My experience with a chronic anal fissure

Thank you so much for taking the time to write this. I have been given so much clinical advice but nothing with timelines and how similar my pain patterns are to others. It is nice to know that there is an end point coming and my symptoms are actually within the norm (despite me saying 'no one has any idea how much this hurts).

On a personal note, my clinical evaluation required me to go under general anaesthetic as I was in so much pain. The fissure has and is affecting how I am walking, sitting and lying. I am adapting to this hoping I will see benefits soon. I have started to apply a lubricant to the area which has offered a cooling, relaxing treatment and aids passing stools.

I'm counting down the days until I feel even a reduction in the size.

That is a superb post for all of us fissur sufferers, only point I would add is; some people get massive headaches from GNT, so they should use DILIAZEM cream. Good luck

Hi everyone, this may sound strange at first but please try heat packs to stop the pain. I'm a 34 year old male who was suffering from 2 fissures for about 10 months. I got them from a botched banding procedure. The best thing you can use to stop the pain, in addition to diet change, is Heat packs. Really, heat packs. I was in so much endless pain from the fissures until I found relief by using heat packs. Take a heat pack, one of those ones filled with silicon beads that you heat in the microwave for a few minutes that then stay warm for about 40 minutes or so. You can find them at most pharmacies.

Gently press the heat pack directly up against your anus and keep it there, the heat forces the muscle to relax and stops the spasms, which stops the pain caused by the fissure. You can use a hot water bottle too as long as you can mold it to place up against your anus. Seriously. This saved me from so much endless fissure pain, it's like a concentrated hot bath focused directly where you need it, but without the inconvenience of running a bath and being stuck in a bath just to get relief. (I know baths are nice and all but not really always practical or accessible)

Best position is to lie on your back in bed, put your knees up like you’re going to do a sit up and then place the heat pack between your legs right up against your bum hole. Sorry for the graphic image but I can't really think of another way to describe it. Just be careful not to burn yourself, you want the heat pack/heat bag or hot water bottle to be hot but not so hot you burn your skin. It helps to wrap it in a pillow case that's soft and then if your heat pack is too hot, wrap it in more layers of the pillow case, which will protect you a bit more if it's too hot at first.

Before the heat packs I was taking dangerous amounts of pain meds to deal with the fissure pain which for me was all the time, including during the nights which were really hard... until I discovered the heat pack. Which thank God I did because they really work. Please try them, I understand this might seem silly and I haven't read it anywhere else but I know the suffering from fissures and this will help keep the pain at bay. Seriously, heat packs, heat bags or a hot water bottle pressed lightly up against your anus and held there, keep it held there and it will work. I sometimes keep it there for 15 minutes or more and then I take it off. Then when the pain starts up again I'll put it back and the muscle relaxes and the pain go's.

Try it. I had tried everything from which hazel oil in my bum to manuka honey in my bum (my wife called me sweet cheeks because of the honey), but the best thing to stop the pain has been the heat packs. Heat relaxes the muscle, stopping the spasm and the pain.

Ultimately though you want to find a solution to heal the fissure once and for all so I suggest the surgery. I've had Botox and that did not work, in fact I was in a lot of pain afterwards, then I got the fissurectomy/sphincterectomy combo surgery and I am finally free from it all. I know it sounds nuts to get a surgical cut to fix a fissure but it’s the sure way to fix it. Conservative methods like Botox and Rectogesic Ointment did not work for me, in the end only surgery worked. I wish I had done the surgery first cause I went through months of pain and hopelessness that I could have avoided had I just done the surgery first.

Though very important, make sure you research and choose a reputable specialist to perform the surgery. Don’t just go with anyone, find and choose the best that you can cause for me it was the 3rd specialist that ended up fixing me with the fissurectomy/sphincterectomy. The first specialist caused the problem, the second specialist didn’t help and made my pain seem trivial until finally I researched and found the best in my area and he, the 3rd guy fixed me. So it’s worth it, pay a little more, travel a little farther if you have to but see the best that you can or at the very least someone with a lot of experience with exactly that surgery. If you’re in Sydney Australia then the Prince of Whales private hospitals “Sydney Colorectal Associates” really have a great team; Dr. Newstead fixed me and I am so thankful for him but he’s part of a group of several specialists there that all seem good.

Until then though, heat pads, use heat pads to relieve the pain.

I’ve come on here to give people this info to help but sorry I don’t think I’ll come back to follow up cause honestly I just want to move on with things, so please take the advice above and save yourself pain and anguish.

Heat pads then surgery.

I've been to the doctor and tried the nitroglycerin and everything.

Drink 2-4 glasses of miralax and 2-4 glasses of water daily and you'll heal in about 2days to a week. It softens your stool to the point that your bm no longer hurts.

I just healed myself from a fissure of 2+ months.

I had an acute fissure once before during college that healed within a week with minimal pain.

It was after my son was born that I developed a chronic anal fissure. It just wouldn't heal. And the spams were driving me insane. The combination of my c-section, immobility, pregnancy suppliments and breastfeeding made it even harder for me to get better.

I spent most of my wakeful time searching the internet and praying to God that I would get relief, and that I wouldn't require surgery. 3 months of relentless pain.

The interesting part was that defecating was really not as painful as the spasms that would set in an hour after coming from the loo.

This is what worked for me-

1. Praying. Asking people to pray for me. Being patient.

2. Fixing my diet.

Neither did ispaghola husks, movcol, or lactulose (duphalac) help....

Neither did fruits or vegetables...I even tried prunes but it did next to nothing for me. Figs seemed to help, but I didn't have soft stools. Just normal ones, and that was very painful.

Rather, I have been having a decent bowl movement with breakfast cereal (especially oats) AND fish oil. Like magic. No hard stools.

3. Plenty of water. Duh.

4. Mobilizing. Moving around. Walking as much as is possible with your baby.

5. NOT straining. Straining makes everything worse. Even though I wouldn't have the satisfaction of a full evacuation, I realized this dropped the pain down to more than 50%. Slowly with the fish oil and cereal I had no need to strain at all.

6. Don't avoid the urge. Sit and give plenty of time, but don't strain.

During the acute phase I used almost every medicine that could be used to heal the fissure.

GTN did nothing for me. Just made the area burn as well. That sucked.

Xylocaine made no difference. Even with liberal and frequent use.

What DID help was ibuprufen 40mg, before going to the loo, or voltral SR 50

Also, 2 suppositories gave me marginal relief, I used these for 2 weeks.

1. Proctoglyvenol. Most useful, reduced the swelling to a great extent, that helped particularly because my anal canal was so swollen I could barely insert the suppository let alone have a bowel movement. I used this twice a day regardless of bowel movements.

2. Neohealer. This was useful after I finished my proctoglyvenol course. I used it on an SOS basis.

Another useful tip is to always insert some petroleum jelly or better yet polyfax before and after a bowel movement. Before, to lubricate the area for smooth passage. After, to aid in healing.

Being a muslim, we are used to washing ourselves rather than using toilet paper or wipes. Its essential to keep the area clean to avoid infection, that could further impair healing.

Sure, sitz baths help for temporary relief. Very temporary. Within 15mins of coming out, my pain would start again.

Be patient. It took 4 months for my fissure to heal. I don't require medicines and I am free of spasms. But one thing is for sure, I will not let go of my cereal and fish oil routine because this pain is arguably worse than delivery. I never ever want to have an AF again. Hope this advice helped.

As a fellow sufferer I can feel everyone's pain. I'm just 19, got an abscess at aged18, was prescribed antibiotics. However it never fully cleared up this was in March 2015. It's now July 2015, my situation has gone from bad to worse. The pain is not so bad. But I wouldn't recommend using DETTOL for antiseptic. This has burned the lining... And I'm left with fleshy open skin. Being referred privately this week. But this has really made me depressed. I find my self constantly crying cos I can't go out and have fun with my friends, and I've never felt so low in my life😓 the fact that my specialist will be a male doctor whilst I am a female makes me feel like I've already lost my dignity and self respect😔

Just found this thread trying to track down what medicine is left on the shelf and throw out.

Nothing worked for me. Diltiazem was a flop. All sorts of creams and stuff. Nothing worked.

Until I just sat on a heating pad for about 20 minutes, 2 or 3 times a day.

Fixed it in no time.

Give it whirl. Worked for me.

Somone who knows

 

Your post was very helpful.

  thank you

Hi there, I was told having surgery for fissures can cause leakage. Do you know anything about that, and is it life threatening? Because it seems my surgeon and two gi doctors have mentioned it and are procrastinating my having surgery for it.

I have been given rective medication for 6 weeks last year which helped some after having a bowel movement but wasn't successful overall because my pain has not changed, it's chronic.

Hi from New Zealand.

I have been suffering from AFs since Sept 2010.

The pain is unbearable .. it sends me into spasms after a hard BM.

It can last at least 10hrs and that's after taking 2x paracetamol every 4hrs and Sitz baths.

I used to take tramadol but that causes constipation.

I have been on a course of ultraproct, rectogesic, lavolac and Metamucil which I take 3x a day to sort this out.

Now I'm I've been prescribed Diltizem 240mg/white Parraffin Cream to take externally, just rub it around the anus, don't put it inside 3x a day for 6 weeks.

I am on a high vegetable /fiber.. no sugar alcohol diet , 8 glasses of water a day.... I have gone from 118kgs in last 4week's to 100kg cause of this.

I'm at my wits end.. having to take days off work because of the pain it's like glass...

Please help. .. next step I suppose is Botoix.. is Surgery. ..

Had two injections and fissure operation things improved a lot but still suffer small leakage and feels very senitive  have used all types of cream  would welcome any new advice that you Edmund.

hello Guest, So are you saying the GTN ointment has healed you? or are you still having pain. I understand I need to relax and take it day by day I got that..i live me life to the fullest. But still get drained and sore from the pain.