One day in late August, I started having sharp pain during BMs and intense dull pain that would peak about three hours later and only get tolerable about six hours after that. I started taking stool softeners (Docusate Sodium), eating lots of fiber, drinking lots of water, taking warm baths, and using Prep-H and even K-Y before BMs, but the situation didn't seem to improve. It took me over two weeks to get in to see a specialist, during which I could hardly function because of the discomfort. The doc (a GI) prescribed Analpram, which started helping pretty quickly. I've kept up with my diet changes and stool softeners; however, as of my six-week followup last week, I could tell that I still have the AF (just not nearly as bad). The specialist now has me on Diltiazem.
After perusing the forum, I get the idea that Analpram doesn't actually help the AF heal and that I should avoid it if I can. I'm hesitant to quit using it since it has helped (with the pain at least). Hopefully the Diltiazem helps. I'm also going to re-start taking warm baths, and get some softer toilet paper.
I'm pretty sure that I've had mild AFs before, because I've suffered some mild pain and the characteristic blood streak before. In fact, I think my current problems actually started in June, since I had some mild problems since a difficult BM at that time. I'm very concerned that this is a chronic situation, but I really don't want to risk surgery unless I absolutely have to.
Thanks for setting up this forum. It's already been a big help.

Hey William,
I'm in a similar boat as you. I'd give the diltiazem some time, the topical creams take a bit of time to do anything. I haven't used diltiazem myself (I've been using nitroglycerin and nifedipine) but I know others here have had success with it. Also, is the docusate sodium softening your stool sufficiently? If not you might consider a great stool softener called Miralax. Docusate sodium never did much for me but Miralax softens things right up!

I would stop with the analpram and keep using the diltiazem cream.To help with the pain you can apply lidocaine(OTC Nupercainal) cream on the fissure to numb it a little.Like NG says just give diltiazem time,it will take about 3 weeks before you notice any difference but it has helped some people to heal.If your using toilet paper make sure to moisten it in warm water.Don't worry about an operation just yet,if you have the right doctor he will go through non-surgical treatments first like botox if the diltiazem doesn't work.Don't fret you've come to the right place and you will get the info you need in dealing with AF.

Btw NG did the botox take effect yet?

afugh!! wrote:Btw NG did the botox take effect yet?

Hey, unfortunately not it seems. Haven't really noticed much from the Botox except maybe a little bit of continued soreness around the injection area ... minorly annoying but nothing terrible. If anything the last week has been a little rougher than usual, probably because I cut back on the Miralax due to my abdominal pains. Since I'm getting a colonoscopy in a few weeks and will get a definitive answer then as to whether I just have a fissure or something more, I'm probably going to start taking full doses of Miralax again. Can't say the Botox has done much, but it also hasn't done any real harm. I'd put it in the "shrug" category so far.

Aww man I feel for you.Lets hope it's nothing more than an average fissure and stomach ache.Well you said it takes 7-14 days before botox takes effect so maybe its just taking it sweet time with you.

NG, do you still bleed after BM's?

afugh!! wrote:Aww man I feel for you.Lets hope it's nothing more than an average fissure and stomach ache.Well you said it takes 7-14 days before botox takes effect so maybe its just taking it sweet time with you.

Thanks dude, I hope so too. Whatever it is I just want to know though. Inflammatory bowel diseases aren't nice but there are worse things out there so I just want to know once and for all. First time it's going to be basketball season and I'm going to be watching without beer, that's going to be new :)

Nebelwerfer_ wrote:NG, do you still bleed after BM's?

Yep I still do on occasion. Lately I've been playing with my Miralax dose and the stools have become harder than usual, which has been associated with more bleeding. It's not nearly as bad as when the fissure first started but it's there for sure.
How are things going with you? Any substantial improvement from the Miralax/nitroglycerin regimen?

the nitro relaxes the anus, i cut down to a half dose of miralax a day and my bm's got harder the very next day, not hard enough to make it bleed though.
so i think i might go back to a full dose daily for the next few weeks to give the AF more healing time