by Scientist2516 » 14 Nov 2013, 12:23
When I googled Amitryptline, it came up as an anti depressant. So perhaps it WILL help you relax during your BMs. I think I've read on this forum that some CRS's prescribe valium because it relaxes the anal area as well as reducing the anxiety brought on by pain and fear. So maybe Amitryptline will help you in both these ways.
The rectogesic should help the spasms, but you really need to attack this thing on all fronts:
1) soft stools - lots of water, plenty of soluble fibre in your diet, maybe a stool softener and/or a laxative. Whatever it takes to make your stools consistently soft. You don't want diarrhoea though.
2) not too many BMs. It's difficult to find the right balance here, but if your diet/laxative regime causes you to have more than 1 or 2 BMs a day, that's probably too many. The dreaded 2nd BM is often worse than the first one.
3) deaden the pain. This could be with ibuprofen, topical lidocaine..........it's really hard to find a pain killer that actually does anything to ease anal spasms, but personally I lived on ibuprofen for 2-3 months. It didn't stop the pain but it took the edge off. You need to break that cycle of pain causing spasms, which cause more pain which causes more spasms.
4) ease the spasms with heat. You can take warm baths, use a sitz bath, sit on a heat pad or hot water bottle. The heat does ease the pain and also increases blood supply to the area, helping you to heal. I like a hot water bottle because you can sit on it all day long, and put it under your bottom at night. Just don't make it too hot, because if you burn or overheat, you'll get spasms from that, too.
It does sound as if you've got a fissure, but even if you haven't, all those things should help. You are right that you need to break the cycle, because the spasms are hindering your healing - reducing blood flow and making you tense.
Re-reading your post, I wonder if you need to pay careful attention to your diet. Keep a diary and see if you can see if any foods cause you to have BM pain. Try cutting out some of the obvious suspects like gluten, dairy, nuts.
I am NOT a doctor, so please take these pieces of advice as suggestions only. If you keep suffering, do keep going back to the doctor.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!