internal anal pain

Sounds like an anal fissure to me. They are pretty common. Do a search here or Google, and you'll find tons of info.

Good luck.

Jan

Sure does sound exactly what I had a few months ago. Fissure!!! You need a certain cream. My doctor sent in an order and had it made for me and they sent it to my house.

I sure know how you feel. Those hurt sooooooooooooooo bad. So sorry you are going through this.

Thanks for the replies. I had to go to the ER from the pain in the rectum and abdominal pain. They gave me pain meds, told me a fissure was dead on and gave me a cream. Hopefully it helps!

can you tell me cream used for fissures

Hello again, this pain that I'm feeling won't go away. I can hardly move at all from the pain. Jan has mentioned here that it sounds like a fissure and the ER docs said the same. But, this pain feels like it's up inside deeper than what my understanding of a fissure is. The cream the ER gave me is for the outside of the anus, but like I said, this pain feels deep inside. It's sort of like a severe toothache, only in my butt! My GI doc can't get me in for over a month, but I'm in too much pain to wait that long. Am I just being a baby an/or overthinking this?

wow not to me..call dr. if he is any kind of doc your situation is emergency and the office should be able to fit you in ..or find another one that will..does it cause bleeding?may be dealing with that myself..but pain not consistent..

No, a fissure is NOT outside, but inside the anal canal. The pain is often describe as severe, particularly during a bowel movement, and throbbing/aching for hours afterward. Oral pain meds do little for it, as it is from the spasms of the sphincters that occur in response to the local pain. Hot soaks in the tub or sitz baths help the most, then topical anesthetics and/or topical vasodilators, such as nitroglycerine (old school) and nifedipine (newer treatment). When all else fails, Botox injections may help healing, but may cause temporary incontinence. The effect of the injection wears off after about 3 months. It is like a temporary sphincterotomy, the "real" last resort, as it is surgery.

I agree that a month is too long to wait if the ER treatment is ineffective. It is possible that you have a perirectal abscess too, so this should not go untreated or properly diagnosed. Are you talking about your GI surgeon or gastroenterologist? If one is a month wait, call the other guy.

Jan

P.S. Here is a link to more information regarding anal fissures. http://www.fascrs.org/patients...itions/anal_fissure/

If you cannot get in to see your surgeon or gastroenterologist, make an appointment with your primary physician.

Well, Jan it's a pretty stupid story how yesterday and today played out. If you can hang on long enough to read this, I'll tell it to you. On Monday I woke up to intense, and I mean intense pain. I was using the restroom while my son ate breakfast. I thought I was going to pass out it hurt so much. A little blood passed, but not much. My wife and I decided that it made no sense at all to call the GP doc because she would just send me to the ER. My new GI doc has only seen me one time a year ago, so I assumed when I told him what I was suffering with, he'd send me to the ER also. So we got to the ER at 11am with me in intense pain in the rectal area. I waited for 3 hours to even get triaged and have bloodwork done. I then waited almost another 2 hours to get a CT scan done. In the interim the doc on call visited with me and took me to a separate room to do a digital exam. As many of you know when the lining of your rectum has been removed, that exam is not pleasant. With that being the area of the problem, when he used his finger to see what he could feel, my screams could be heard across the entire hospital! I discussed with him that I take up to 3 Norco 5.325 pills per day for my Fibromyalgia, but that dosing is not doing anything for this rectal pain. He agreed that it wasn't enough. After my CT was done, I still did not a bed in the ER! They kind of lost tough with where I was at any time, when in fact I was sitting in a wheel chair in the main hallway/!!! By this time, its approaching 5pm, so I've been there 6 hours with no sign of a bed and no pain meds. Finally given a room and it was basically I could check out. The nurse saw how much pain I was in and asked what I had been given, and when I told her I hadn't been given anything. She freaked out, got the doc to order a morphine shot and she delivered my script of stronger Norco pills. When we got home, I called my GP, who I have a pain contract with, and asked if I could fill this script of stronger pills. She agreed, and thanked my for asking. Next hurdle, the pharmacist took it upon herself to call the ER and tell them I already had a script for norco and didn't need another. So the doctor on duty today, NOT THE DOCTOR I SEEN YESTERDAY, cancelled the new script under the assumption that I was just a drug seeker. How can 1 doctor make such an assumption on a patient he's never even worked with??? I'm beyond irritated by both the ER doc and the Pharmacist! Meanwhile, I'm still in a lot of pain that I apparently just have to deal with. I can't even walk upright there is so much pain in my rectum! Somebody please help me!

What a mess! I certainly can understand your deserved frustration. I guess that is part of the fallout of our improved, integrated narcotic watch system. Unfortunately, there are lots of drug seekers out there and it just makes it miserable for those of us who are just trying to function. You'd think that your doctor who you have a pain contract with should be able to override that nonsense. But, that is a separate issue.

I would suggest that you do not assume what your GP or GI would do, and sometimes it can be a different thing if you are sent to the ER by your doctor, rather than just showing up on your own accord. I summarize medical records for my job, and one of the things that drug seekers do is run around to ERs in pain, without being referred by their primary. I am not saying that is what you were doing, far from it. What I am saying is that having your doctor send you to the ER adds that layer of legitimacy that might be what you need in your area. Maybe not, but worth considering. Primary doctors know how to recognize and treat a fissure or refer to someone who does.

If this is a fissure, you probably can be most helped by topical anesthetics than oral narcotics. The reason being that with your sphincters in spasm, the blood supply is diminished and systemic drugs just do not get there very well. You can get a prescription or just try over the counter hemorrhoid creams. Even Anbesol (for teething) is OK.

Also, hot sitz baths are the primary treatment, 3-4 times a day for about 20-30 minutes. They help relax the sphincters, improve the blood supply, and aid healing.

Hopefully, these measures can help get you over the hump until you can see the doctor who can help you.

Jan

Thanks Jan,
First I want to say that I've trying your suggestions and they seem to help. 2nd, I'd like to make it 100% certain that I was in no way seeking pain meds. I know you believe that, but I'm not sure the ER does for whatever reason.
Next I'd like to ask, am I correct with my assumption that a fissure feels like something is ripped or torn internally and that after a BM it hurts like a son of a gun? That's what I have going on, so much so that I'm not eating much because I don't want to end up in the bathroom!
Thanks again, hope everyone feels well!

Yes, an anal fissure is like a paper cut and your BM is the lemon juice!

Fiber supplements can help too, because they tend to absorb that caustic fluid.

As to being treated like a drug seeker by the ER, I can imagine how angry that would make you. Something to avoid, for sure. This is why I think being sent by your doctor helps prevent that stuff. Your own doctor could have changed your prescription and that might have avoided the pharmacy snafu. She might have even said to double up on your regular pain med until this was sorted out. My experience has been that the ER is usually the least helpful choice, unless it is "life-or-death."

Jan