Severe pain with anal fissure- only option to go private??

[MrsBloxby]

Hi, posting here for traffic.
I had an anal fissure diagnosed in September. Ive tried the GTN creams, laxatives twice daily, prune juice and Diltiazem.
The latter didnt work at all and now the GTN which used to take the pain from my bum (but give me a splitting headache) is not working either.
Last month I had a flexible seismodocopy which ruled out anything sinister. It was so painful, the nurse couldnt get the enema in. I had to guide it in myself. The procedure was awful too.

Now everytime I have a bowel movement it feels like I have a piece of glass wedged in my bottom. The only thing that stops the pain is 5ml of morphine. Im at my wits end.

The GP said she couldnt think of anything else I could try and suggested I go private. At £300 for an appointment, is this the only option I have.

I feel so anxious at the thought of having a bowel movement at work. Its affecting my everyday life.
Any advice gratefully accepted and sorry for the long post.

I had fissures, the only cure was 5mg diazepam at night. I don't know how it worked but it did.

@mumof2bambinos are you coping ok with the rectogesic ointment? It worked for me but gave me the most awful headaches ever...

Have you tried a footstool when you do a poo. Apparently western toilets are not geeat for people with piles and fissures because it puts pressure down below and causes us to strain even when we dont want to. Try using a footstool- google diy squatty potty!

I do think you need to see your GP if it doesnt improve. Hope you feel better soon.

@CherryRipe1 i have been using stool softener (laxido) and now they are just thin stools. I used to do bulky stools before this damn fissure. What can i use to bulk them up gradually please. Im just so scared

@Blufelt was your fissure internal? And how long did you have it for before it healed. Mine is internal and i used vaseline around the ring as much as i could but i dont feel it made much diff. Also did your fissure bleed

@MrsBloxby i feel like ive got used to the headaches. Yes ive been using a footstool and that helped a bit. I just feel traumatized by this all and losing hope it will get better

@allthelittlelights my doc wont even prescribe me anything. He just keeps saying wait for the hosp referral. Theyr just useless at my GP. Ive even told them how much pain i am in

@mumof2bambinos Sorry you are suffering this awful painful thing. My daughter suffered chronic bleeding fissures for some years due to medication & useless fobbing off at GP's. I'm not sure if bulking stools is advisable really, the NHS consultants my daughter eventually got to see in the North West were somewhat scathing about GPs prescribing bulkers. Rectogesic applied with a finger stool is probably the best thing your GP can offer until you've seen the specialists. Her operation was eventually done at Spire private hospital via the NHS. She saw Dr Gur then a Mr Carter who took a special interest in her as her 2 x afs were complex. An initial private consultation might be the way forward given current NHS queues. Don't worry, there is light at the end of the tunnel as daughter is pretty much ok now apart from the odd bleed & finds a high vegetables, fruits and salads diet sorts it out if it starts to play up. All the best.

@CherryRipe1 thank you for all the info you have provided. Its really warming being able to discuss this with someone who has been thru it first hand or knows someone who has been thru it. Il continue with the rectogesic and will just wait for a specialist app. They just keep saying due to covid theres massive waiting lists and im not really a priority as theres others with more importnant conditions. Even though i dont agree with them as anyone with a fissure knows how difficult and debilitating life gets. So glad to here your daughter is better. Im guessing she had LIS surgery done?

I know its hard @mumof2bambinos but I would go back to your GP and say the rectogesic is giving you headaches...its been nearly a year since my fissurectomy and I am so grateful to be pain free. I have had to completely change the way I eat etc but I never want it to come back.

How bad is your pain on a scale of 1-10. I was prescribed morphine for the fissure pain before surgery- which is ironic because a side effect is constipation 😫

@MrsBloxby at times i feel like its 2 out of 10 but then randomly after a BM it can be 8 out of 10. Oh no thats what i worry about. Like if they gave painkillers that constipate you. Its like a catch 22. So pleased your healed. I cant even bring myself to think about possible surgery there. I dont think i could cope with the surgery pain

@mumof2bambinos I was scared too.

I had no piles so the GP knew it was a fissure. I went throught the route of rectogestic, sigmoidoscopy to identify the fissure further, Consultant gave diltiazem which did nothing. I wanted a botox injection but the NHS dont offer it anymore. In the end, the fissurectomy- though painful means I am now pain free.

Keep on at it with the GP, I know its difficult. I even had to complain to the Practice Manager at the GP because it was so bad and he apologised...really hoping it gets sorted for you.

My daughter had an advancement flap treatment. It was quite painful after the morphine wore off but she recovered eventually & was careful with her diet. I'm quite miffed the NHS no longer offer Botox as that did help. I understand AF's are one of the worst pains along with kidney stones. 😕

I'd like to add that after suffering for at least 2 years I had LIS surgery and I know it's a terrifying prospect but any post surgery discomfort in my experience paled in comparison to the pain I'd already been through with the fissure itself. I wasn't put in morphine at any point. I feel that for some people rectogesic just doesn't do the trick. Ideally other solutions would be explored, it seems that some people have success with Botox injections etc but for me having the operation put an end of to years of suffering and misery. So although the idea of the Op is alarming and it was for me too, I was very anxious in medical settings at the time, the really awful prospect is to stay in pain. Another issue is getting the help you need through the NHS. It shouldn't be like this but if it's at all possible for you to access an appointment privately with a specialist surgeon or proctologist, I wouldn't hesitate. I wish an end to this horrible cycle for you, Cherry, you deserve to live in peace and without pain. And I'm very glad things are going well for you OP!