Anal stenosis (narrowing of the opening of the anus) - Help!

More than two weeks ago, I developed constipation despite suffering from D. I did have D but I could not pass stool easily and used to use stool softeners. I did post then at this forum asking for help and a lot of fellow Crohnies answered thankfully that it is normal to have D. My main problem is chronic proctitis and I need to use steroid enemas. However, I could not insert it. So, I saw my doc and he decided that I should stop taking any kind of enemas to relieve the rectum.

Two days ago, the proctitis pain returned and I know very well that if I leave it untreated, a flare up begins. I took the steroid enema and it was a torture. So, I saw my rectal surgeon, he examined me and told me that I have narrowing of the opening of the anus because of scarring of fissures, prescribed gtn (glycerine trinitrate) 4 times/day for 4 days, stop any enemas and call him after these 4 days. I browsed the net and found that this narrowing is called anal stenosis and it requires a lot of times surgery.

My proctitis started to be more painful. So, I have two questions:
1. I'm afraid of leaving the proctitis untreated as proctitis flare up take a long of time to be treated and require a lot of meds which irritate my stomach. Is there anything I can do to prevent proctitis relapse?
2. Has anybody been through this before? How was it treated?

Your replies are highly appreciated.
Thank you.
Minnie
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Current meds: Pred (5 mg tapering), Entocort 3mg, Methotrexate 25 mg im inj/week, Pentasa tablets 3g, Nexium 80, an anti-ulcer med 1x3, folic acid, weekly B shot and mulivitamins.

minnietoty, I have issues with my rectum/anal area too, but mine *usually* resolve fairly quickly if I keep applying Cortate, take sitz baths, chamomile, probiotics, and make diet changes, especially when flaring horribly. Eating very plain easy to digest food or homemade soups makes things easier too.
It is so painful having issues in that area, and I'll have to remember to ask my GI for a suppository again. I also have colon and rectum spasms and roids which are quite painful too. Do you have those as well?

That might be the same feeling I get in my rectum. Honestly, it feels like something big is in there, but there is no stool or anything (Sorry, all, I know that's graphic and gross). Does it sound the same as what you get?
For me, I'm pretty sure it's related to flaring roids, spasms, inflammation, etc. I had it so horribly just last week that I could hardly walk and lying down didn't even help, so I got into the tub ASAP and loaded it with epsom salts.
Tylenol didn't help much that time, so if that happens again, I'm going to take something a little stronger like tylenol 1.

Is the pain like tenesmus, also, minnietoty? I find that taking warm baths, using hydrocortisone cream/suppositories help with the spasms and inflammation! On those days where I just can't take it and I feel like I have to 'D' but it wont come out I use the hydrocortisone cream and use a 'butt paste' after appling that and I usually have a BM fairly soon. I take the cortisone suppository 2 times a day because the Canasa ones haven't been cutting it. My GI suggests when the inflammation is bad an I'm 'constipated' (tenesmus) to just take a half dose of miralax and go on with the usual med routine and that helps a lot!

   When all else fails I take tylenol and maybe a lortab...I'm not big on pain medication but ya gotta do what ya gotta do sometimes. Tylenol does nothing  for me though when everything is swollen shut..

  Hope the pain/inflammation subsides and you can get in touch with your GI asap! Happy holidays

Keepingfaith and Roni, Happy Holidays.

Keepingfaith, thank you very much. I always thought that anal problems are the responsibility of a surgeon but yes I think that i have to contact my GI. They both tell me that they have to cooperate together in treating me but when I consult the GI alone, the surgeon gets upset. I like the idea of hydrocortisone suppositories very much and hope he will prescribe it. I'm just worried would this narrowing get wider by medication or does it require any kind of surgery? I remember that my GI warned me against any anal surgeries as this might cause incontinence. This gtn causes me severe headache and I skip taking it every 6 hrs. I just take it twice per day instead of 4. Also, I can't take any painkillers for the headache because of my stomach problems.

Roni, mild painkillers stopped working for me altogether and my GI has difficulty in finding me stronger ones as I got used to all types of painkillers.

Take care!

Ep 49,
Thank you very much. Things are not going on well. Normally, I have 4 or 5 bowel movements a day or even more but now I can't. I keep straining without any effect. I don't know how to act. To top it off, I have severe cramps and need to defecate. That's really horrible.
You mentioned the dilation issue, is this going to be regular? Is it painful? I'm ready to bear any pain but don't have this awful feeling. I want my normal D again.
Take care!

Ep49,
Thank you. Now, I started to get anxious about this dilation issue. I had a bowel movement without trying to strain but the pain was horrible afterwards. I wake up out of pain and take this gtn ointment. I have to wait for more than 2 days and then call the surgeon and see what he thinks.
Hope things get better for you and the steroid effect lasts long:)
Take care!