch what I was eating / drinking as best I could and the pains simply went away.
Around a week or so after my return I got quite drunk (oops!) with a friend of mine and the issue came back. Knowing that this is probably a fissure, I tried to manage it myself over the course of 3 weeks. Some good days some bad, but generally improving. I would typically have considerable pain during the motion and then pain would subside after 10mins, followed by further pain which started around an hour later for 3-4 hours.
On Monday I thought I was almost better but happened to have an extra bowel movement that day which was watery and stung a bit. Didn't really think much of it and still ate well, with no alcohol etc.
The next morning my bowels decided to deliver something quite the opposite... it opened me right up and there was considerable pain followed by burning (which I'm used to now) which subsided like normal. Again as normal the secondary pain came on after an hour, only this time it was delivering an intense (unbearable) sting. This increased in intensity until around 1pm, at which point it had me in tears and immobilised - I have never felt pain like it. If I'd have been offered surgery or any way out I'd have taken it there and then. It was unbelievable pain. If I had to describe it, I would say it felt like someone was cutting me open then pouring something nasty into the wound.
By 6pm I was at the doctors (worst car journey of my life) and he had diagnosed the fissure and straight away prescribed me glyceryl trinitrate to stop the muscle spasms. After around 12 hours of pain this seemed to work fairly instantly, and despite slight pain still being there I managed to get to sleep.
Today I woke up thinking everything would be OK (despite still feeling pain) now I have my prescription, only to my horror I've still had to endure 8 hours of similar pain. Granted this is an improvement over yesterday, but is this really normal?
I know I'm probably a bit out of the ordinary with this, but the pain going to the toilet doesn't actually bother me as it's over quite quickly compared with my secondary pain. Yes it hurts lots, like passing razor blades followed by a very hot curry, but I could actually live with this if it wasn't for the secondary pain. I do wonder if my ability to tolerate the initial pain during bowel movement has made my situation a whole lot worse.
I guess my question is; has anyone else had such intense after pains and what did you do about them? 12 hours, even 8 hours of intense pain was something else and I want to avoid this situation again tomorrow.
Thanks for reading and apologies if this is a bit long !!
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Re: Newly registered, been reading for a while...

Postby CrackinUp » 31 Jan 2013, 02:55

Bit of a painful BM this morning. No blood which has to be a positive. Had a bath and pain subsided after 10-20 mins, 50 mins later I can feel burning but not much else.
I've opted to try BM before medication, on the basis that it may prevent the spasms which normally kick in an hour afterwards.
Time to apply the GTN (glyceryl trinitrate), I hope this helps prevent the spasms... yesterday they lasted 8 hours. I don't think I actually got the dosage correct and used too little.
In case anyone is reading I'll probably post an update later.
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Re: Newly registered, been reading for a while...

Postby PIA » 31 Jan 2013, 03:12

Hi CrackinUp,
Seems like you have well and truly entered the world of AF pain. There is a really good You Tube post with an Indian Doctor talking about Anal Fissure. He describes the post BM pain. It is most likely that the sphincter has gone into spasm after the BM. Hopefully the GTN ointment will gradually reduce the duration. In the early stages when my pain was exactly like you described I applied a little GTN ( 1/2 cm)before the BM to ensure the Spincter was not as tight therefore not as affected by the passing BM. I also took some Ibrufren about a half hour before the said BM. I then get straight into a hot bath that I had started running before I go to the toilet.( I put a previous post up but I am over 50 now and cant remember where I put it. Image ) I Put more GTN (1cm)on after drying area gently after bath. I then try and lay down for a while as I get headaches form the GTN...this is much less now. Gradually (over a few weeks) the pain and spasms have decreased. Read the other post regarding drinking lots of water and diet changes including adding stool softeners to your diet. Let us know how you go .XX Pia
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Re: Newly registered, been reading for a while...

Postby CrackinUp » 31 Jan 2013, 03:35

@PIA thanks for the advice - that's a great idea with the GTN. I'm going to give that a try tomorrow.
Can I ask how many minutes do you apply it before the BM?
I'm like clockwork, so can be quite precise with things like this. I don't have any fear of painful BM so can't see this changing for me. Like I say, intense pain for a short while each day is manageable, but 12 hours is not!!
Thanks for the diet tips... unlike many people I feel I've not really got far to go on this front. I've been drinking like a fish for years now. Currently drink 200-250ml (8fl oz) every 30 mins.
I've always been quite an anxious person, which I believe is a trigger for my IBS and the varying BMs!
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Re: Newly registered, been reading for a while...

Postby PIA » 31 Jan 2013, 06:37

Usually half an hour before BM.
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Re: Newly registered, been reading for a while...

Postby CrackinUp » 31 Jan 2013, 06:58

I will try that tomorrow. Right now in the exact same unbearable pain, the GTN has done very little for me.
If I could take surgery I would do it, to be in this much pain for such long periods is life stopping. I'm completely immobilised. 5 hours in so far today.
Going back to the doctors this afternoon as there must be something that can be done for this pain. "Just a little fissure" he said last time.
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Re: Newly registered, been reading for a while...

Postby delasama » 31 Jan 2013, 20:01

after i poop i wet a ball of toilet paper with really warm water then i hold it against my anal opening and it gives somewhat instant relief from post bm spasm
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Re: Newly registered, been reading for a while...

Postby Savaici » 31 Jan 2013, 20:10

Hi CrackinUp. So sorry you are in such pain and hope the doctor came up with some suggestions. If not, you might suggest a mild prescription of Valium for the spasms. My doctor prescribed this for me and it did help. I believe that Valium can also be used in a suppository but has to be done by a compounding pharmacy in the US.
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Re: Newly registered, been reading for a while...

Postby CrackinUp » 01 Feb 2013, 04:10

Thanks for the support... this is such a bizarre condition.
What gets me is trying to explain to people why you are immobilised - what do you say? I'm self employed and am supposed to be at a clients next week... I just have no hope in hell of being able to make it.
Anyway my body kindly decided to give me diarrhea last night before bed, which never happens to me. So I had to go twice yesterday... Image Boy did it sting, but I actually got to sleep! I woke up a couple of times in the night with the usual pains, only I was able to control them somehow. Was most strange. Maybe the GTN is starting to work? This is my third full day on it now.
I've been as usual this morning, and although it was short and watery, it still hurt like hell for 20 mins. Just over an hour later I'm actually really happy to be sat at my desk working (err and typing this) on my new heat pad! I have it in my mind today is going to be way better.
My doctor gave me some cinchocaine hydrochloride, which I believe is an anaesthetic? So today I also have a secret weapon.
Fissure spams lookout - I'm ready for you!!! Image
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