Hi all. Just found this forum after surfing about looking for information on lidacaine that I have just been prescribed.
Anyway here's my intro to the wonderful world of the AF in brief. I was given a new start in April of last year when I was able to take advantage of weight loss surgery. I had battled with my weight for my entire life. With a recent diagnosis of diabetes and sleep apnea, I grabbed the chance of surgery with both hands.
I underwent the Duodenal Switch operation and have subsequently lost approx. 140lbs. I felt great and had pretty much returned to a normal diet. Since surgery, one thing I have been unable to do is gulp down liquids (something I had always done before if I was thirsty) and found I needed to sip constantly throughout the day to ensure I took in enough water. Well that is where I fell down; I haven't been drinking enough water and developed pretty bad constipation. One thing led to another and I developed an AF. It briefly healed but came back with a vengeance over the Christmas period (even though I was drinking water pretty regularly and having soft BMs).
Fast forward to the last week or so and I have been pretty much housebound. I can't stand for more than 5 minutes without acute symptoms hitting me; leaving me weaping like a 9yr old again. BMs are a horrific experience and even though I feel I could cope with the pain of the BM, my bowels disagree and are in an almost constant spasm. This spasm is what is causing me the most excruciating pain that only seems to ease if I sit on a fairly firm seat or lie own on my bed.
To top it off I am now getting stomach cramps as I can't help but strain when I am trying to have a BM. Life has just taken a huge step backwards, never known pain like it :(

Hi Jaybee,
I understand how you feel, I think everybody on this board has been through that at one stage or another.
The first thing i must stress is under no circumstances should you strain during a BM - this will only make things worse. You need to ensure that your BM's are as smooth and soft as possible. I dont know what country you are in but most people on here either use movicol or miralax - this should help your constipation and soften things a little. Also look out for stool softeners (we have ducoease in the UK) and a few people (myself included) have found that taking magnesium tablets on a daily basis also helps.
Also aim to drink at least 6-8 glasses of water per day and stick to soft foods such as veg, wholemeal pasta, soups, etc.
As for lidocaine this is the first prescription item a doctor will prescribe for a fissure - Lidocaine is a anaesthetic that is applied before a BM to help try and numb the pain of the BM - this probably wont help the spasms however.
If things dont improve the next thing the doctor will prescribe is a hydrocortisone to reduce any inflammation, if this does not work then it will be GTN (Nitro) which is aimed at reducing spasm pain.
I hope you're feeling better soon

Hey Jaybee! I'm so sorry you are suffering - we all know your pain! My AF contributed to digestive upsets too, so finding nice, fissure friendly food might help, as Davo suggests. There are some really good ideas in the Diet Tips and Supplements forum. I also agree with Davo's advice - water and Movicol are extremely helpful, as are nice warm baths, to calm the spasms. The only thing I would add is be careful with the hydrocortisone. Lots of docs prescribe that stuff, but it actually isn't very good for fissures, and if it's used too long it can thin the skin and make things worse. Many of us here have had that experience. You might want to see your doc about getting Nitro, nifedipinen or diltiazem ointments - those are the proper ointments for fissures because they stimulate blood flow, which promotes healing.
Congratulations on your awesome weight loss! I really hope you find relief very soon.

Hang in there Jaybee - as I have been reading - there is hope and we just gotta hang on.. God be with you..

Hi guys. Really appreciate the replies. This evening has been a little easier but haven't tried to have a BM and don't plan on doing so until tomorrow morning now. Had one in the night last night at around 4am and spent the rest of the day in agony without sleep grrrr.
I have been taking Dulcoease which has certainly helped to keep things moving although I might have overdone it a bit so am not taking quite so many a day now.
I had been prescribed Scheriproct ointment and Suppositories which seem to be made up of prednisolone hexanoate and cinchocaine hydrochloride. I didn't seem to have a lot of joy with either of these so the doc has now tried the lidocaine which I am picking up tomorrow.
I read a blog about AFs and the lady who penned it recommended trying to get used to massaging the area with your finger to try and help relax the muscle. This certainly does seem to help. Anyone else found this to be useful?
Going to check out the diet section as recommended but any absolute nonos other than spicey foods? Bear in mind I have had a DS and need to get around 90-100g per day of protein into my diet.
Thanks again :)

Hey JayBee,
An absolute No no for me was anything sharp or scratchy like nuts and chips. Many people have had problems with pop corn even after the surgery while recovering. Nuts seem to be an individual thing but from my experience they were like pooping glass. Just avoid anything that can make bm's harder. Substitute red meat for seafood, and chicken.... Good luck :)