My experience with a chronic anal fissure

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Hi all

I thought that I would post this as a lot of people appear to be going through the same agony that I was going through for over a year.

Anyway, I was at uni and going through a bad time in my life, whenever I get stressed my guts go into turmoil. As a result I was off uni for a week with severe rectal pain and feeling lower than a snake's belly. I booked an appointment with my GP as I had experienced similar symptoms before.

My GP recognised the symptoms immediately, I thought I had piles, she said I was too young so had a look. The digital examination wasn't fun, in fact she said she had never seen anyway change colour so quickly but it was worth it because I was refered to a colo-rectal surgeon.

I took my sick note back into my tutor and as I was doing a clinical degree, he said straight away that fissures were worsened and sometimes caused by stress. The penny dropped.

As I said I was going through a very very bad time in my life which necessitated me going on antidepressants (Cipralex) for my emotional state. When this was added to wall climbing agony due to fissures I was near breaking point. I remember after one bowel movement almost fainting with the pain, I was lying at the top of the stairs at my mum's house and clawing at the wallpaper with my fingernails - I have had a broken leg and in terms of pain that fissure was far worse, trust me.

I went to see the colo-rectal surgeon a few weeks later, I was terrified, but he was a lovely man, very very considerate. He told me that I had a large fissure that could be helped with an ointment. I told him my background so he talked a bit more openly and said that fissures are an incredibly debilitating condition. He once had a 16 stone rugby player openly weeping on his consulting couch with the pain - I can understand why.

I was prescribed GTN ointment and started using it as directed. I had a slight headache which I could live with, but this was far better than the agony of the fissure and this headache was pretty much gone after the first week. After a week of use the pain from the fissure had also subsided to nothing. After six weeks I went back to the surgeon and I was healed.

I wish that was the end of the story but it isn't, I have probably had four or five bad flare ups since and dozens of other twinges, spasms, bleeds and itches since but I am nowhere near as bad as the first time - I can live with this now. I have seen the surgeon twice since and he has offered surgery but my frame of mind precluded me from that, I was simply terrified.

My GP is very understanding and I can get GTN on prescription whenever I need it. I was prescribed Anoheal by the surgeon as well but this didn't work as well as GTN for me, but I have seen cases in work where this has been incredibly effective.

As I said earlier, I was doing a clinical degree, which I have now passed, so I feel that I am pretty well qualified to offer a bit of advice, so here it is.

1. Go and see your GP. Don't be embarrassed, your doctor has seen dozens of these - they are very very common. If you get fobbed off or feel that you haven't got anywhere, go back and tell him/her that you are not happy and you will go elsewhere i.e. change your GP. Changing your GP hits their bank balance, and as GPs are notoriously greedy, they will do something. Nobody should have to suffer with this.

2. Take something for the pain but NOT codeine. Ibuprofen worked best for me.

3. Drink plenty of fluids and lay off the alcohol while you are healing.

4. Eat lots of fibre and fresh fruit and veg, switch to brown bread and have something like Weetabix for breakfast. This softens stools and makes them easier to pass - less pain and less damage to existing fissures.

5. Use a stool softener, one Movicol sachet daily really really helped me. You can buy these over the counter from your local Pharmacist but tell them what it is for. Alternatively get them on prescription from your GP.

6. Lay off the red meat, there is some science to this as meat increases the residence time in the gut and predisposes to harder stools. This really helped me and I have seen a few accounts here where sufferers also say that.

7. Try to relax, easier said than done, but try simple things like having a hot bath instead of a shower. If anything helps you, no matter how crazy or off the wall it may sound, carry on doing it. Going out for a drive helped me. Staying active also helps constipation and makes you feel better. Don't stay in and stew - stay positive.

8. Stick to the doctor's directions of any drugs you are given. If you are told to apply a cream for 6 weeks into the anus, then make sure it goes into the anus for 6 weeks. And into the anus means into the hole - not nice, but a lot nicer than the agony from an untreated fissure.

Remember you are not alone, these things can be cured. You will feel terrible and you will feel like nobody else understands what you are going through but believe me, these things are very very common.

And if all the above doesn't help there is a simple operation that can be done on a day case basis that has a 95% chance of curing it for good.

If you are reading this you are no doubt feeling horrible but believe me, there is light at the end of the tunnel.

Good luck with your pain in the ass.

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  • Posted

    Hi

    Can you tell me when using GTN were you advised not to apply it internally under any circumstances, as i was?

    Been reading conflicting information regarding this, so not sure what i should be doing for the best result

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  • Posted

    I am so gld i have found a group of people who understand the pain of an anal fissure - I have been suffering for over 6 months and thought I must have a really low pain threshold and should be able to get on with coping with a small tear!

    I have read some of the treatments advised and will try them out - perhaps there is light at the end of the tunnel - Thanks to all of you.

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    • Posted

      I would not say that you have a low pain threshold.

      I have had 6 children a total knee replacement and many other surgeries, but the pain from a fissure /piles or any rectal problem is by far the worst pain I have ever had the misfortune to experience.

      Unfortunately most people know very little about it & the severity of it.

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    • Posted

      I agree I have 5 children and have had several surgeries. I have a very high pain threshold and the pain of the fissure is one that leaves me weak and trembling. I have yet to find any relief from the pain I wait for it to subside or sleep in my bath tub when it is to bad! I have seen a surgeon, creams, pain meds and ointments and still no relief. I feel for everyone going through this!
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    • Posted

      I got hit by a car and left with a swollen leg and also crashed a scooter and cracked a few teeth, split my knee, lip, and chin open and left with stitches. I rather do both those again than have this fissure that is ruining my life and causing me so much pain! I take Motrin for the pain and it helps. I'm usually fine after a few hours in the morning. But sometimes I have to have a BM more than once in the morning and that can be a little irritating on the anus. But I'm looking forward to having surgery soon. No creams have worked, they help, but after awhile you need a solid solution and by reading all these threads, surgery seems to be the best thing anyone has ever done. 

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    • Posted

      Hi,

      I read your post. I had to have my whole colon removed 2 years ago so when I started getting the anal fissure I went to my GI. He referred me back to my surgeon. My surgeon has to be careful treating me due to a pouch and no colon. He did a botox injection. I was put under for this but within a day I felt so much better. I was able to go back to work 2 days later. I just had my second botox shot yesterday as it last about 4-6 months. It is not very painful and you can be up and moving around the next day. Typically within 2-3 days you are healed enough to go back to your normal routine.

      You should talk to your Doctor. You can also look it up but beware cause I saw first hand sometimes what you read with freak you out but its not all real. Good luck

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    • Posted

      Hi Cindy, 

      I also have a pouch due to uncontrollable Ulcerative Colitis. I believe my fissure is cause by constant bathroom trips, the fact that pouch stool is far more caustic in makeup and the straining that comes from not feeling 'empty'. I have also been given very expensive suppositories (even wtih private insurance, they were still $150 USD) but having no colon, they weren't effective.  I'm going to try one more time with my current GI and bring up the Botox method. Wish me luck! 

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  • Posted

    Hi all just thought i would let you all know my past and present with anal fissure.

    I have suffered with anal fissures on and off for nine years since the birth of my son, I have had an anal stretch 8 years ago very succesfull but soon came back when i got constipated. I have now been suffering this time round for 3 months, I went to see my doctor and he said because it hadnt healed they were classed as chronic so probably wouldnt heal on there own. I went for surgery under general anastetic 6 days ago. When I was under they had a look I had 2 anal fissures and hemorrhoids. They proceeded to do hemorrhoidectomy to remove these then also applied botox to my anus.

    After surgery is was in severe pain for the first day. Second day the pain was only bad when i opened my bowels so took pain killer ensured i kept my bowels soft and had 3 sitz baths. Third day a little better only needed 2 sitz baths and pain killers. Fourth day no sitz baths but took pain killers just in case. Fifth day no pain whats so ever, didn't take a bath or any pain killers. Sixth day still no pain. thank god.

    All i can stress to anyone suffering is that you have this done if offered, it is the best thing I have ever had done. There is a risk that they can come back but i have stepped up to solve this once and for all. I have changed my diet by eating load of veg or salad and fruit. I have a glass of prune juice every day along with fresh orange juice plus 3 pints of water spread through the day. I am still taking the laxative prescribed to me until i have been for my check up. So in my case keep stools soft after and it only takes 5 days for pain free days.

    I am so happy now and Ive even lost some weight.

    Hope this story helps anyone who reads it and that's suffering.

    Thanks Bev

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    • Posted

      Hi, Ihave had hemorrhoids for 3-yearsnow and iI just got diagnosed with small hemorrhoids from a Colonoscopy which I just hin the past 3-years gi doctors and two surgeons have assumed I have ana fissures because of my severe pain I have that lasts up to 8-hours after a bowel movement. But they also tell me a fissure surgery can cause leakage. So out seems they haven't suggested surgery just yet because they seem like there trying to prevent it. Do you know anything about a leakage and how dangerous it can be to have surgery. I'm so exhausted from this chronic pain and dead tired of being bounced around from gi to surgeon and not getting the help I need. I've taken tectonic medication for 6-weeks and I'm still in pain. Also have changed my diet to more fruits and veggies, lost 20lbs amd I'm still suffering. I need advice. Anything.
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    • Posted

      Hey after getting every thing under the sun I finally decided to have the surgery 6 years ago. I remember like it was yesterday. I stayed in pain before the surgery. My only regret is not getting the surgery sooner. There was no leakage although they said it may be. You'll be fine, but if you don't get the surgery you'll stay in pain. The sooner the better.
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    • Posted

      Go for the surgery, I've had no leakage at all, I had another in May last year and so far have had no return which is a really good sign for me, I'm keeping everything crossed now for myself, this is the order of my surgerys anal stretch, Botox, then Botox again, then a sphinterotomy, followed by Botox again. This was over 15 years xx
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    • Posted

      Hi Melissa.

      Ive suffered from Anal fissures for several years, had botox injection around 3 years ago and that helped me. But during periods of stress it seems to flare up tried painkillers, sitz baths, changed my diet nothing seems to help.

      Im a lorry driver and the pain is unbearable at times and as silly as it sounds even my gp says he cant understand how it helps but found sitting in hit bath for a few minutes and then rubbing deepheat on buttocks helps with the pain.

      Be careful not to get it anywhere near the Anus but just on the buttocks this seems to help more than any of the pain killers.

      I feel for everyone suffering from AF the pain can be unbearable at times.

      I only came across the deepheat when I was on a long journey and the pain from the AF was bad and sitting for a long period was causing my buttocks discomfort so got home that day and sat in bath and rubbed deepheat to ease the aches in buttocks but to my surprise it helped the pain of AF aswell.

      So whenever i have a flare up now I carry a tube of deepheat with me where ever I go

      hope this helps you as much as it helps me.

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    • Posted

      I ACTULLY FEEL LIKE U STRAIGHT TALKING TO ME.IVE BEEN SURFFERING FROM CAF FOR OVER A YEAR AGO BUT I HAD HEMMRHOIRD FOR ALMOST 5 YEARS. BEEN DIAGNOSED WITH ANAL FISSURE WHICH AT FIRST I TAUGHT IT WAS JUST PILES ETCCC...

      MAN IM TELLIN U IT RUINED MY LIFE FROM DAY TO DAY IM 26 ACTIVE RIDE BIKES ........BUT WITH THIS I BECAME HOMEMAN LOL...PASS STOOL WAS COMPARED TO SITTING ON FIRE BUTTNAKED...ANY I TRIED ALL SCREAM POSSIBLE FROM PREPARATION H TO OITMENT SUPP...HOT SITZBATH...ALL

      NO MY LAST THING IS TO GO FOR A SURGERY WHICH I DIDNT WANNA DO FOR BEING A SCRAY CAT (LIL PUNK)

      -MY ONLY FEAR IS WILL THEY CAN COME AFTER SURGERY,SAY AFTER MONTHS OF HEALING AND CONSTIPATION OCCURED?WILL THE TEAR REOPEN AS HARD STOOLS PASS?

      I SMOKE WEED DAILY AND DRINK ONLY ON WEEKEND.DOES IT HAVE ANY INCONVINIENCE?

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    • Posted

      Didnt have any problem with pain but still got small leakage so I say go for it as you dont have much of a choice you are young and fit so you have every chance best of luck.
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    • Posted

      Just a follow up on my experience .

      Had CAF since 2012... hard to pass BM.

      Blood in stool and in toilet bowl

      Been off work for 5 weeks due to so much pain... Lost 18kgs

      Did all the creams and and a high fiber diet

      Pain is unbearable

      Finally went for Botox injection on Monday and they found an anal abscess as well which they have drained.

      Now it for days later on paracetamol and 10mg morphine tablets along with Diltizem cream and Lignocaine gel and stool softner tablets and Lavolac .

      I also am taking Chinese weight loss tea at night as this loosens the stool quite well.

      I still have sore BM as it is only a days since surgery but I'm hoping it will work out.

      Just need to keep focused and hope I can sort this out

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    • Posted

      Hi Bev, So you had surgery and that took care of it. Well Its been two weeks now since my suregery (Lft Lateral Internal Sphincterotomy) and im still in alot of pain with my BM.  Maybe im pushing it a little but how long does it take to fully heal from the time of surgery?
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    • Posted

      You also said Botx injections help? Ive never heard of that until ive been on this Discussion. Thats interesting. Did that also help you out alot. And would you recommend that for my self? I am so drained from this pain, its eating away my energy and daily routines.
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    • Posted

      Had botox twice like you and and then sphinterotomy problem not completely cured could another botox injection help bev what your opinion edmund.
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    • Posted

      You are one of the lucky ones. Had hemorroids and skin tags removed 12 weeks ago. 12 weeks of bleeding and agony with every bm. One week ago had second surgery to put Botox in butt. Surgeon removed fissure and skin tag and injected Botox. Still in excruciating pain especially with bm. Don't know what else to do. It has effected my lif hugely

      Debbie

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    • Posted

      So glad I've found u and read this. I'm laying in my hospital bed @3:30am with my 13 week old baby on my chest as I've been in hospital for 5 days then admitted again today after extreme constipation and obstructed poop ... I've so mentally drained and exhausted from this like I could give up on living a daily normal healthy be happy life again and finally getting to enjoy or even be capable of looking after my baby . I have a chronic annual tear from child birth after teeing and getting cut and from the use of forceps - if I had of know these risks associated I would have pushed and demanded that c section the prepared me for seconds before using the forcepts, tearing and cutting me. I feel like it's hard to have hope that my bottom will ever fully recover and reading your comment has restored my faith and it's so nice to have people on here understand the sever, unbareable pain of anal fissures. I have two anal fissures. I had Botox injections 2 days ago as I begged and begged for these and had to come through a different hospital that would help me as the hospital where I had my son at didn't want a bar of me or helping get me in for surgery as the cream just wasn't cutting it and making little or no progress.

      Can I ask what surgery did u get?

      I know there is Botox injections then there is the sphincterotomy (Anal stretch) this sounds painful but surely nothing as painful and persistent as untreated and in healed fissures that just don't get a chance to fix.

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    • Posted

      Hey,

      Sorry to hear this I know it's painful. I'm 26 myself and just been healed from anal fissures by simply changing my diet and eating healthier. I also drunk prune juice and lots of water and I also drink magnesium citrate which break down your stool and makes liquidy so it's not painful when you go. After the diet and prune juice, water and magnesium citrate I was healed in three days trust me it works...

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    • Posted

      Hi Bev great to hear you had a successful outcome.

      I wish I could say the same.

      I had a hemmoroidectomy some years ago, I suffered for many weeks after followed by anal skin tags which developed post op.

      I am only just out from having removed, my time in hospital was a dreadful one where my pain was under rated, & under medicated.

      resulting in me suffering a great deal.

      I would like to see a greater awareness on rectal issues.

      Then perhaps I would at least have been some empathy.

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    • Posted

      I have dealt with this same pain. My surgeon actually put me under and did a botox injection and out of everything that has helped so much. It does only work about 3-6 months. I just got my second shot yesterday. By the next day you are feeling much better and by the 3rd day I'm able to go back to my regular routine and go back to work pain free.

      Also you should use wipes when you go to the bathroom cause toilet paper can make a fissure worse and more painful.

      Hope this helps

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    • Posted

      I had same as you botoxs injections two of then and then surgery because had leakage problem no pain but did not cure leakage problem improved it a small bit really getting me down how can i solve the leakage very bad when go to toilet more than once a day would love to hear from you.
      Report Reply
    • Posted

      Hi I've been suffering with really bad rectum pain after bowel movement it can last for days can you please give me some advice I've tried loads of creams but don't get any relive

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