When I went to see my CRS for the first time, one of the most curious aspects of the examination was that she was unable to actually SEE my AF. All the symptoms match up, and I'm young with no family history of any sort of cancers, so I guess she felt confident making the AF diagnosis.
Has anyone else had this occur before? I'm not worried about polyps or the like, although I guess it is a possibility, but rather thinking it might be a good idea to consult a second CRS?

When I saw the CRS back in April, they couldn't see the AF at all. They did a digital exam, and could tell from my symptoms and the spasming that I did have one.
(Having said that, when I went back the other week, they still couldn't see it, but because the spasming was controlled by movicol and diltiazem, I was declared healed. I'm not convinced, but am seeing how it goes.)

Are you still taking softeners and following a strict diet? More importantly, do you still experience pain/bleeding during BMs?
I can live with eating a high fiber diet and drinking lots of water for the rest of my life, but it'd be nice to feel comfortable knocking back some cocktails and hitting a buffet when the mood strikes.

My fissure was diagnosed by symptoms. They didn't see it until about a month before my LIS. I've read online that many times they are diagnosed by symptoms because most patients can't bare the exam... The PA in my CRS's office told me when a patient can't handle the exam, they usually know it's a fissure before even seeing it.

When I saw my GP with my fistula, she said "you haven't even got a fissure, never mind a fistula!!" I did have both, and had surgery for them some time afterwards, but it is very possible for them not to see it.

Biaxident wrote:Are you still taking softeners and following a strict diet? More importantly, do you still experience pain/bleeding during BMs?

Well, the CRS told me to stop taking the movicol and dilt immediately, but to take fybogel everyday, which is what I've switched to. My diet isn't restricted at all, tbh, but I do drink copious amounts of water. I'm still breastfeeding, and get migraines if I don't drink enough, so those in addition to the AF means I always have water nearby.
As for your second question, I'm going to start a new thread on the topic, but yes I do still experience discomfort/pain and occassionally I'm bleeding. I've stopped bleeding atm, so I'm holding off going back to the docs. It's difficult cos I've no faith in the GPs, and from my experience my faith in CRS (they were 2 different ones I've seen) is waning.

I know exactly how you feel there, Bernie, losing faith in the CRSs! I honestly don't know the answer, or how to find one who actually knows what they're talking about.
I've just spent thousands going private, having a private MRI, and they're STILL wrong

Well, I suppose it makes sense then that the CRS was unable to visually locate the fissure. However, the thing that has the wondering is that, aside from a brief pinch when passing a BM, I am experiencing zero pain. Sitting, standing, walking, laughing, coughing -- none of it brings me any pain. I've yet to read a similar account on this board. Makes me think there could be another reason for the bloody stools -- reasons much worse than an AF.

Are you taking any softeners/creams? When I was on dilt + movicol I had no pain, and no bleeding. It's only since I've stopped them, that it has returned.
I think if *you* would feel better, then it certainly is worth getting the opinion of a second CRS; especially before worrying about anything too sinister yet.

I've been using diltiazem 3 times daily, plus warm water baths, stool softeners, 30+ grams of fiber and around a gallon of water per day. Since I started using the dilt I've only had one instance of bleeding.
Before I saw the CRS, I was operating under the assumption I had an internal hemorrhoid. I was still taking softeners and baths, but nowhere near as much fiber. At that point, I was seeing blood daily with BMs, but even then the pain was limited to the BM itself.
One factor that led the CRS to diagnose the AF was that things were very tight down there. It just seems that, after reading so many accounts of people being near tears, I would have had some pain. Unless it is the spasms that are causing other people's pain, and I've simply been avoiding them through the warm water baths?
I think I will start hunting down a second CRS. I feel fine and don't mind avoiding alcohol, drinking a ton of water, etc. Those are things I would be doing anyway. I just want the piece of mind.