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.
15 likes, 216 replies
jon71786 Guest
Posted
I have found that many of these same things are true for me (even here in the US
. I have also found, from discussions, that fissure management or, hopefully, healing, can differ from person to person. Part of my problem is that, being back in school, I am taking my ADHD medication now, and that exacerbates the fissure problen. If this helps, the final ingredient for successfully managing fissures for me (now 6 months symptom free with one exception, when I was unable to follow this) was Vitamin D.
My colorectal specialist didn't mention it, and the only reason I started taking supplements was that my physician told me I was vitamin D deficient. If the Internet is correct, however, apparently D helps with calcium absorption and Calcium helps with constipation.
My current regimen is lots of water, milled flax seeds, and vitamin D3. Exercise and paying attention to what I eat (less Red meat is better) helps.
The one caveat is that I am actually vitamin D deficient according to my blood work. I take a supplement based on my physician's recommendations, following the dosage he tells me.
ababacarharlem1 Guest
Posted
I just had the surgery on the 18th ,2 weeks now and I'm feeling great no leakage nothing.The pain is pretty much gone right after surgery,I swear I didn't feel nothing literally and I was terrified to get the surgery done for years but I regret why I waited so long to do it. Please go for it,I read thousands of forum,cream,sitbathz,Traditionel medication (I'm from Africa so yeah)...etc
Anale fissures ruined my life,I'm 26 young active..work...etc good but long story short if u wanna get your life on track get the surgery and stop thinking twice.Good luck
Guest ababacarharlem1
Posted
Tinkv22 ababacarharlem1
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Dave
Guest Tinkv22
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I had the procedure later than planned as to be honest I was a little scared. I opted for the epidural anisthetic, I didn't feel a thing. The anisthetic took about 6 hours to wear off and I was released from hospital same day. I left hospital virtually pain free. I was terrified for my first bowel movement but I was greatly surprised a little uncomfortable but pain free. I didn't even pull the towel rail off the wall which I have done before...twice! No down time! A little stinging rectified with warm salt water baths. A greater consumption of water and a teaspoon of Nomacol stool softner daily. Fear made me endure this pain for almost 5 months. HAVE THE OP! I am back to being myself again, even riding my motorbike. I have learned a great deal from this forum re the various treatments. Different things work for different people! Believe me I spent a fortune on C
Guest Tinkv22
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ikeko Guest
Posted
Hi there...
I need to share with you all what has been working for me!
Let me begin by stating that I suffered, as you all know how bad it can get... GREATLY.... as someone did put it, it's like having a tall broken glass stuck in your rectum, and it's Constantly shifting, making you experience a new kind of pain you Never Imagined existed...
I like many was becoming increasingly afraind to go to the bathroom, as it was like playing russian roulette and felt I was losing more often than not, suffering through several hours of constant agonizing pain.
I have gone to 4 specialists... until I found the one general doctor - an Incredible woman who's dedictated her life to medicine - and she Strongly advised me I do not go through surgery. If it goes wrong, you are stuck with one hell of a problem for the rest of your days... She emphazised the fact that it was important to keep my stool as soft as possible, for as long as possible... or at least 4 months.
I Thought prune juice was the tric at first.... but all that does is it makes you evacuate rather quickly, when what you need to do is maintain a sof consistency.
My Dr suggested Mineral oil (2 to 3 table spoons) daily up to twice a day, Metamucil, Lots of water, and of course stay away from starches, pasta, rice, anything that may constipate or hardens poop.
I took her up on the mineral oil and staying away from starches, but I didn't want to stress about reversing the effect of metamucil if I don't intake enough water daily... plus the added stress of it all so I did the following and PEOPLE, I HAVE BEEN PAIN FREE Since!!!! If I deviate for more than about 4-5 days, then my poop gets harder.
I take 3 table spoon full of mineral oil: first thing in the morning and before going to bed. So long as I take that amount in a day). PLUS 3 kiwis a day. That's was All it Took. No risky operations, nothing expensive, just keeping up with that combo (oil+kiwis) Litterally Saved My Ass. Litterally.
Keep in mind that I stay away from rice (although I might have a little sushi perhaps once every couple of months)... and I try not too overload on protein - I can't do protein shakes... BUt honestly, I feel I have my life back again!
I promise the Mineral Oil is the perfect consistency to help evacuate poop, and the kiwis soften your stool... it is Amazing. I've been feeling this way for 6 month now...
Sincerely
ikeko76
Tinkv22 Guest
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Bev1975 Tinkv22
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Hi I have had several surgeries, my last was over a year and half ago, I was back at work 3 days later, I am happy to say I think I am now cured after an anal stretch then Botox twice then finally a sphincterotony then my lady was a combination of stretch and a bit of Botox. I suffered for 15 years in total but this last procedure seems to have worked. I am of course also female so I can't have anything else now as it may cause incontinence. Good luck I am so much happier now x
edmund15166 Bev1975
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scott19759 Guest
Posted
Hi, New to thread. I have had blood in stools for years but little pain. I saw both gp and cr surgeon. After a series of tests, etc. small anal fissure and rec. fiber, stool softeners, etc. Years went by with frequent bleeding but still no pain. 2 months ago started becoming painful both while having bowel movements and hours after. Got referral to kaiser cr surgeon. Recommended months of nifedipine 4x day (in vaseline form). Seems to have loosened me as the bm's are much less painful but still in pain 2-3 hours after which is exacerbated by sitting. The cr surgeon strongly recommends against surgery and/or botox. Its been 2 weeks and it seems like its one step forward and 2 steps back. 2 bms in a day is horrendous as it hurts into the evening. Any suggestions?
rosie88 Guest
Posted
Hello everyone,
I'm new to this post but I decided to share my experience as reading all of your posts has helped me make my decision. I first got my chronic anal fissure last May of 2016 and it took over my life and my thoughts everyday.
Firstly, I went to a walk in clinic and got misdiagnosed for hemorrhoids and was given medication to treat that but it obviously did nothing. I ended up going to my family doctor who sent me to a God awful specialist that I didn't go back to. He wanted me to go over to his clinic every day to apply the Nifedipine cream himself at 7 am in the morning because apparently I can't do it myself, everyday! The only good thing that came out of it was that he diagnosed me right and told me what the problem was, although my family doctor had already mentioned it too.
Anywho, I called back and asked for another specialist and after months of suffering finally got to see a new specialist. She prescribed me Nifedipine cream mix, same as I've read on this forum, from a compounding pharmacy. The fissure would go away for a bit of time but would come back very easily. I had it come at least 4 to 5 times since. It became easier to manage it after each time but the pain was still unbearable. One trick that really helped me was applying coconut or olive oil inside before every BM and it helped it come out easier. I also took laxatives and didn't come off them for months. This was another issue as I got tired of the effects of a laxative and how it makes you go. The last time I got the fissure back I had decided would be my cue to ask for surgery. My doctor had done a sigmoidoscopy and dismissed my request for surgery initially as she was in a hurry to leave...doctors are great...
Anyways, I finally asked for the surgery, lateral internal sphincterotomy, and had it last Monday on the 6th of February. My fissure wasn't even inflamed when I had the surgery just because of the date and how I kept managing it. I decided this had to be worth it if it meant I get my life back. My surgeon also took out two skin tags I had because of the fissure right around my anus as this was making it more difficult to pass stools and had tightened that area furthermore. He told me I had two fissures. He prescribed me percocet for the pain and stool softeners to avoid constipation. The first day after surgery I only ate soup but shortly after I threw up so I gave up on eating that day as the thought of having my first BM was freaking me out. I had a fever all night and had pain that kept me awake as I didn't want to take the pain killer to avoid constipation. In the morning I finally caved in and took my pain killers and fell asleep for most of the day. Then I had soup again and still had no BM. There was a sterile dressing inside I had to pull out which was probably the most unnerving thing I had to do but it wasn't painful as I did it in the bath tub. The third day I noticed there was another one I had to pull out which was again not painful but scares you nonetheless. I had my first BM on my third day. It wasn't as painful as I had expected. The stool softeners had kept my bowels soft and this helped a lot as did my fiber rich diet. After waiting for the pain to go down a bit I was able to jump in to the bath tub and wash out that area which was the best relief. I took pain killers that day out of fear. The next day I had another BM and decided to brave the pain without the painkillers. I've been off them since and I am now on day 6 of recovery.
I would recommend this surgery, if you have felt the pain of a fissure lingering for 8 hours every day, this surgery is a bliss. I researched a lot before I decided to go for it. The incontinence is a very small percentage and I haven't had any issues so far. If you are younger too, you will recover from this. My parents were against this surgery because of fear of the risks as I'm a 26 year old female but were thrilled after they saw the smile on my face. I'm hoping the pain will go away in a few weeks and I'll get my life back. Eating healthy is key but I know first hand that had I done nothing the fissure will come back no matter what as it did several times. Hope this helps someone.
Tinkv22 rosie88
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k23652 Tinkv22
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How was the recovery? I'm waiting for surgery and can't wait. I'm having a bad 2 weeks right now. It's been going on for almost 4 months this time around.
rosie88 k23652
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You'll be nervous for the first bowel movement but if the doctor prescribes you pain killers and stool softeners you will handle it better. I would say the first day is the worst but once you pass that it's an uphill climb. My pain post surgery was nowhere near the fissure pain and didn't last very long. Jumping into a bath helps relieve the pain. After the first 2 weeks I was able to go to work as I didn't have any pain anymore.
k23652 rosie88
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I'm so excited for the surgery. Did you experience any complications or side effects?
k23652 rosie88
Posted
I can't wait for the surgery. This is the 3rd time this has come back and this time it's lingering longer than the other times. I'm afraid it's just getting worse. I'm on a list for surgery. Hopefully it will be sooner than the 3 month wait period. I'm scared too. But I hear all positive stories after surgery so I'm really excited for it. I want my life back too.
rosie88 k23652
Posted
No complications thankfully. I had a follow up appointment with the doctor two weeks after the surgery and he put me on antibiotics to avoid an infection just in case. That's the thing you need to watch out for is getting an infection as it is a sensitive area. Make sure after surgery you keep the area super clean, have a few sitz baths throughout the day and you'll be fine
. I made sure to use unscented natural soap products and unscented baby wipes.