Acute rectal pain - help needed!!

[jcoplest]

I am a 53-yr old European male; from mid-Frbruary this year to the start of April I suffered from a severe gut infection, which was not identified. Antiobiotics appeared to clear it up from mid-April but I continued to lose weight - from 14 stone in February to 9 1/2 stone three weeks ago; at which point I was diagnosed as being coeliac. Following a strictly gluten-free diet since then has returned my digestion to 99% normal, and my motions are now normal in appearance and consistency (if slightly soft since I am eating more fruit than I ever did).

However, at about the same timeas this diagnosis, I developed a number of painful rectal fissures, and previously 'quiet' haemorroids flared up. The pattern of pain (which is worsening on a daily basis) is now as follows: before defecation - very painful fullnes accompanied by a sense of spasming, burning, tearing pressure, as if I were attempting to pass a large ball; during defecation - the same sensation, accompanied by sharp stabbing pains (I have passed out, from a sitting position, 3 times in the last 2 weeks); afterwards - intense burning sensation lasting up to an hour.

These pain symptoms are now untouched by creams (Ultraproct, Lanacane), and prescribed painkillers (Tramadol, Co-Codamol.)

In a word - HELP!!

[Kevin Pho, MD]

Anal fissures can indeed be very painful.  The diagnosis is typically made clinically - or in conjunction with a colorectal surgeon.

Treatment options can include nitroglycerin cream, oral calcium channel blockers, or injection of botulinum toxin (which is a more investigational therapy).  

If conservative measures don't work, you can then explore surgical options.

You can discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[Inanga]

I think you need to be examined pronto - it's obviously causing severe disruptuon to you. A doc will want to rule out other serious potential causes.
I had some minor fissures - pain was there but not too bad but they bled nice bright blood into the toilet - I got onto a high fibre diet (with plenty of water) to soften the stool - this let the fissures heal without aggrivating them. After a fews days it resolved itself. Lots of fruit including Kiwi and prunes - a bit digusting but it worked. Good luck.

[nauseatedsusan]

I had one and I know what you mean!  UNBELIEVABLE....The best doc in the world for this is Dr. Stephen Gorfine in Manhattan and it is worth the trip.  He does a much smaller incision and the surgery is a breeze. He also discovered how Nitroglycerin cream .02 % can help...In my case I needed the surgery and was scared to death of incontinence...no problem with this doctor since he does a variation that is terrific.  you are up and about in one day.