Shocking anoscopy results!

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Shocking anoscopy results!

Postby LostForWords » 08 Oct 2017, 10:03

Hi all.
I recently had an anoscopy done, under general anesthesia. The prime reason for the GA was that I would also be given some Botox injections at the same time, in an effort to heal my multiple chronic fissures that I have been forced to deal with for almost 4 years now but also because I was expecting the procedure to be rather painfull due to the multiple fissures.

When I woke up from the GA, I was told some shocking news.

Not only did I not have any fissures. There was no sign of them having ever been there (as in, they must have been healed for a long time) and no other problems were found. They even did a more extensive examination, a rectoscopy, which didn't show any abnormalities either.

The thing is, I still have symptoms every single day and I don't feel healed in any way. The CRS seemed to be stressed out of his mind and didn't even take the time to talk to me after the examination so I didn't get any ideas on what might be causing me trouble or how to fix it. I will be contacting the hospital shortly, hoping that I will be able to get him to talk but I figured that the reason for his silence is that he has no idea what might be causing my symptoms.

I would like to get some opinions regarding my situation. Right now, I feel pretty clueless because while I do know a lot about anal-fissures and how to cure them, I know very little about curing anal-fissure symptoms without having an actual fissure. Basically, I don't know what's wrong with me and as you can quess, It's pretty hard to treat something when you don't even know what that 'something' is.

Here's my story, with what I consider to be the key points and events.

It all started 4 years or so ago. I was going through a very hard time in my life and was becoming increasingly stressed. This finally led to a complete, non-psychotic, breakdown, in which I had to drop out of school.

The next 6 months were spent at home, trying to get less stressed out, which I did, but my social anxiety was getting stronger and I started to become depressed. At the 6 month mark I thought "well, I don't think Ill get any better from now on just from staying at home so I might as well go back to school, amongst other things".

That was probably the single worst decision I have ever made! My social anxiety went through the roof, I developed a quite severe depression including suicidal ideation and before I even knew it, I also had developed OCD.

As you can quess, I was soon sent home on sick leave once again. This has been the case for the last 4 years, mostly due to the above mentioned stuff but my fissure adventure was only just about to start!

So, being as depressed as I was, I was no longer able to take care of my basic needs. I started to eat less healthy foods and replaced them with fast foods.
I no longer got any exercise (and I used to exercise a lot, as I had my whole life up to this point).
My sleeping schedule was reckt and nothing really worked for me.

It was about this time that I developed my first fissure. This part of the story could be very long so I'll cut it short in a chronological order, spanding about 3 1/2 years.

Fissure developed, most likely due to constipation, symptoms ignored.

Symptoms too severe to be ignored, started research, came to the conclusion that it was an anal-fissure, started home treatment.

Home treatment failed, went to GP. He looked and concluded that not only did I have an anal-fissure, I had at least 4. Diltiazem cream and Movicol treatment started.

Movicol helps a lot but symptoms remain. Diltiazem creme failed. Refered to CRS at local hospital for Botox injections.

Went to hospital for pre-op examination, multiple fissures found, date for Botox scheduled.

After multiple attemps on my part to go to the hospital, the botox was dropped as my anxiety was making it impossible for me to go to the hospital for the procedure.

Multiple home-treatments tried over the next 2 years, everything from creams to sitz-bath, self-dilation, supplements, life style changes, squatting, diet. Some of which definately does help but nothing has cured me.

Goes back for botox only to get told that I'm healed and has been for a long time.

So that was a 4 year story made very short. I'm still taking movicol everyday and have been doing so for these four years or so.

Here are my symptoms that remain to this day
* The sharp and very painful fissure pain associated with new fissures are long gone but have been replaced with more of a dull pain while having a BM. If the stool are just a little too dry or large, it feels as if I retear and mostly in the same place. This happened just the day before my examination, thus what feels like a retear to me, actually ain't one.

* I have a very hard time having a BM and I'm pretty sure that it has something to due with my internal anal sphincter being too tight because if the stool is soft and not too big I will still have to strain as if to force it past the sphincter, while if urgency is high and the stool is somewhat large, it will feel as if the sphincter has no choice but to let it through but this causes fissure like pains and the sphincter returns to a state of being even tighter afterwards, to the point where I can easily feel it being tight all of the time which can make sitting uncomfortable, walking and well, pretty much anything, uncomfortable.

* I sometimes gets a little swelling down there if the BM required straining. I figured this was hemorrhoids but again, the anoscopy showed nothing.

* If I don't take a sitz-bath after having a BM, the internal sphincter (or at least, what I'm assuming it to be) will feel significantly tighter than if I had taken a sitz-bath. If I don't take a sitz-bath following every BM, I also run a great risk of getting itchy in/around my anus, something that almost never happens as long as I use the sitz-bath but I know from experience that the itch will return if I stop using these baths.

* I'm completely depended on daily Movicol in order to have somewhat pain free BMs. Without it, my stool is always way to dry and yes, I drink lots of water. It gets too dry because it sits in the bowel for too long I think as I go less often without movicol and also feel like I’m not able to get properly emptied, thus causing the first part of the next BM to become too dry.

* More often than not, I don't feel like I have completely emptied my bowels while having a BM. It feels as if, once the sphincter lets go and say, 80 % of the stool has been past, the remaining 20% ain't causing enough urgency/bowel stimulation in order to go past the sphincter. I'm therefore left with the option to strain like crazy or just forget about it. Straining has caused more trouble for me than what it has solved so I opt for the latter option thus leaving me with a wierd feeling of not having to go but not being emptied either. Add to this, the significantly increased risk of my next BM (or rather, the first 10% or so of it) being too dry.

With my background story and symptoms in mind, does anyone have any idea what the cause of my truble might be and how to fix it?

My working theory is that both the mental as well as the physical trauma of my past experiences with fissures has caused my internal anal sphincter to become too tight at all times even though the fissures are long gone. This could be exaggerated by my anxiety issues, which, along with stress, are know to be a cause of muscle tightness.

Another theory, perhaps supplemental to the above, is that I actually do get fissures often but that these are very superficial and can´t be seen during examination. I’ve read something about this happening once on this forum before. That could explain the pain that feels like fissure related pain to me.

Any advice would be much appreciated!
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Re: Shocking anoscopy results!

Postby LemonMan » 08 Oct 2017, 11:25

Hello Lost for Words,

How long were you taking Diltiazem for? The reason I ask is I have a theory that it can weaken the skin if taken too long. I applied it for probably a year and I think it eventually did more harm than good.

My other thought is, have you had an MRI? Again from my own experience I developed an abscess, which can feel similar to a fissure but not possible to see.

Anyhow I hope you get to the bottom of it.
Good luck, LM
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
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