Hi all, it's great to be able to find so much info and comfort here in this forum. I'd like to share my story here and hopefully someone can shed some light or point me in the right direction on the path to recovery.
When the problem first occurred, I had to consulted three GPs before a correct diagnosis was given and needless to say valuable time was lost. The first GP dismissed my claim that it was AF w/o even examining the wound and argue with me that it was only hemorrhoid; the 2nd GP sent me away (without detail examination either because the clinic's booking was quite full that day) with different brand of cream and suppository as I complained that the ones that I got from the 1st GP was not effective. It was the 3rd GP who correctly diagnosed that I had AF. However it was too late because the level of pain had became so unbearable and the duration increased from 4 hours to 8. That evening I rushed to A&E hoping the doctors there could give me a shot to stop the pain.
Just when I thought it was bad enough that it took 3 clinic doctors over 1 month to give me a correct diagnosis, I found out that hospital doctors are not any smarter. Those inexperienced junior doctors were unable to observe the tears and insisted that it wasn't fissure. They said until they conduct a endoscopy, I couldn't say that it was AF. I was horrified and rejected their suggestion because with the amount of pain I was in, there was no way I would let them stuck anything in there, not to mention the invasive examination would cause more tear to the already traumatized wound. It was until much later when a more experienced consultant came around and identify the multiple fissures at the anus that I was spared the potentially damaging invasive examination.
Unfortunately my bad luck didn't stop there. When I was admitted, the doctors gave me stool softener and large quantity of metamucil to soften the stool so that it wouldn't tear the anus. The following day was the most painful bowel movement I had ever had in my life, much worse than before I was admitted to the hospital. Thanks to metamucil, the stool became so bulky that I felt I was giving birth to a baby and I could feel how it torn open the lining from inside to the anus!
After that I was moaning in bed for 8 hours, none of the ointment cream worked, tramadol (allegedly the most powerful non-addictive painkiller the hospital could give) was absolutely useless. The pain was like someone stuck a sword in me and kept pulling it back and forth at the wound for hours. Not only did it feel like it would never stop, but any light and sound would make the pain even more unbearable. I had the nurse called the doctor on duty to came in and gave me a needle, but that only stopped the pain for 1 hour, after that the pain returned and the doctor indicated that there's nothing they could do. So I had to lie there and wait for the pain to go away. The following day, a doctor came and told me there's nothing else they could do except surgery.
At that point, it was obvious that none of the GPs nor hospital doctors was experienced in dealing with AF and I had lost all my faith in them. It seemed like they knew absolutely nothing about AF except what was on their text books. So I told them I would go home and think about it but the truth was I wanna google about AF and the surgery first before making any decision. I was then discharged with stool softener and tramadol. Actually not only was softener unable to soften things up, it gave me gas. So the spasm started, sphincter would locked the gas inside and then pressure would build up and make the pain even worse.
I took the softener for 3 weeks and later it became obvious that everything I got from the doctors didn't work. And my condition was deteriorating, the pain after BM got from 8 hours to 10 and then later 12. At this point, I was extremely depressed. I was afraid to eat and try to avoid toilet. When I found out sitz bath was actually more effective in soothing pain than any painkiller, I stayed in bath tub for 12 hours.
3 weeks after being discharged from the hospital, I finally gave up hope and thought perhaps surgery was the only way to go. It was when I started googling info on AF and surgery that I stumble upon this forum. Things you guys shared on this forum taught me so much that would make the doctors I consulted seemed like idiots.
When I learned from this forum that Valium was the only kind of drug that could stop the spasm pain by relaxing the muscles in that area, I tried asking the doctors for it but they all refused without giving any reasonable explanation. I knew about the addiction problem but I think with that amount of pain one has to put up with, it definitely worth the risk. Unfortunately the doctors here don't share my view. It was when I saw a guy in this forum said that he couldn't get the drug in UK either, then I realized most likely doctors here would never prescribe Valium for AF here as well.
Although I was taking stool softener along with high fiber diet, yogurt, fruits, etc, none of them work and I started having trouble passing stool 3 weeks after being discharged from the hospital. I had no choice but to go and buy a pack of glycerine enema from a pharmacy nearby. Surprisingly, things started to smooth out and one week later, the hours and the level of pain were both reduced.
Now that 5 weeks has passed, I am able to reduce the use of enema and am almost pain free. However, I still have to stay in bed for up to 6 hours after each BM. If I tried to get up before that and walk around for a long time, the wound inside would swell and became extremely sore (but not the acute stabbing spasm kind of pain).
I wanna know:
1. if anyone on the recovery path gets the same swelling pain or need to stay in bed for the same amount of time like I do after each BM? ;
2. how long does it take to get to the really pain free stage (that you don't have to stay in bed even after BM)? ; and
3. will I be able to do vigorous sports (such as football/martial arts) after fully healed?
Many thanks
Maxim

Welcome to the forum, even though I wish you really didn't have to be here. Im sorry to hear about the pain those GP's put you through, thats crazy. Well before I say anything further I think you should look into finding a good CRS which is a colo rectal surgeon. That would be your first and biggest step towards curing this monster. Sitz baths are a godsend as you already know, they help bring blood to the area reducing the spasms you have, which is keeping you in bed for so long.
If I may ask how long have you had this fissure for?? sounds like for quite some time now which would classify it as chronic. These types usually don't heal with ointments or creams. Im not too familar with enemas, so I can't really help in that department. But I can say that if you have to lay down for six hours, it still pretty bad down there.
Stool softners, good water intake, and a healthy diet is a must!!!!
Find the balance that works for you and stick too it. If and when you do see a CRS or you do happen to go back to your GP (which I hope you dont) you may want to ask for diltiazem or nitroglycerin as vallium isnt the only thing that can be taken.
as for your questions you asked.
1. I did get the spasms you speak of for the same amount of time until I started dilt. It took the edge off A LOT!!
2. Try looking for a good CRS and see what they say. Without much of anything done you cant get better.
3. Dont worry about the sports just yet. Take care of that butt!! :D

Thank you JR for your reply. My AF started in Sept and I know it's already in a chronic stage (doctors said that the chronic symptoms are all there), which means it is unlikely to heal by itself and a surgery is needed. But thank god, I AM recovering from AF. Yesterday I had an outpatient visit and the doctor just confirmed that he couldn't see any fissure at the anus anymore and if lying down could ease the pain, then it sounded more like a hemorrhoid irritation than fissure.
Notwithstanding what he said, I still felt a little uncomfortable at the posterior of the anus when the doctor tried to stretch it during the examination. So I guess it's not completely healed yet but it's recovering slowly and steadily.
As for finding a good CRS, I did directly and indirectly talk to a few of them. Whether they are good CRS, I'm not sure, but one thing I'm sure is that they all sound like blood sucking leeches. All that they want is to put me on their surgery table. When I told them that I preferred trying Valium first and if that didn't work, I'd then think about LIS. However, it seems that getting muscle relaxant from them to get rid of the pain is not an option available from them (They are, however, very willing to give me painkillers such as Tramadol which I knew very well that it didn't work, at least not for me). So it seems to me where I am, the CRS don't want that little pill to ruin their chance of making money from LIS. So until I come across a CRS that's not so blood thirsty, and since I'm healing, I don't think I'm in a hurry to find a good CRS right now.
As for diltiazem and nitroglycerin, I know they are commonly used for treating AF. Unfortunately, the doctors here didn't prescribe them to me. But they seem to be the kind of drugs that related to cardio issues and blood pressure problems. I don't quite understand how these drugs could help stopping pain like Valium does (If I remember correctly, AF pain comes from muscle spasm and Valium is a kind of muscle relaxant, so it can stop the muscle spasm and therefore stops the pain). This is just for interests sake, now that the pain is gone, I don't think I'll need any of those anymore.
Now my question seems to be whether anyone here has had similar experience that after the pain of AF stopped, they need to deal with the irritation/pain from hemorrhoid? The doctor now puts me on Daflon which I know it's for shrinking the blood supply to hemorrhoid (or something like that). I wonder how effective it is.
Oh, Merry Christmas!

Maxim wrote:Thank you JR for your reply. My AF started in Sept and I know it's already in a chronic stage (doctors said that the chronic symptoms are all there), which means it is unlikely to heal by itself and a surgery is needed. But thank god, I AM recovering from AF. Yesterday I had an outpatient visit and the doctor just confirmed that he couldn't see any fissure at the anus anymore and if lying down could ease the pain, then it sounded more like a hemorrhoid irritation than fissure.
Notwithstanding what he said, I still felt a little uncomfortable at the posterior of the anus when the doctor tried to stretch it during the examination. So I guess it's not completely healed yet but it's recovering slowly and steadily.
As for finding a good CRS, I did directly and indirectly talk to a few of them. Whether they are good CRS, I'm not sure, but one thing I'm sure is that they all sound like blood sucking leeches. All that they want is to put me on their surgery table. When I told them that I preferred trying Valium first and if that didn't work, I'd then think about LIS. However, it seems that getting muscle relaxant from them to get rid of the pain is not an option available from them (They are, however, very willing to give me painkillers such as Tramadol which I knew very well that it didn't work, at least not for me). So it seems to me where I am, the CRS don't want that little pill to ruin their chance of making money from LIS. So until I come across a CRS that's not so blood thirsty, and since I'm healing, I don't think I'm in a hurry to find a good CRS right now.
As for diltiazem and nitroglycerin, I know they are commonly used for treating AF. Unfortunately, the doctors here didn't prescribe them to me. But they seem to be the kind of drugs that related to cardio issues and blood pressure problems. I don't quite understand how these drugs could help stopping pain like Valium does (If I remember correctly, AF pain comes from muscle spasm and Valium is a kind of muscle relaxant, so it can stop the muscle spasm and therefore stops the pain). This is just for interests sake, now that the pain is gone, I don't think I'll need any of those anymore.
Now my question seems to be whether anyone here has had similar experience that after the pain of AF stopped, they need to deal with the irritation/pain from hemorrhoid? The doctor now puts me on Daflon which I know it's for shrinking the blood supply to hemorrhoid (or something like that). I wonder how effective it is.
Oh, Merry Christmas!

hi Maxim, i'm sorry that u're still suffering but take heart, knowing that there's light at the end of any tunnel. Like you, i have hemorrhoid before the fissure, then fissure taken over all the pain and as i was recovering, my internal hemm prolapsed and caused occassional irritation/pain, but it's mild and only when it prolapsed (out of the anus). It's common to have hemms with fissure, as both came from the same cause - straining and pushing. My hemm prolapsed as time passes as the tissue loses it's elasticity. Like you i was given daflon, but it did nothing to me except to harden and dries up my stools. I consulted my CRS again, only to be told that this reaction only happened to a SMALL group of ppl which of cos i'm a part of. Soo... i stopped the daflon, having done tons of research on fissure which helped me to heal, i research ferciously abt hemms, and found this cream called the HORSE CHESTNUT CREAM. It's a herbal cream meant to strengthen the blood vessels and tissues (which is what the hemms are made of), so i used it to about 6 weeks and found that my hemms has reduced it's frequency and degree of prolapse! Of cos, it has to be combined with sensible fiber diet (DO NOT LOAD UP TOO MUCH ON FIBER, ELSE STOOLS STILL BE HARDEN / DRY) and NO PUSHING/STRAINING during BM.
I do have the nitroglycerin (brand new tube) which i bought frm the hospital, but i didn't have to use it anymore as my fissure has healed. This cream did helped me to a certain degree as it's supposed to relax the anus ,muscles, achieving the same as LIS, to encourage a gd blood flow to the fissure so as to heal.
I can air-mail this nitroglycerin to you, if you are interested, do private message me.
BTW, if you like to know how i healed my fissure, take a look at this thread "my success story"