Fissurectomy result

Hi Graham

I read your post and shudder - it brings back recent memories - I too suffered greatly after Botox and sentinel pile removal.

Worse still I ended up in hospital emergency a week later - pain so intense even the morphine drip did not work for 6-8hrs later!!

That was back in June 2013 and with careful regime I am well on road to recovery.

It felt back in the summer that life would never be the same again and like you my work/home life was being ruined by the pain. Nobody I think can truly understand just how bad it is until you have been through it.

If anyone is unsure then I think more than once it has been said by women giving birth and had fissure agony - they say they would go through birth anyway as the pain of a fissure in comparison is far far worse.

All I can offer to you is my own advice as to what worked for me.

1. Get to your GP and demand pain killers: Traumadol - Paracetomol and Diclofenac was what I took to kill the pain.

2. Take your pain medication 2hrs before going to loo

3. As disgusting as this sounds - I found showering up my arse whilst going helped ease the intense pain - just get lots of disinfectant for clear up afterwards.

4. IMPORTANT: I originally took laxatives in tablet and liquid form. Some from doc / some over counter - they are too harsh and can cause as much problems as help. I discovered MACROGOL - which is a powder you mix with water (take a sachet twice a day) - it DRAWS WATER IN to the stool and keeps it very soft.

No explosion because you took too much laxative but a gentle experience.

5. I have been taking MACROGOL since July and will not stop for foreseeable future - checked with doc and its ok to do so.

6. I was prescribed Glyceryl trinitrate (GTN) to begin with - tried it pre-ops (I had botox twice) and after - all it did was give me a headache - then after July horror op - I tried ANOHEAL (I got it on NHS). Together with the MACROGOL I put my recovery down to this combination.

7. Never get dehydrated

So to recap

1. GET YOUR PAIN UNDER CONTROL

2. DO WHAT EVER YOU NEED TO TO HAVE LEAST PAINFUL BM - showering whilst going isn't pretty but by good it helped and getting ultra clean as quick as poss. is important - less BM n your fissure for least poss time is my motto

3. GET ANOHEAL and MACROGOL (no headaches with ANOHEAL unlike Macrogol).

Stay strong - I can imaging right now your life is intensely miserable and not good for those around you.

IT WILL get better - it took me 2 years.

Always here for you mate ;-)

Jeff

One other thing worthy of mention - its likely your muscle below is in spasm and therefore very tight and not wanting anything to pass - its easier said than done to relax going to loo when you are in real fear of pain and your muscle is like a clenched fist not wanting anything to pass.

I was prescribed Diazepam tablets which help you relax - its primarily prescribed for anxiety but it relaxes muscles - and of course in case of fissure as much relaxing as poss is needed to go to loo with minimal pain and further bleeding etc.

Doctors can be incredibly helpful or not but trust me you got to insist you get pain under control as well as relaxation and healing!

Today (day 4) much better. No screaming. Pain far less intense and shorter lasting. On other hand, BM much smaller so may just be storing up problems. Head basically clear and I see some hope. Only eating raw vegetables and congee (rice porridge) and porridge porridge. Still feel a hard swelling in anus, is this he Botox?

Yes I had same hard area - i thinks its a combo of where they sentinel pile was and also the fissure itself - will be a few weeks at least before it becomes unnoticeable

Thanks Jeff,I agree the whole issue of laxatives needs greater explanation as the point is to get it out on a controlled, predictable way that won't cause you any anxiety and therefore pain, not just to get it out at any cost. Also, the role of alcohol should be explored, if I drink some drinks it helps in faeces formation and therefore less pain, whereas other drinks could dehydrate. For 2am pain relief when doctor not an option then vodka saved me, and for me bitter produces moist faeces!

Never tried alcohol - was too out of it on pain meds - NHS prescribing bottles vodka etc - ill get myself a pre-paid NHS card int hat case ;-)

Seriously though whatever helps is ok

Hello, just wanted to share my experience with you as I too have a fissure and am only 4 weeks in to my last bout of it flaring up. I am not requiring an op though thankfully as I think mine is under control now .

I had a mild fissure for years from childbirth and just lived with it however 2 years ago I moved to Dubai and with the heat I very foolishly didn't drink enough water which causes hard stools and caused my fissure to tear a lot more than it ever had.

What I have discovered is glycerin suppositories, you need to get the fissure manageable before you can even consider using these but after weeks of using rectogesic ( I flew home to the. UK for this treatment ) and dealing with the headaches it had healed Enough so I was able to manage to insert a suppository, wet it first and keep it held in as long as possible, this softens the stools and relaxes the muscles and it's all over over very quickly, I am not suggesting this is the right thing to do but it's given me my quality of life back and I also take 20 ml of a lactose medicine every day, what I like about the glycerin is that you then control when you have your BM .....hope this helps someone as I wouldn't wish this pain on my worst enemy.

Day 5 post-op - oh no back into world of pain. Only vodka helps.

Blimey graham ...I feel your pain .....all I can say is soft sort soft liquid stools ...only way forward ..... Then the vodka ! Hope u get better soon ! X

Day 8 - a lot better today but only if I dont move my legs or buttocks. Yesterday was horrific, 6 hours in bath, screaming pain, worst yet, only vodka helped (again). Went to see consultant who checked wound and didn't see anything wrong, said I am just unlucky to be at far end of pain spectrum. Hoping better again tomorrow.

Day 22 post-op - I no longer need to lie down after a BM as of day 20, but as recently as day 18 I was still lying down for 6-7 hours. Situation still delicate but something definitely changed, guess the fissure healed. Over the 20 days I was improving say 4% a day, some days didn't notice any progress at all. Still taking lactulose, eating less to reduce stool size, still have a sitz bath on standby post BM just in case....Day 18 was bad because I over exerted. Don't be tempted to rush it and expect 3-4 weeks off work.

Reading these posts this morning has made me realise that I’m not alone, I am filled with hope.

I’m 15 days post Fissurectomy and Botox and couldn’t agree more about lack of info around life disruption post-op. Because my specialist didn’t even mention there might be serious pain issues, I assumed I’d be ok but how wrong was I. For 4 days after the op I felt mild discomfort, a different kind of numbed pain, probably from the Botox and anesthetic. I foolishly thought I was on the road to a quick recovery. But since the morning of the 5th day I’ve been in absolute agony, my bum feels like it’s on fire.

There was no mention of probable requirement to take time off work, so I just ploughed on, dosed up on insane amounts of painkillers, wincing every time I moved a muscle, putting on a brave face, laughing along, crying inside. In the end the pain was so unbearable I had to get up unannounced half way through a meeting and run to the disabled toilet, locking myself in, head on knees to let it air for a few minutes. I had the view that I must have a low pain threshold, as the specialist did not set expectations. But I now know that’s not the case.

Graham, I know that your comments regarding vodka, 6 hours in the bath and feeling much better but only if you don’t move your legs or buttocks were not written in jest, but they’ve had me in stitches this morning (pardon the pun). I think the relentlessness of the situation has made me slightly hysterical. There’s something oddly comforting and humorous about reading about other people’s misfortunes when they relate so closely to your own circumstances. I hope you’re feeling much better; any positive news would be well received.

Writing this email has been like therapy, killing time sat in bed, waiting for the inevitable… the looming pooh that will ruin the next 5 hours of my life. Perhaps like you Graham, I should turn to the vodka.

I’ll sign off with this quote I found.

“Laugh whenever you can. Keeps you from killing yourself when things are bad. That and vodka.” ― Jim Butcher

Hi Milo

For sure hostels and consultants give next to nothing in terms of a realistic discharge plan/information regarding what is in store.

I have been bottomed twice - 2nd time was much worse and I ended up be admitted via A&E to the word for several days - it's take over 5 months to get back to some semblance of normality - not cured yet.

Pain management meanwhile is essential

See my post here

https://patient.info/forums/discuss/botox-injection-in-muscle-for-anal-fissure-outcome-14782?page=3

Keep us posted on how its going ;-)

jeff

I am now around day 35..... I was about to say much better now, in that much of pain has gone, but actually I am not sure if I have really improved much since pre-op. I no longer need sitz baths, or to lie down after BMs, but I do have aching pains still that make it hard to sit for extended periods for 6 hours or so post-BM. This is pretty much my state pre- op! If over-exert it can hurt and need painkillers. Seem to be on right track....

Hi there- I'm looking for help and advice. Diagnosed with chronic anal fissure 4weeks ago by colorectal surgeon after severe pain since october. I think mine was brought on by starting a new job and the stress of this. If I do a poo in morning I'm still in agony at 7pm. Can't drive for longer than 10 min or I need to get out the car the pains so bad. It's taken over my life and I'm miserable with it and so depressed. Been on treatment (see below) for 4 weeks now and only 2 days ive felt a glimour of hope and don't no why. I've to go for colonoscopy on 6th June to rule out anything sinister and dreading the day before of having to clear out my bowel. Doctor sounds positive that this will work but I'm not sure- he said some people use rectogesic for 18 weeks before it works and then he do Botox injection. I just want it to go away and live my life again. 

Heres what I do daily but painkillers don't help much. Can you advise? 

Rectogesic morning and night.

tramadol, 400mg Brufen and paracetamol (was prescribed 30mg/500mg solpadol but they make me feel sick

hot daily baths

20 ml lactolose and 2 ducolease at night (stools fairly soft with this)

bran and dried fruit, wholemeal bread and kiwi for fibre. 

Sorro for being such a moan but desperate for advice and help. Thanks, gilly