Can the pain be bad enough for me to not go to work?

Dear friend

I was in a situation just like yours in 2014. It was horrible. Doctors tend to go through a protocol when they deal with anal fissures: they first prescribe pain killers, anti-inflammation medicines and anti-biotics to try ease pain, enhance circulation to the fissure and prevent infections. But when you have severe pain like you are experiencing, its due to muscle spasms: your fissure is so deep that it is exposing muscles which are contracting, cutting off circulation to the fissure thereby preventing the nutrition necessary for healing and thus protracting your situation.

You have to tell the doctor under no uncertain terms that the pain has become unbearable and that you can't work, sleep or even be awake: there is no relief because the pain in constant: he or she will book you with a specialist to exam you and they will do a fissurectomy on you to close the fissure with a skin graft. I did this: I was a student, living alone in a foreign country and had no help. But after a month of pain and suffering; of creams of all sorts; herbs and salt baths; I went in for the fissurectomy, was in hospital for aboit 20 hours and discharged. There was no pain and the bleeding stopped within 72 hours. And I have never looked back. I have a post under my username which tracked my recovery.

Please tell the doctor directly that you want surgery. The procedure is about 40 minutes long. When I went for it, I couldnt even wait in the hospital waiting room. They took me into a special room where I could lay flat on my front with my buttock opened to ease the pain. It was bad. But I am good now.

Get some laxido and take every day without fail. It makes the consistency easy to pass and will allow the fissure to heal up. One thing I would say is lay off a lot of fibre for now, what you need are less bowel movements, each one annoys the fissure and when it’s open and bleeding it can’t heal when it’s constantky in use.

I know you are probably thinking the more fibre the better, but not with a fissure. Everything will be soft anyway, and there will be less to pass so you might get away with one toilet trip a day. I ate lots of fibre because I was terrified of being constipated and having hard bowel movements that would split my fissure, it was dripping blood. It was my colo rectal surgeon who told me to take laxido/movicol/macrogel, all the same ingredients just different brand names. I did as told, and get it on prescription. If I miss a day I have problems. Hopefully it will work for you. Calmoseptine cream helps with healing and the pain you have now. Yes it is excruciating and your family have no idea, unless they have been through it, you can’t just get on with things, it dominates your life. 

Hooe this helps.

https://patient.info/forums/discuss/going-for-fissurectomy-tomorrow-4th-of-february-359712

You don’t need to even think about a fessurectomy at the moment, you say you’ve only had this for two weeks, try to heal it first, mine has healed, and it was a bid one.

Hi l hear you it is a pain that is indescribable l was in pain like that for at least 9 weeks l to had to work and found it very difficult. After many visits to difrent doctors finally found a doctor the prescribed me a cream that works its 50 nifedipine l have to use it for 3 weeks lm on my third week now and feeling much better no pain just burning sometimes . I'm booked in to have Botox and hemroid banding and there also going to do something to fissure and colonoscopy. Hoping that my be the end of it . All the best hope you feel better 

FORGET UR GP GO TO A COLORECTAL SPECIALIST 

Hi everyone, it’s now 3 days later and I’m still in as much pain if not more! The pain is now constant even when laying on my front in bed and putting no pressure on my bottom at all. 

Went back to the GP yet again today and saw yet another Dr who tried a bit harder to examine me this time much to my dispair. She’s told me she’s definitely sure about one crack but thinks I also have some internal cracks as well but can’t be 100% because she could barely insert her finger without me crying out in pain. 

She’s told me to stop using the first cream I was prescribed as she thinks I’ve had a reaction to it (which would explain all the burning pains I have) and prescribed me rectogesic (I think that’s how it’s spelt) instead which she thinks will be much better for me. She’s also said I need to use a barrier cream because everything is so red raw. 

Tried to use the cream for the first time and insert it with my finger because for some reason it doesn’t come with a nossle like all the others! The pain was excruciating (which now seems to be my most used word) and I think I barely managed to get any inside but instead managed to smear it around outside. 

She’s also put me off work for the week which is both a relief and an annoyance as I literally did 2 days back at work last week after having 3 months off for another reason. And now I’m signed off yet again with an anal fissure and tonsillitis! 

Dr is also not 100% sure if I have a perianal abscess or not  but obviously because I can’t stand her to exam me properly so we’ll have to wait until the cream hopefully takes effect. She’s also said that if the pain worsens I have to get back to her as soon as possible and not to leave it. 

Thank you all for your experiences and advice, it’s honestly made me feel like I’m not alone in this! 

Sorry it's still so bad. Regarding the rctogesic, you don't need to put it inside if it's too painful. Smearing it on the outside will also work. It's to boost the blood supply and help the area heal, so putting it on the outside will also do the job.

Had one years ago and I feel your pain. I took 4 ibuprofen (which is prescription strength) and that finally gave me relief. Not something you want to do long-term, though.

After suffering with that bugger for over a year, here's how I finally healed it and made sure it never came back:

The key is to try to have super soft stools for at least a week, while also taking the ibuprofen (which stops the spasms). Try eating about 1/2 cup of canned pumpkin or the pumpkin pie filling every day. It softens stool like nothing else. If that doesn't work, drink a little mineral oil or do a mineral oil enema if you're constipated (that can get messy, though. Don't pass gas unless you're on the pot.)

Also, take a couple of magnesium supplements before bed. It draws water from the colon and keeps the stools from getting too hard and dry. I have been taking 2 magnesium tablets EVERY night since I had the fissure in 2003 and I'm never constipated anymore. 

Avoid iron supplements during this time. That's what did me in. Especially those pre-natal supplements.

If you can go a week with really soft stools, you will probably notice the pain has decreased significantly so that normal movements won't tear it open again. But you still have to take care to not have any really hard stools. Stay with the pumpkin for another week or two just to be safe. Or make pumpkin pies!

Your family members need to get one of those devils to realize how excruciating the pain really is. like having an Xacto knife shoved up your butt!  I was lucky in that I was a stay-at-home mom and could soak in a hot sitz bath if it got too unbearable. 

Just another update, ending up going to hospital because the pain got so unbareable. Saw 3 drs who all agreed that I had a perianal abscess, and would probably need surgery. 4th dr came along on the ward round and told me it wasn’t an abscess and that he was just going to give me stronger painkillers and laxatives and send me home. So, I’m now at home feeling like a space cadet because of the tablets which also make me feel like I’m going to be sick all the time. He also said I just need to keep using my cream and persevere with it but if it got that bad again I needed to go back and see my GP. 

Looking at my discharge notes when I got home they said I’ve got anal fissures and possibly an anal fistula which is causing weeping but no abscess because all of my bloods were fine. Still being told by my family that I’m a drama queen despite being told by all of the drs I saw that I’m not and I definitely have an issue that may take months to resolve. 

Still feeling deflated, in a lot of pain and just downright useless and alone.