A very warm hello to everyone.
I am new to this forum and it means a great deal to me to know that there are people who understand what i am going through.
I have a CAF which has tormented me for the past. 3/4 months.
I have been prescribed rectogesic , xyloproct and diltiazem , which to my dismay have not worked.
2 weeks ago i was given botox injections , which so far has not helped. I was also prescribed neurontin for the pain, which unfortunately has made no impression on the terrible pain.
I am not able to take ibuprofen due to takiing asprin daily and paracetamol has no effect.
The burning / stinging pain i experience lasts for hours and leaves me housebound.
I would very much appreciate any suggestions from members as to which pain killers were effective for them. I live in England.
Thank you so much for taking the time to read this.
I look forward to any replies.

Hi there, I am so sorry to hear you are in such pain!!

I have tried Botox, and it takes a little while to fully kick in, so hopefully it will start working for you soon.

I was prescribed a few tablets of oxycodone (a narcotic) after my Botox treatment, though I didn't need to take it. A warning! - narcotics are *very* constipating, can be addictive, and have a raft of other side effects.

Out of all the things I've tried, though, hands down the most soothing thing is heat. I guess this makes sense as the pain is largely from the blood supply to your tissues being cut off by the spasm. Heat helps relieve the spasm and makes blood flow increase.

The long and the short of it, though, is that you don't need to suffer in silence and your doctor can help. If they don't - find another doctor!!

Let us know your progress. Take care.

Thank you Water Bear for taking the time to reply, i really appreciate your excellent advice.
I am taking Movicol which really helps me to be free of constipation so i will mention the drug you suggested - oxycodone to my Doctor. It will be a big help having this info when i go to see him.
I also like the idea you mentioned regarding the application of heat , which is the best way of applying it?. Sorry, i know i should have the answer .
You take care and i will keep you informed.
Thank you again.

Hi valiant162.

For heat application, I use a heat pad which you can buy from boots or other pharmacies. You microwave the pad for 20-40 seconds & sit on it. There are also sitz baths but I've never used one & taking a bit bath, but this time/water consuming. I have also heard of infra red heat lamp therapy - which can be bought on Amazon, if your AF is external it could help. Mine is internal, so it would not likely reach the AF site.

Hi Familylguy.
Thank you for your kind reply.
A heat pad is something i will definitely try.
It's something i would never have thought of.
Creams and tablets have been no use so far as well as Boxtox , wouldn't it will be ironic if something as simple as this works to relieve the pain.
My daughter works at Boots so you couldn't have suggested a more suitable store to buy the heat pad from.
All the best to you and thanks again.

I've found relief with Acetaminophen and Codeine. Acetaminophen in the UK is Paracetamol and I believe that Codeine is Codeine on both sides on the pond. I took the 60 mg tablets (only available by prescription). They didn't completely eliminate the pain, but took it down a notch, which made a huge difference.

Re heat - after a BM a warm bath or shower will be very soothing. You can also buy Sitz baths from the chemist, which are like a little bottom-sized basin that you fill with warm water and then sit in them. I haven't tried one of these as I find the shower good enough, but they are often recommended by GPs and colorectal surgeons.

Like Familyguy, I also use a wheat-bag, which I heat right up in the microwave and then place it against my pelvic floor. I find doing this lying down a bit more comfortable than sitting directly on the wheat-bag, but we just have to try different things. I hope you can get some relief quickly!

I alternate heat pack and cold pack. Wrap the packs in a towel and sit on them, never apply directly to skin.

Thank you Chachacha, Hurtinend and Water Bear for kind and helpful replies.
I do agree that we have to try different things because what works for one person may not work for someone else.
I know this can't go on because i'm only 54 and yet the pain is causing me to become inactive , i ' m just waiting for the pain to pass which unfortunately takes hours.
Heat pads and yet another visit to my GP to ask for the painkillers which you have all suggested is the way to go.
You are all very caring people and i appreciate your help.

Hi, as an alternative to opioid painkillers like oxycodone or NSAIDs like Ibuprofen, you might want to ask your GP to prescribe a neuropathic agent like gabapentin or pregabalin. I have found the latter effective in treating the pain caused by anal swelling and inflammation, and while it doesn't remove the pain completely it reduces it quite a lot. It also reduces anxiety, which is helpful in a condition like AF. Hope you feel better soon.

David