Dear All
I'm sure this has been said a hundred times already but I couldn't believe my luck when I stumbled on this forum, after numerous google searches over the last few months to try and help find out more information on AF.
I've looked though many of the threads and although I don't want to spend much time reiterating the same things you've all heard/had yourselves, for me, this is a big help to actually share my experiences with people that are also in the same boat. More importantly, I feel I just want to share my diagnosis so far and whether people think I should push a bit more, with my Dr/Consultant. I guess its the 'Is there something more sinister causing the AF' question, that's in the back of my head. I've changed my diet, built up the fibre, reduced white bread and all that, but it doesn't seem to have much effect. I'm pretty healthy too.
I'll make this as brief as possible...I've been suffering with the symptoms of AF for over 2 years now. I suppose my problem has been, not wanting to cause a problem! Does that make sense? I didn't want to keep going back to my Dr, to keep being told the same thing and to just walk away with a prescription for Fiborgel or Anusol cream. So on off, on off suffering for two years, I see blood when I go to the loo.....I would use anusol or take fiborgel 3 times a day for a few weeks and then after 2 months, it all goes away. ALTHOUGH, if anyone else is like me, it doesn't mean I don't keep looking ALL the time, just to make sure! Oh how pleasant!
Since first being told it was an AF in Jan 08, I've had it on average 2-3 times a year. I'm suffering again and this time, my Dr referred me for an examination with a camera. GREAT, I thought. Finally I get to see if I get the all clear of anything sinister and if its a tear that isn't healing, they can give me my next options. But when I went to see the consultant 2 weeks ago, he examined me himself, said straight away that there was a fissure (but on that day it was healed) and that he didn't see any point in further examinations. He's recommended I take a Fiborgel sachet once every morning and to use Rectogesic twice a day for 1 month.
I started using Rectogesic last Sunday. The fear of the head aches worried me, I do get them almost instantly as soon as its applied but they ease off after about 30 minutes or so. Is that good?? Normal?
I really do wish I'd pushed the consultant to do the further examination - but we're meant to believe them when they say they are not concerned. I'm 30 year old female, with an uncle who has worn a colostomy bag since he was a kid, from having crohns, but no other family history of problems. I've had blood tests to rule out crohns and coeliac diseases and they came back negative...and to top it off the consultant followed that up with "Yes, but that doesn't mean anything"! Cheers Doctor, that helps a lot! He did tell me not to worry too much about my diet and the fibre husk sachets should do enough to help things move through easily.
Pain wise - its been ok. I suffer a little bit after I've been to the toilet but that eases after a while. It doesn't sound as bad as some of you seem to suffer with.
So now, I shall be continuing with the Rectogesic cream and the Fiborgels one each morning (although so far, they aren't making things smooth just yet!) and I just have to wait and see.
I have now got to the point of wanting to bang my head against a wall, because of how this makes me feel. I do have an understanding 'soon to be' husband that couldn't be more supportive and friends who I've shared my problem with, but as they don't know how it 'really' effects me, its hard for them to understand.
So...I look forward to reading any hints/tips/similar experiences that others may have to share with me. I'm really grateful for anyone who might be able to give me some encouraging words - but like I said, having read some of your stories already, I do feel now that I'm not the only one suffering with this really annoying problem.
Thanks everyone....and sorry for waffling on!

welcome orchid!
the good news is that you had this checked out and based upon that, you seem to only have the fissure, as if that is any consolation - but worrying about other anorectal maladies would be much worse.
the only thing time will tell is how you feel and what you want to do next.
to be honest, i have managed the last two years quite beautifully but had flare ups in between and thought to myself at times, wouldn't it be great to not have to deal with any of this anymore? i mean it wasn't anywhere as bad as the first four to five years.
you're from the UK and some UK peeps will pop up to say hello.
waffle on whenever you'd like as we all know where you are coming from.
i hope you have a great day and let these two items work on you for a month or so and see what happens.
if you continue on with pain aftewards with more bouts of blood and retears, then it may be when you will step up to the plate and demand what is next.

Welcome orchid,
I'm from the UK too and know just how the DR's can be, some of them can be quite ignorant when it comes to rectal issues, anyway keep up with the Fybogel sachets and Rectogesic, give it a chance, then if nothing changes be persistent with the DR's, it's your bum and you want it fixed.
Good Luck - Steve

Hi Orchid,
I am new here too. But I haven't been suffering for two years! Ouch! Poor you.
I just thought I would pass on a news item that they aired on TV some months ago that sticks in my head. It said "It does not pay to be a nice patient". In other words, you don't get the best care by being nice... and based on my experience with the health care system where I live (in Sweden), it's completely true. I'm learning to be more assertive and to push harder than is my nature when I deal with health issues and doctors. I've been in a lot of situations here where the health care provider (nurse, doctor, whatever), does not do a thorough or proper job. I have to think for myself and be my own (or my loved ones') best advocate! Unfortunately, I think it's needed... So, I hope that helps you too!
- Bumbutt

Thanks Happyass, your right that the diagnosis has been done and that's all I should think about and focus on dealing with (rather than worrying about anything else at this stage). I certainly will carry on with the two treatment options I have and just see how it goes.
Thanks Steve & Bumbutt - I like how you both understand how Dr's can be and your right about the 'pushing' part!!! Sometimes I just flake when in that situation!! If things don't get helped by the fybogels/rectogesic then I will go back and ask to be referred again.
Here's hoping I wont need to though!
Thanks Again :)

Hey Orchid,
I'm from the US but just wanted to say-it took me six months of seeing doctors before I even got diagnosed. I cried, wined , called the doctors office just about every week until they realized I had a fissure.
I think it's much easier here to get LIS pretty quick than it is in the UK from what I've read... But you still have to be assertive with your health care and pushy if thats what it takes. It's our bodies and no one cares about them like we do.

Hi Orchid,
Sorry to hear that you're in this boat with the rest of us!
I've had my fissure for a little over a year and a half. We are about to celebrate our second Christmas together! I haven't gotten him a gift or anything ... but there's always the mistletoe I guess
Anyway ... I, and everyone else here know exactly where you're coming from with the worring and fretting about you're symptoms maybe being caused by something worse. Sometimes you just want to say to the Doc, "So, how canyou be sure this isn't ... (insert deadly disease here)". My CRS didn't want to do a full examination with a camera etc either, as he said that the fissure was obvious, and that it would only hurt me to do anything more than a quick exam with his finger. His giant FAT sausagey finger that is! That hurt just fine all by itself!
If you're not happy and still a bit worried though, better to get pushy and look neurotic than stew over it. You've got enough to cope with right now.
Rectogesic gives me the same swift headache, although mine can be severe and sometimes lasts all day. If yours typically resolve in 30 minutes, then I think you're doing pretty well. I think some people find that they go away entirely after a week or two, so let’s hope that happens for you.
It looks as though I will have to get pretty pushy myself in the very near future. I haven't even been able to get an initial appointment in the publicly funded system we have here in NZ. This is an excerpt of the letter I got last Friday:
"While you have a clinical condition that needs attention we are not able to see you within six months due to our current resources. We are therefore returning your referral bak to your general practictioner for ongoing care. If your condition changes or you have concerns about your condition please return to your general practitioner for further assessment."
WTF!
Get pushy if you have to!

Hey Orchid, another Yank here :)
The headaches after nitroglycerin are normal. Mine lasted maybe 15-20 minutes and eventually became almost unnoticeable after a few days of use. It's definitely more fissure-appropriate than Anusol, so you're on the right path.
I saw that you take Fybogel to add fiber but it's not making your stools soft enough yet. Have you tried any laxatives like docusate sodium (Colace here in the States but not sure about in the UK) or Movicol yet? I'm personally a huge Movicol fan. Some people can't tolerate it because it causes loose stools for them, but one thing I've never heard anyone say is that it's ineffective at softening stool :) It's worth a try if you're having problems with stool hardness. It was absolutely a lifesaver (or is that buttsaver?) for me. All the fiber in the world won't make a difference if your stools aren't soft enough.
Your doc is right that blood tests can't detect Crohn's. The blood tests were probably just for erythrocyte sedimentation rate (measure of general inflammation in the body) or anemia, which can pick up Crohn's if it's causing a lot of inflammation or bleeding. But it's far from conclusive. You're right that a colonoscopy would have a lot more diagnostic value, but the doc probably doesn't think it's necessary based on the overall clinical picture. If it makes you feel any easier at all, a lot of us have had colonoscopies and the vast majority of them are negative. But if you think it's necessary, definitely push push and PUSH for it! Worst they can say is no. Also, there are less invasive tests like abdominal CT scans (with barium as contrast material) that can also pick up colon problems. That one exposes you to a good deal of radiation but is much more comfortable than a colonoscopy. Maybe the docs would be more open to an alternative?

sphinctersaurus wrote:It looks as though I will have to get pretty pushy myself in the very near future. I haven't even been able to get an initial appointment in the publicly funded system we have here in NZ. This is an excerpt of the letter I got last Friday:
"While you have a clinical condition that needs attention we are not able to see you within six months due to our current resources. We are therefore returning your referral bak to your general practictioner for ongoing care. If your condition changes or you have concerns about your condition please return to your general practitioner for further assessment."
WTF!
Get pushy if you have to!

Awww man that sucks! If that's the kind of response you're getting, you're MORE than justified in getting reaaal pushy

Yup NG, it really does suck doesn't it.
I visited my GP today to ask if there was anything I could do. He said that unless I could prove that the situation had worsened dramatically, then ... no. So that's it apparently. I can't even reapply. He assured me they would NOT change their minds.