Is this typical of an anal fissure ?

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Can someone please reassure me that the following description is a typical presentation of an anal fissure :

?intense and immobilising pain and spasm in rectum prior to a bowel movement

?pain so severe at this point impossible to know whats going on down there ...pooing one's pants ????

?painful bowel movement despite not being constipated

?some fresh blood at this point but not always

?some reduction in the pain and burning a couple of hours later

Does this sound like the anal fissure my GP is treating me for with rectogesic?

I've been referred for investigation and fear anal cancer

Hoping for some reassurance

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  • Posted

    eek I don't think this is an anal fissure. Sounds like something else that needs to be looked at. You will definitely need a colonoscopy. And always get a second opinion from another doctor.  I had an anal fissure a couple years back and I seriously thought I had Anal Cancer because the pain was so extreme and chronic that I was afraid that was the end of me. I had to get a 3rd opinion before a doctor finally told me what was the problem. My fissure was external , not internal. So I'm not sure what the difference of internal would be. Good Luck!

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    • Posted

      Thanks Melissa

      I have been referred to a consultant for investigation so hopefully he /she will do some exploratory tests

      In the meantime it would be helpful to know which of the symptoms i listed you thought indicated something other than a fissure

      Look forward to hearing from you

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  • Posted

    Yup definitely .. the spasms are normal or rather I had them. I had a chronic fissue, couldn't, walk, sit, lie down, nothing worked. I had regular spasms and even when I told my proctologist he seemed surprised which surprised me because they were real and regular. Bleeding is normal. 

    Very unlikely cancer, but obvious go get checked out. Best advice I can give you is to drink as much liquid as possible, not just water, if you able to drink lots of water great, but I struggled, drink what you like, the more the better, I drink juices and healthy smoothies from the grocery store. Stay off of stool softeners, they bad for you long term and don't even work that well short term and are expensive .. water / liquids are your friends.

    Also treat your bottom like a table top, it must be flat at all times, so when you sit, try not to squish or clench your butt, use your hands to widen your butt when you sitting down, also make sure your butt is pulled out left and right and flat like a table. Sit up and walk straight.

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    • Posted

      Thank you for your response esp your "table top " a

      advice

      I am drinking lots more water than usual and am taking a tablespoon of psyllium husk daily since this started

      I have a high fibre vegan diet and am not constipated .

      Thanks again

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    • Posted

      Not been constipated is going to help a lot, just keep up on the liquid in take,  you going to have good days and bad days. Never strain ever and always go as soon as you need to go, don't want.

      I disagree with some peoples advice, surgery is the last resort, it takes a while to treat it, I was in pain for over 1 year, but am almost recovered. I couldn't even see a surgeon as they have a long list of patients and rarely recommend surgery now days ... 

      There are various recommended ointments you can use from doctors, none worked for me, I tried them all, honey, coconut oil, you just going to have to try them all until you find something that works for you.

      You basically in management mode now, you need to manage it verses trying to heal it. Healing will come in time as long as you manage it properly. 

      One thing for sure it, it will eventually heal, you just need to give time. There is a food list you can try avoid if you drinking too much coffee tea etc, they say try avoid caffeine for 3 months, but I suspect you might be doing this any how if you a vegan.

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    • Posted

      I am having 3 sitz baths a day with Epsom salts and coconut oil and applying rectogesic twice a day ....no idea if the rectogesic is helping as there is no relief when I apply it

      The warmth of a hot water bottle is comforting

      I do have coffee once a day but otherwise a very healthy unprocessed plant based diet with no alcohol

      I really enjoy the coffee but would give it up if I thought that would help

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    • Posted

      sitz baths never worked for me, I was trying everything, so keep it up, if it helps great. My proctologist was not a fan of ritz baths, hot water bottles. Basically he explained it like this, it is a typical skin condition and sitting in hot baths or using  hot water bottle just prolongs it from healing (Does make some sense) but heck if I am in pain, I am going to try everything to make it stop.

      The only way to know if coffee or anything else is causing the issue, is to stop it for 90 days. This is a long time. I had a list which I have been meaning to find with all the things I had to stop for 90 days which include dairy, caffeinated tea. He said stop ALL coffee even decaffeinated ones because it still has caffeine supposedly. when I find the list, I will provide it. Don't stop your coffee yet, but if things are not healing, then you may want to cut out food you have regularly like dairy/coffee and just cut back on them.

      Do you have eczema by any chance ? If so, this could make things a little worse.

      I gave up alcohol completely. He also said avoid prune juice or prunes, supposedly it makes your stool runny and people take it to make it easier like stool softeners ..

      I was given a whole bunch of exercise and the the table top one by far helped the most, you don't realize it until someone points it out, same thing as walking straight .. .was interesting exercise for sure and many eye openers ..

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    • Posted

      Thanks again

      I'm vegan so don't have dairy and I don t drink alcohol ....I 'll see how things go and cut out the one coffee a day if I need to

      I'm in bed now as its 1.30 am and have no pain at all .....this afternoon I was hopping around the house yelling with pain unable to straighten up and walk properly prior to a bowel movement

      Thankfully I was at home....how do people cope in public ??..

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    • Posted

      Probably a bit of both, but basically out body muscles and posture are out of whack. Before I was told the obvious, I was sitting and probably putting a lot of pressure in the area, stretching your buttocks out over time definitely made a huge difference for me. I guess if you dig deeper in body mechanics, your butt is meant to be flat and sat on, clenched up tight and pressure on a certain area. You might not even realize you doing it until you in pain and now realize that might not be a good posture.
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  • Posted

    Hi Jennifer,

    This definitely sounds like a fissure. I would definitely see a specialist and 

    here are some suggestions I have for you to help you through in the meantime:

    1. Try somee zinc oxide in the form of calmoseptine which has menthol to soothe the area down there as well. Calmoseptine can be bought at almost any local drugstore and can be bought online too.

    2. Try squatting when going on the toilet instead of sitting. This is a much  helathier position and the poop sometimes will just slide out,  no pushing or straining involved.

    3. I would definately take a fiber supplement, specifically metamucil  is what I take evveryday,  in ordr to allow your stools to be soft and to allow them to pass thorugh easily. THis being said, with any fiber supplemetn, you must drink lots of water when using them, or they will not work veffectively. Also, do not take too much as too much fiber can irritate your bowels on the way  out and diarreah actually does worse down there.

    4. I would recommend getting a sphicteronomy surgery if htings dont get better. I waited it out, gave up, had the surgery, and was able to heal within about two weeks. I had a chronic fissure, so I knew where you are ocming from with v all the pain and discomfort.

    Try listening to music to distract your mind a bit, especially when going to the bathroom. If you are in writing pain, distract yourself with a movie or TV show right after. Also, to prevent myself from screaming and from putting more stress in the area down  there, i bit down on a washcloth in order to make the tensions with my teeth instead of my sphicter muscle.

    Hope this helps!!!

    Best,

    Myles

     

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    • Posted

      Thank you Myles

      Much appreciated

      I have googled the calmoseptine and it doesn't seem to be available here in the uk ....I will try and find an alternative with the same active ingredient

      I have a high fibre vegan diet but have added some psyllium husk ...

      I'm drinking lots more water than usual and am not constipated

      Can't believe my life is centred around my bum 😕

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    • Posted

      Hi Myles

      I went to see a pharmacist today about the calmoseptine and he was reluctant to suggest an alternative

      Fortunately my appointment for the colorectal consultant has come through for next week so I haven't got to wait long 😊

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    • Posted

      Hello Myles

      That's really thoughtful of you to ask

      I have seen the GP twice in last fortnight and she has acted promptly referring me to the colorectal services locally ....I have an appointment next Weds

      In the meantime after a really horrible couple of days today I have a lot less pain both before and after a bowel movement so am feeling less anxious

      Keeping positive has been tricky at times as my thoughts keep returning to anal cancer

      It's also tricky explaining why I'm not socialising and going out much as only my husband and two close friends know what's going on

      How do people deal with the embarrassment of all this ???

      Hope you are recovering well from your recent surgery 👍😊

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    • Posted

      Keeping positive is really the trick of it all. And the embarassment is a whole other component of the anal fissure that is hardly addressed. I actually wrote a paper in college for this recently pertaining to the embarassment you mentioned. You might find it interesting: https://drive.google.com/file/d/10EnNy5mpfFvOxoB9GlQ4xEd9XQPuYOd1/view?usp=sharing

      In the meantime, hope you keep feeling better and the future appointments go well.

      Best,

      Myles

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