doctors no help...advice please...desperate

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doctors no help...advice please...desperate

Postby xcharliex » 08 Nov 2012, 15:40

Hi people im charlotte i am new to this forum i have come here because i am so desperate for help so hopefully someone can help me!
Firstly it started off i noticed i had mucus in my stools... then on one occasion i went to the toilet and ther was bright red blood in the bowl ( but the blood thing has only ever happened once)
I go to the GP who said its propably either IBS or bad diet but they never tested .
Everthing was fine then, until about 6 months later ( the mucus was still present) and it felt like i had anal fissures so the doctor gave me some ointment and it cleared up. They did a stool sample and it was negative of any infections or anything.
3 months on and the fissures are back, everytime i go to the toilet i am in extreme pain or suffer from really bad anxiety worrying if its going to hurt me or not.
The doctor now sees me as a pest as they say theres nothing more they can do for me as they have done the stool test and its clear.
Anybody else had a similar situation and if so can anybody give me advice please xx
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Re: doctors no help...advice please...desperate

Postby vchelp » 08 Nov 2012, 17:03

Sorry for short reply, here is what I did and still doing
1 warm baths where I sit in tub 2 - 3 times per day
2 banana and apply daily
3 when not in pain, try to do some form of exercise, walk for 20 mins
4 no starch foods
5 LOTs of water
6 apply coconut oil or Vaseline before using toilet
7 i am using Diltiazem that doctor gave
I have also measured my pain since it started
First few weeks was 8/10, now 3/10
Hope the above helps, be sure to do like I did and give advice back as you improve. We all need support and everyone here are truly kind hearted human beings.
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Re: doctors no help...advice please...desperate

Postby Lauren12 » 08 Nov 2012, 18:01

I'd try another doctor if you're still in pain and this one says there's nothing further they can do. Did they ever diagnose anal fissures? If they are fissures, there are further forms of treatment beyond using cream, if the cream hasn't been effective to stop the condition recurring.
I have been in the position where a doctor (a colorectal surgeon) seemed to view me as a pest and wouldn't offer any further treatment. I then saw a different colorectal surgeon who could tell exactly what was causing the pain and gave me the lateral internal sphincterotomy operation, which in my case gave a permanent cure. I saw three colorectal surgeons in all, and only the last one cured me.
Why not ask for a referral to a colorectal surgeon or, if there are other possible conditions, like IBS, which might be contributing to it, a doctor who deals with the gastro-intestinal tract as well? I don't think it's acceptable for you to be in severe pain and your GP to tell you there's nothing further they can do. Have you ever seen a specialist at any point?
I'm in the UK by the way, and don't know how the system of medical diagnosis and referral works in the US and other countries.
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Re: doctors no help...advice please...desperate

Postby xcharliex » 09 Nov 2012, 04:48

thanks for the replies people ..and lauren i am also in the UK.
No i havent had an actual diagnosis of anal fissures but i am experiencing what feels like anal fissure if that makes any sense, never has a doc done an examination even though ive been to the doctors a few times and explained.
just a few questions people if i may...
1. whats causing your anal fissures? as id like sum ideas as to whats causing mine.
2. could the mucus in my stools be causing the fissures?
3. could ibs cause all this likethe doctors seem to think?
thanks for your help people x
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Re: doctors no help...advice please...desperate

Postby Ever the Optimist » 09 Nov 2012, 08:08

Hi Charlotte,
Welcome to the forum and sorry you have to be here (although it's probably the best place to be!!!)
Image
I'm also from the UK and my immediate response was first, go get another opinion from a different GP. We all pay our taxes and NI here in the UK, which go towards the funding of the NHS and I expect decent treatment and a bit of a respect from the system in view of that! There are some VERY helpful GP's - Don't let this one fob you off. A good GP will offer you Diltiazem or Nitro in the first instance, may perform an internal examination and refer you to a CRS for a thorough investigation, which you evidently need. They should also discuss the anxiety side of the issue with you and offer you assistance on your stress connected with it. This factor itself makes the situation a million times worse as you need to be relaxed when you have a BM.
Fissures are generally caused by straining and tearing, constipation, or alternatively, something within your stool might have caused the tearing. Excessive diahrroea can also be a culprit because of having to go so often and wiping. IBS doesn't help because sufferers tend to be constipated or the opposite or both, but it can be controlled. I know - I have mild IBS and stress has a HUGE effect on my bowels.
On saying this, anyone is pretty much susceptible to getting a fissure, regardless of age/ sex etc....
I doubt very much the mucus in your stools has caused the fissures. I would say it's part of it and the symptoms of what you are suffering but you really need to get a decent GP and proper diagnosis. IBS doesn't help but I know a lot of people with it and no fissures, so again, I doubt it's the cause but have made you slightly more prone to your suffering.
For me, I also question the same - but I figured it was possibly down to childbirth, maybe a bit of IBS and poor diet at the time of developing the fissure.
Wishing you all the very best in getting through this. Just scour this site for all the advice and info you need. There are some great tips and some wonderful people here to help you.
Image
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: doctors no help...advice please...desperate

Postby Lauren12 » 09 Nov 2012, 14:11

Hi Charlie,
Ever the Optimist has done a very good post. I'd only add a few things. Firstly, when I first had appalling anal pain and went to my GP, the GP that I saw examined me and diagnosed haemorrhoids, even though she couldn't see or feel a thrombosed haemorrhoid on her examination. She therefore prescribed me treatment for haemorrhoids. It was only when this did no good whatsoever and I got to see a colorectal surgeon, that it was discovered that in fact I had an anal fissure. The GP hadn't spotted it and it took a specialist to be able to see it. So in my experience, GP's aren't always adept at spotting fissures.
I'm surprised you haven't had a rectal examination at the GP's surgery. Bright red blood in the toilet bowl following bowel movements, as you describe, can be symptomatic of haemorrhoids. 14 years ago I got bright red blood in the toilet bowl on several occasions. Again, I saw a colorectal surgeon at that time who recommended a haemorrhoidectomy, after which, no more blood and no more pain (until I formed an anal fissure over a decade later!)
So blood and anal pain can be symptomatic of both haemorrhoids and anal fissure.
Secondly, during the treatment for my anal fissure, I had scans and investigative procedures to see if there was anything further up the bowel that might have been causing the pain. There wasn't, but they did ask about the symptoms for IBS, in case that might have been a factor. There are certain conditions which tend to cause fissures. One is Crohn's disease, but don't worry, if that was a factor I'm sure you'd know about it and the GP would have picked it up. I don't know, however, if IBS is particularly associated with fissures.
As to what causes fissures, even the colorectal surgeon who cured me gave a wide variety of possible causes. I'd always been constipated for instance, but didn't develop a fissure until the age of 55. Ever the Optimist is right however, in that people of both sexes and all ages develop fissures. What led to one developing for me was an attempt to cure my tendency to constipation and establish a regular bowel habit! I tried prune juice for the first time in my life. Unfortunately I didn't read the container, where it recommended only 200 ml a day, and thought of it as like a standard fruit juice. I liked the taste so much that I was drinking pints of it at a time! I thought the more the better. Big mistake! There was a very sudden and dramatic change in my bowel habit and stool quality. For the first time in my life I was producing large, bulky stools at least once a day and sometimes more often. After about a month of this, I developed the fissure. It also happened to be during hot weather and my CRS has said a couple of times that dehydration can be a factor. As Ever the Optimist has said however, diarrhoea can also cause fissures.
Someone else I know was due to take a long haul flight back to the UK. Unfortunately, the day before the flight, he ate a hot curry and developed diarrhoea. So that it wouldn't be a problem on the flight, he took imodium to control it. On returning to the UK he then couldn't have a bowel movement for a couple of days. When he did, it was so large and hard that it caused a fissure.
The only two other people I've heard of in my day-to-day life who developed fissures healed spontaneously, I think with the help of one of the creams, as it sounds you may have done when you said a few months ago the pain with bowel movements cleared up with the use of ointment. One of the people I know took six weeks to heal and the other ten weeks. Neither of them has ever had a recurrence. I think most people with fissures do heal this way.
As you're once again bothered by anal pain however, you do need to pursue it, in my opinion. It's not satisfactory for your GP to fob you off. It's good that your stool samples were all healthy. I never had a stool sample tested by the way, so it may be your GP was testing for IBS, rather than focussing on the possibility of anal fissures.
If you're registered with a group practice, is there another doctor in the practice you trust more, who might give a different response? It's also sometimes possible to find out from a surgery's website, what the areas of special interest are for all the GP's in a practice. For example on completely different issues I've consulted a GP about, some GP's seemed clueless but others very well clued up about the condition I was consulting about and prepared to progress things.
If you're anywhere near London and have health insurance or can afford a private consultation, I can recommend the Colorectal surgeon who finally cured me if you like. He deals with both the upper and lower gastrointestinal tract, so would be informed not only about conditions of the anus like anal fissure, but also conditions like IBS. He does have an NHS practice and you can ask for a referral to any doctor in the country. However, with the NHS, you stand the chance of seeing a junior when you turn up to the appointment, even though the referral was to the Consultant. If you book privately, then you're guaranteed to see the Consultant you want to see.
All the best with things, and I wish you speedy relief. There's lots on the board about what kind of diet can keep your stools soft and regular, thereby making bowel movements easier and giving the anus a chance to get better.
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