My experience with a chronic anal fissure

Posted , 107 users are following.

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

    Hey all, well I'm still pretty much bed bound, pain just as bad and waiting for a second opinion appt in London, the first being cancelled. Last two weeks have been worse for some reason, really not sure why as I'm eating and drinking the same as I have been for ages. Had my morphine put up to 40mg a day plus between 20 and 60mg as required which, if I'm honest, isn't making any difference to the pain - when it hurts, it hurts. No one seems to know what's up, so just waiting for hopefully another exploratory. It just feels RAW up there, like nothing has healed from the fissurectomy. I'm bored, my wife is bored, my daughter is bored... I hate my arse.
    • Posted

      Hey JamieinPain, I am so incredibly sorry to hear about the excrutiating pain you are stil in.  I can't say that my bottom issues ever got that severe but what has been working for me after trying the sits bath, creams, etc is plain old prune juice and stool softeners. Seriously, I had been suffering from being afraid to go to the bathroom to it not being an issue anymore.

      My issues started in August 2010 and since drinking Metamucil nightly as well as 2 over the counter stool softeners every night since March of this year, I have been pain free.  I hope this can help you as well.  And over the counter stool softeners are safe long term smile

    • Posted

      Hi Yvonne, I use between four and eight sachets of macrogol daily, with plenty of fluids, and that is keeping me generally ok, but my body sometimes rebels - stress and anxiety make e instantly constipated - and that basically leaves me in agony and bed ridden for up to four days. I'm in a ridiculous situation where I went for a second opinion in London and referred for an exploratory under general anaesthetic, and a barium MRI but the referral was sent to the wrong practice so I'm back on the roundabout of waiting lists etc, even though they keep promising to treat this as urgent. The last consultant agreed that something seems to have gone wrong during the fissurectomy/Botox op. Interestingly a student  GP tried me on a drug for nerve damage and that halved the underlying pain immediately, meaning it's very likely that they cut into a nerve during the op. I'm currently on 900 mg of gabapentin and between 60 and 140mg of morphine a day. I went to football on Saturday and forgot my meds all day, and went into opium withdrawals on Sunday, which was absolutely shocking. Won't be forgetting meds again, that's for sure! I'm looking into suing the hospital once they know exactly what's gone wrong, and I'm adding getting me addicted to opiates to the potential nerve damage. I don't usually agree with the whole litigation thing but as well as the pain and drugs, I've got five months and counting of completely lost earnings as well as the stress and extra work that my wife has endured. Sorry for the long rant but I'm kind of at the end of my tether!
    • Posted

      Yowers!!  Your case is absolutely horrible and jeepers I sure you get to the bottom of it soon!  Before any long term side effects from the drugs start.

      Wish Drs. had more knowledge about AF and treatment.  Hoping for a cure real soon!  I'll let you know if I learn about anything new. Wishing you the best.

  • Posted

    There is the possibility that I may have a rectocele, and that may be cause for my fissure.... Here I am managing.  sad
  • Posted

    Hi, Great to read all these posts...don't feel so alone! My CAF has flared up again in the last few weeks, and I started using my GTN cream (which was REALLY helpful last time). Thing is the cream was 8 months old. Was too ashamed to go to doctors and ask for a new one, so I just used the old cream. It started to work again. I got ill with a fever last night and so today went to the docs, and asked if it might be connected to using the old GTN, she said it wouldn't be related and gave me some new GTN cream...great!  BUT, today I think I've teared again in a new place and it hurts like hell!! I want to know if I can apply the GTN cream more than twice a day. To be honest I've applied it 4 times today already, but I want to make sure that I'm not gonna harm myself in doing so. Does anyone know?
    • Posted

      It is a serious medication so be careful. I believe it can give you headaches and affect your blood pressure.

      4 times a day is the most it had been prescribed to me.

      Hope you feel better soon.

  • Posted

    Thanks for that, I do find it somewhat addictive too. At first the headaches were terrible, but now I quite like them in a strange way. Re trigger foods....good to hear that popcorn might be one, as I couldn't think what brough on this last bout, but I remember eating loads of popcorn one day! For me Banana is BaNONO! x
  • Posted

    Honestly, you don't know how pleased I was to find these posts. No one can describe how depressed and anxious I have been, my mother died of bowel cancer and I honestly thought that's the way I was going. However, after weeks and weeks of being afraid to see a GP, the pain got the better of me and I have a CAF. I believe that my former GP was negligent, I've never had an examination and they just accepted the fact that I walked in and said I had piles, therefore given the usual medication. Granted, things settled down for a while, but I realise now that the pain caused was a fissure, which probably healed to some extent and is now chronic due to lack of intervention. Embarrassment, fear and all the other emotions attached to pain in this area stopped me seeing a doctor, if I had done so earlier, things might not have gotten so bad. I now have GTI, hoping that to some degree this will start to heal but two days in, nothing has changed except I now know what I'm dealing with. Painkillers hardly touch this and the pain radiates so far across the lower body sometimes, you wonder where the actual source is. Scared has not been the word, but I am otherwise well and suppose common sense should apply. Reading these posts has helped me a great deal to be honest, knowing that there are some others out there experiencing this and understanding the level of pain which you just can't discuss with anyone. I've managed to keep working throughout with great difficult, how do you tell your employer stuff like this, I just can't imagine. It affects my life to a large degree, I've stopped going out and have ended up just managing this in the best way I can. Please all fellow sufferers, keep posting and help keep us positive.
  • Posted

    Back again! So I've been waiting nearly two months for an 'urgent' appointment with a consultant in the new area we've moved to... I rang the admissions team only to discover that the consultant had downgraded me from urgent to Joe public without having seen me. Unbelievable. I spoke to my GP about it and they basically said that they never get listened to and it's the consultant who makes all decisions, so no point in writing a second time. Fine. I tried to find a direct email address for my new nemesis, but they don't allow that, oh no. Even though they're supposed to. Luckily my wife is a senior manager in the NHS so got hold of it. I sent a lengthy email, detailing my experiences, and mentioning that I intend to sue the original butcher. Low and behold I received a letter less than a week later saying that I was being referred for an MRI scan, with a follow up consultation. No time scale, though, but he did have the decent to explain that the reason for the delay is that their department is swamped at the moment. I'm not happy with it, but at least being told that makes a difference, instead of being ignored. 

    Anyway, my advice to anyone who is being palmed off or locked out or ignored is to write directly to the person accountable. Keep harassing them. He who shouts loudest gets listened to. Your health is of paramount importance, so do whatever you need to, even threats of legal action, because the poor buggers are snowed under and basically wading through huge waiting lists and if you don't stand out from the crowd you'll be left crawling up the list and suffering.

    good luck, and get the treatment you all need and deserve. We will prevail!

  • Posted

    All I can say to everyone is stop living in pain. Do the surgery! I suffered for over a year. Everyday in pain. Going to work in pain. As all of you have. I tried all the creams, the diets, everything. I have now been pain free for about 8 weeks. Surgery was 12 weeks ago. Painful recovery the first week but I would do it again!  Of course I will always eat better. Never want to have an AF again!
  • Posted

    Hi All,

    After dealing with chronic anal fissures for over 2 years I have finally booked for a sigmoidoscopy, possible biopsy and botox treatment next week. I would like some insight on what to expect with the treatment and recovery as I will have to go back to work soon after the procedure. 

    I would also like to talk about my experience to see how it compares to others. 

    I believe my fissures started over 2 years ago as a result of me holding my bowels while at school. The muscle is now so strong that even the smallest poops feel like I am giving birth to baby elephants. I have used rectogesic and ultraproct at different stages which helped the pain and relaxed my muscles, but my fissures still became irritated with the next bowel movement. I also found that plum juice worked much better than laxatives but I have been unable to get my hands on the unsweetened version from my supermarket in a while. I felt as though seeds in bread were increasing the pain and after cutting those out my BM were much more bareable, but still sore. I was tested for a gluten intollerance to see if I was right about the reaction but results came back negative, I still think I have a sensitivity to gluten and will cut it out completely up until my surgery to see if it makes a difference. I had previously refused the procedure because I am petrified of hospitals and needles, but after hearing about my grandfathers bowel cancer symptoms and experience I was practically running to the doctors. I am really afraid that my surgery will reveal a more serious diagnosis. 

    I would also appriciate some post OP advice in regards to diet and activity...

    I am a vegetarian, wine drinker, and admittly don't drink much water. I am mildly active. On my bum all day a uni but constantly on my feet at work. 

    Thanks in advance. 

  • Posted

    One more thing, does anyone know the effects salt, sugar and sex have on AF. Just trying to minimise anything that may halt the healing process after surgery. 

    Thanks

  • Posted

    i finally sucked it up and got surgery for the anal fissure and fistula..i had a ruture due to stress Jan 2014 and pain and blood ever since.

    I had chronic problems and price in USA for surgery was retarded. i planned a trip to visit family in South Korea and everything was great.. I asked around and they said a hospital in Seoul specialized in those things went there. Daehang Hospital.. took a week to do blood test and then surgery was one day andspent  one night there,  then they said no flying for 2 weeks should be ok. So total my trip was 3 week which is my normal trips to Korea..

    Everything was great flying back home next week almost no pain already after 5 days... Total bill was about $1000 USD without insurance.. i did the cheaper route with 7 person bed for one night. They said with insurance is $300 USD..  

    They cut out the fissure and now can go to bathroom without any pain..still some blood but thats normal.

     

  • Posted

    Thank you so much for this post!

    I have suffered from chronic anal fissures since Feb 2008! The pain was been so bad that it wasn't hard to remember the date!

    Since then up until now I've had on and off fissures and every time I make a bowel movement, i've always been very nervous. Sometimes I'd go months with no problem, but when I did get a problem, it was always very painful and caused problems with my daily life until it decided to heal.

    I have seen GPs about this more times than I can count, along with rectal examinations. It often didn't lead anywhere, and SOMETIMES i'd be given a cream to help, which never did. I was taking movicol for months to the point where the taste of the stuff made me feel like I was fighting to urge to vomit, and it wasn't strong enough.

    To add to my bad fissure problem, I have IBS. I go through phases of very soft and easy to pass stools to rock hard constipation, the latter of which always causes painful tears. It seems to be triggered by stress instead of my diet, since I have a fairly healthy diet which hasn't changed. My stress levels also can't be helped since I suffer from severe anxiety and depression.

    I feel like i'm trapped in a very painful vicious circle!

    I have seen a surgeon before, who did a very painful examination of my bowels, which came out with no problems, though he mentioned he noticed the fissures. Nothing has ever been mentioned to me about sugery, and since I've suffered with this for so long, i'd jump at the chance of it!

    I now have a few fissures at once which are the most painful i've ever had since it started. On top of that, I have a hemorrhoid which after treating will not settle. I'm fighting the urge to scream and vomit from the pain when I am making a bowel movement, and last time I felt dizzy for two days after!

    I went to see my GP the other day, who is very hard to get an appointment with, but we only had time to talk about my depression, since that has also gone down hill! I'm going to try to get a new appointment tomorrow, though in the meantime i've sent my mum to the pharmacy with my debit card and asked her to get me whatever she can! I was advised on this forum under the IBS section to try Laxido for the constipation, though right now I think my body won't let me go because of the extreme pain.

    Having this problem along with my severe anxiety does not work out too well.

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