biopsy results from August

I called yesterday and got my GI to email me my colonoscopy records, so I'm all set to see the rectal surgeon next week!

Hi quincy! Thanks for the reply, and thanks for the info on the crypt structure. That had me a little worried.

My GI was also confused as to why the fluid is clear. He said that a fissure or fistula would be more likely to have a brownish fluid. DH has been reading up on the leakage issue, and he's convinced that it's either being caused by my internal hemmies or that I have some special kind of polyp that he read about that's causing it.

I have inflammation in my rectum that comes and goes. Right now it's not inflamed, but it was a couple of weeks ago. Felt like there was a hot poker up my butt all the time. :)

The only tummy meds I'm on at the moment are aciphex for the reflux. I don't even think it's working that well, but I'm waiting to follow up with my GI until I see this new surgeon, then maybe the GI will try me on a different med. I'm also trying the probiotic Florastor, which is working ok but not as well as VSL#3.

My acupuncturist treated me for the tummy inflammation a couple of weeks ago, and I really think it helped, so I'm seeing her again this week.

I'll let you guys know how it goes with the surgeon!

Hi quincy! I went back to my GI two weeks after my c-scope. All he told me was that I had precancerous polyps. I asked him if there was anything I could do to keep from getting them, and he just told me to come back next year for another scoping. I'm going to do some more research on my own into the biopsy results and come back to him with questions.

I was on two weeks of suppositories that were supposed to help with the hemmies, and they didn't do a thing for the inflammation or leaking. I'm guessing I'm not on 5ASA because I don't have UC? The inflammation seems to occur when I have more frequent BMs, so I'm guessing that it's caused by more frequent BMS. Also, the leakage started after I'd had the runs for about 3 weeks.

Yes, I'm seeing the rectal surgeon for the leaking.

I take coarse-ground Metamucil every day. That helps in general, but it doesn't do much for the leakage.

Florastor...I just went on Drugstore.com and read the reviews, and people seemed happy with it. I picked that and two others to try if it didn't work out. I'm going to try Culturelle next.

Thanks for the tip on Primadophilus! I'll look into it.

I'm using a heaping tablespoon of Metamucil a day. I guess it has artificial sweetener. It's orange flavor and the ingredients include sucrose and "natural and artificial flavors."

I'll ask my GI about 5ASAs next time I see him. Thanks!

Thanks for the warning!

I take Vitamin D and calcium in the morning, iron and C at night, Elmiron for interstitial cystitis, and Synthroid for my thyroid. Sometimes I have marshmallow root tea for tummy or bladder inflammation.

Yeah, I got diagnosed with IC six years ago, around the same time I had surgery for endometriosis. I love my Elmiron. It got my year-long IC flare under control and it mostly keeps me from getting new ones.

So today I met with the rectal surgeon. He thinks the source of the leakage is a fissure that he could feel, and it hurt me when he pressed on it. No one else has noticed it. He said that it's too small to operate on and it might rip again afteward, so he prescribed a cream to relax the anal sphincter. He said the sphincter is too tight and that is keeping the fissure from healing (I guess from friction?)

The bad news is that he's worried that the pathology report from my last colonoscopy might indicate cancer. He said that cell dysplasia combined with all the polyps is a big red flag, so he's requesting my films from my GI. They're supposed to get back to me in a few days to tell me if I have cancer, so now I'm a wreck. Argh.

Thanks for listening.

This is weird...I posted a reply the other day but it's gone now. Oh well, trying again...

In the pathology report, all of the polyp & dysplasia samples said "non-malignant." My GI had just said that I need a colonoscopy next year, so i think for now I'm sticking with that and trying not to worry about it.

I'm adopted, so unfortunately I don't know my family history.

The fissure ointment is called Diltiazem ointment. It's not something that's commonly carried by a pharmacy, so the nurse gave me the recipe for it to give to the pharmacy:

Cardizem: crushed 20 tablets of 30mg each
Hydrophilic Ointment - 30gm
Mineral Oil - 2 cc

The ointment is supposed to relax the anal sphincter to allow the fissure to heal. This website pretty much says everything my doctor told me:
http://www.fascrs.org/patients/conditions/anal_fissure/

I have a history of pelvic floor tightness, and that can apparently contribute to this problem, so I'm going resume my pelvic floor trigger point work at home and see if that helps.

I have a great support system, thanks!

The pelvic floor thing is interesting. I think my issues originally started because of my bladder pain: the pain caused the tightness, which in turn caused more pain, etc. It creates a really bad feedback loop. I was in physical therapy for it for six months, and it was really helpful. I have a tool to do the work myself, and I was supposed to keep up with it, but of course I didn't, so now here I am six years later in this mess again. I could go back to my physical therapist, but I don't really have the time or the money to do it again, so I might try to tackle it myself to start with.

I really badly don't want to have the sphincterectomy. That just sounds like a bad idea. I actually found a thread on here where someone had the surgery and THEN the leakage started and wouldn't stop.
https://www.healingwell.com/community/default.aspx?f=17&m=1153784

Drinking vinegar did cut back on the leakage volume by about 95%. Unfortunately, it did horrible things for my reflux and I'd have nausea for about 1/2 hour afterwards. The surgeon had no idea why the vinegar would work, LOL! I need to look into that a little more.

I'm definitely planning on having another c-scope within the year.

Thanks again for the support! I'll keep you posted.

Hi! Sorry it's been a while; my internet connection got affected by the hurricane, but we're fine now. :)

I got a call from the surgeon's office on Thursday saying he wanted to see me as soon as possible, so I went yesterday. He said he doesn't think I have cancer, but he was concerned that there was colitis in several locations: right side of the colon, small intestine - and he wanted to impress upon me that the cancer risk is there. I told him I was definitely planning on having another scope within the year.

I do think I have reached the end of what this doctor can do for me. After almost two weeks on the Diltiazem, I started bleeding out of my rectum, and this doctor didn't know why. (I've stopped using it and the bleeding has stopped.)

I asked the doctor if running would make my fissure worse, and he said he didn't know. I asked him if maybe using estrogen cream back there would make the skin more supple and promote healing (I've done that for my vaginal area) and he had no idea.

I told him I was considering removing my internal hemmies to see if that would stop the leakage, and he wanted to band them, while I want laser surgery if I go that route.

He wants me to use a suppository called Calmol 4 to treat the fissure. It has cocoa butter and zinc oxide. I haven't decided yet if I'm going to try them.

I'm having a followup with my GI this Thursday. I think after that, my next step will be to try my gynecologist because I've heard you can get a fissure by giving birth, so they might have some ideas over there about how to treat it. They're a little more hippy-dippy over there and take a more holistic approach to things. :)

Hope you weren't affected by the hurricane!

Clouds for two months?? That's crazy!

Tummy really seems to be fine now, and I've put back on about 10lbs. If I have CD, it must be the most mild case ever...

The bit of reading my DH and I have done regarding hemmies is that hemmies can quite often be the source of leakage, and having them removed stops it. Mine have been bleeding for about 11 years now, so it probably wouldn't be a bad thing to have them removed. Laser surgery seems to marginally reduce the pain and the recovery time, but I don't think my GI offers that, so I would have to seek yet another doctor.

The surgeon thought the fissure was the cause of the leakage, and the timing makes sense since fissures are often caused by long bouts of diarrhea, which I had. No doc has ever swabbed the fluid. It's clear and has a watery texture, so I guess it's hard to see or feel back there.

I have some estrogen cream on hand, but it's two years old, and I need to visit my gyn anyway, so I'll get a new scrip when I see her.

I was on the Diltiazem to relax the anal sphincter to promote healing of the fissure. It worked and I feel a lot better back there now, but the doc said things are still really tight. Apparently the other types of meds you can take for this can give you headaches.

I don't think the hurricane had anything to do with my bleeding, but thank you for your concern! :) I live way inland compared to where the devastation was. We had a lot of downed trees, (one of which I think was on our cable line) but that's it, thankfully. :)

I keep thinking we should turn this thread into a private message thread, but then I think it might help someone later. What do you think?

Ok, we'll keep it public then! I just figured out that fissure discussions probably belong on the Bowel Disorders board, since they seem to talk a lot about rectal issues over there...

Yeah, I can't even imagine what you guys have been seeing on the news. No one really thinks of NYC as having a coast, but our outer coastal area is what got hit. Well, that and the power plant that powers most of lower Manhattan. :)

It feels like dusk all day long? That's gotta be rough. Glad you have a light therapy light that works for you. I have a full-spectrum light therapy light that I use sometimes to wake myself up on winter mornings.

Yeah, the hemmies started bleeding ages ago. How do you know when your fissure has broken? Does it hurt?

I looked into the rectal rockets. Those look huge! But it looks like the design is well-thought-out. I will try the suppositories, but it's nice to have a break from rectal meds for a few days. :)

I haven't done sitz baths. I guess I should try those.

Tomorrow I'm going to try calling my gyn's office. My gyn had to retire because she got cancer, so I hope they can fit me in with one of the other doctors before the holidays, ugh.