Anal fissure - looking for any success stories on Kenalog procedure??

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Hello - I am new to this forum but have tried most tips others have posted (changed diet, increased water, stool softeners, used various topical creams - Nifedine, hydrocortizone, etc.). While this helps some, the pain (like passing glass during BM) comes back. At this point, I believe I have a chronic fissure (or at least I am very prone to the condition) since I have had this on/off for years. First started with stressful job, then I think it healed but came back again during/after pregnancies, and now latest trigger was from round of antibiotics I was taking (for unrelated condition). I have not tried botox but not sure that would help as I do not have spasms - just intense pain during and after! I recently read about Kenalog procedure that is non-invasive (involving dilation and injection of steroid into fissure) but since procedures is relatively new (a few years I think), have not seen or read any "real-life" reviews or experiences so I am interested if anyone has done this procedure and had any success? many thanks! 

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  • Posted

    Hi,

    I’ve suffered from a chronic fissure for a year and a half. I’ve tried both diltiazem and nifidipine ointments and though they eased a little discomfort, my fissure failed to heal. My Colorectal surgeon in Toronto offered the LIS surgery but I wasn’t thrilled with the possible complications given I’m pretty young (early 30’s). I researched and found the Kenalog Protocol performed by Dr Feingold in New York and after reading patient reviews was convinced this was the best option for me, no cutting required 

    I had the procedure done yesterday and wow. I’m currently in no pain. I’m sure it will be painful over the next few days but I’m confident this procedure will be a success. I’ll update as I go through the healing process. 

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    • Posted

      Thanks for your post. Please keep us updated on your progress. Also I would be interested in learning more about the actual procedure and any pre or post effects. Thanks!!

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  • Posted

    Hi Ann, 

    I’m currently on day 3 after Kenalog procedure and my pain is only about a 3 on scale of 1-10. The actual fissure pain I had before was way worse. The procedure only took about 25 minutes under General Anesthesia in which he reopened the fissure to make a fresh wound  and cleaned it out. He then injected it with the steroid Kenalog to promote healing. He also lanced any Hypertrophied papillae surrounding the fissure (hardened normal skin papillae). I was fortunate in that I didn’t have any skin tags with my fissure so he didn’t have to do anything else. He does remove skin tags during the procedure if the patient has them as they prevent fissure healing. After the 25 minute procedure I was ready to go after about 1 and half of observation. Dr Feingold went over all post op care. I have to take a stool softener daily and an anti inflammatory pain pill for 5 days. He also prescribed a regular painkiller should I need it after the 5 days. I also was told to take hot baths twice a day and after every bm. 

    So far I have had 2 bms since the procedure and hardly any pain and no spasm. Hopefully it continues this way. In terms of healing time, he said about 10 days and pretty much all pain free. Up to 6 weeks for fissure to heal completely. He said to me that you come with a fissure and leave with a fissure but you get the procedure that stimulates healing. He has done over 200 procedures now and has almost 100 percent success. He said he had one patient that failed to heal but that was due to other anal surgeries which complicated the procedure.

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    • Posted

      Hi Jessica,

      Thanks so much for posting about your experience.

      I had the kenalog procedure with Dr Feingold as well -- 11 days ago! I'm happy to report that i'm having really minimal discomfort at this time and that things seem to get a little better every day. I'm just so nervous about it finally healing in the 6 weeks.

      I'm not sure if others have had this problem but I have such a hard time keeping my stool soft no matter how much fiber i eat/take and how much water i drink. 3 stool softener (100mg) did nothing and so i switched to Miralax but im having to take nearly double doses twice a day. I still have bleeding with bowel movements (hardly any if soft and more if formed) and I'm just terrified ill ruin the results of the procedure. Staying on top of taking baths and crossing my fingers. My stomach is a wreck from the crazy amounts of water and miralax ugh!!

      Would love to hear more about your contined healing! How are things now?

      • Mary
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    • Posted

      Any update on this? I had the procedure 7 days ago and still feeling some pain, but seems to be slowly improving. Wondering how the first few days went for you and if it ended up being a success!

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    • Posted

      What kind of pain would you say you have? Like debilitating? I've been dealing with this thing since summer, and I go in Tuesday for the Kenalog procedure, and I'm a little worried. My pain comes and goes and the last 2 weeks it's been fairly light. I'm a little concerned about how bad the "bad" is gonna be after the procedure.

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    • Posted

      I'm now coming up on 7 weeks post-surgery. The pain is finally starting to subside! I visited the doctor after 6 weeks since I was still experiencing considerable pain after BMs. I had a deep wound so he said it would just take some time and to wait another 2 months before returning. I was pretty concerned before the visit that the procedure didn't work, but just a few more days after the visit and things seem to be looking up. I can walk around and feel normal for most of the day. I'm still taking very good care though, and will do so for the next several weeks.

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    • Posted

      Hi,

      it is now been over 5 months since my kenalog procedure and I am feeling great! I have no pain during or after bm and have not changed my diet at all. so far I am incredibly happy with the way it went and the results. It did take about a month after the procedure for the pain to ease up so hang in as best you can 😃

      How is the pain now?

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    • Posted

      How much pain were you in prior to the procedure? was it constant, or come and go every few weeks? mine lasts for days or weeks, then seems to get better for a few weeks. I'm in low pain now, but assume it's gonna suck for a few weeks after the procedure. ugh.

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    • Posted

      I was in constant pain prior to the procedure for a year even with the prescribed ointments. I had post bm spasm pain for 5-6 hours everyday 😦 I experienced a similar sense of healing right before the procedure. I thought it was healing as the pain seemed to be subsiding but when I saw Dr. Feingold he said that the fissure was developing scar tissue but that the scar tissue would tear again if it was not dealt with and it would be the pain cycle all over again.

      It was painful for about 3 weeks post procedure but not much worse than the fissure pain I had been dealing with. I didnt even use the pain meds prescribed as I didn't want to risk constipation and i was able to weather it.

      I hope the procedure goes well for you and you have a speedy recovery 😃

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    • Posted

      Hi Jessica, did you try botox injections before getting the kenalog protocol done?? I've had a fissure for about 8 months and I've tried 2 different types of creams. Neither fixed it, just help with symptoms and possibly help prevent it from getting worse. My doctor is now recommending botox injections. Did you try these or were these ever recommended to you? I'm hesitant to go to the kenalog procedure as my next step since it involves cauterizing the wound (also I have a skin tag and I'm worried about the possiblity of incontinence if Dr Feingold would want to cut it). hoping to find out how effective botox is to help decide if I should try that first or go straight to the kenalog procedure before the fissure gets any worse.

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    • Posted

      Thanks so much for talking about your experience on here. As I'm sure you know, helps so much to see how other people are fairing after having this procedure.

      How are you feeling now? Has the fissure almost healed, or have you started looking at trying another procedure?

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  • Posted

    How have you guys been after surgery? I'm a week post, and pain is pretty much relegated to after a bm. However, i bleed what I'd consider a decent amount while sitting on the pot. It's actually increased a bit and sometimes looks clotty. For some reason lately, I've been having trouble actually going after i feel like i need to, but regardless if i go or not, there's always blood. You guys experience this? Thanks

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