Thanks
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon
Anal pains are usually due to one or more of three causes.
1. Anal fissure
2. Thrombosed external haemorrhoid
3. Anal abscess
In the history that you give, it is almost certainly an anal fissure with some underlying haemorrhoids.
With anal fissures, it is a tear to the sensitive area of your anus. As stools pass through, this anal tear is disturbed and there is red blood.
With most anal problems, be it haemorrhoids or fissures, I would recommend an initial trial of lots of water, high fiber and exercise.
You need to get your stools soft and smooth and most of all, avoid straining. You have to keep your diet regular.
When I see patients with anal pains, I often will perform an examination under anesthesia to confirm the diagnosis.
If a fissure is confirmed, I generally will trial various forms of medications and if these do not succeed, proceed to surgery.
However, the majority of anal fissures will be cured without surgery if lifestyle changes occur and the medications prescribed are used carefully.
Ken Wong
http://www.centralcoastsurgery.com.au
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If its been going on for 7 months you must be exhausted. This sounds very similar to my situation last year with a chronic recurring fissure which was excruciating. Skin tags and haemmorhoids are common partners to fissures - just to add to your agony!
Try stool softeners and rectogesic by all means, but if it will not go away, before you consider going under the knife, try to find a specialist that will use a botox injection treatment. After almost 12 months of unrelenting pain, I had the botox treatment and was pain free in 36 HOURS!!! In this case, what do you have to lose, except your pain?
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Oh, and on the subject of stool softeners (speaking from experience….) if you are using something natural, like psyllium, beware of overdosing (even 1-2TBS per day can be too much!) as this will overstimulate your digestion/bowel and cause increased pain. Also, similarly if you use Coloxyl, use only the green, not the red version, as the red again contains a ‘stimulant’ which will over activate your muscles and cause ongoing pain.
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