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Pain management for anal fissure

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jo79024
jo79024

Hi - I would love some advice about pain management for an anal fissure. I had mine diagnosed about three weeks ago, but have had it longer than that. I am currently using Rectogesic (externally - far to painful to try internally) and have started having linseens, a sachet of Fybogel a day, increasing my water intake, eating more fruit and veg, and generally eating less (have lost a stone since this started!) to try and soften my stools, but so far no joy. My main problem is that my stools are still large, and each bowel movement is agony. I really would like suggestions on pain management and how to cope with work. Taking time off is not really an option as I have just had a period of sick leave with an unrelated problem, and if I don't work, I don't get paid. But the pain is horrendous and so far taking Ibuprofen and paracetamol do not even touch the pain. As anyone with this condition will know, once the pain starts it is impossible to think of anything else and trying to work through it is nearly impossible. Even travelling to and from work (by bus) is awful as sitting down is agony and standing on a moving bus for an hour is not really an option. I am just about at breaking point as trying to cope at home is bad enough but I have to go to work in an hour and I don't know how I am going to get through the day. I have already had a hot bath this morning and applied my medication, but think the pain is going to kick in soon. These forums have so far really helped me, just by knowing there are other people out there suffering from this awful condition and any advice you can offer me will be welcome. Thanks.

5 likes, 42 replies

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  • Rear_ended
    Rear_ended jo79024

    Edited

    Hi Jo, 

    where do I start...

    In late Dec 2012 while on a weekend to see my favorite jazz singer in Hollywood California, I had my first anal fissure tear. I had been a pretty healthy eater, juicing a lot, lots of veggies. But had a couple of personal stresses the October before, and had been kind of eating junk and not really been exercising much, and in Nov-Dec I ate what ever holiday food that was put in front of me. The morning before the tear, I had met a couple of people at breakfast and had tried a couple of coffee with liquor drinks that they had made up,(was on vacation, I thought what the hellwink. Went to the bathroom in my hotel room at the Roosevelt a couple of hours before seeing my jazz singer, very hard stool, pain, and a bowl full of blood. All that blood scared me to death, made me feel as if I may need to get my affairs in order so to speak! I laid down for about 2 hours, felt a little better, and proceeded to the concert, wasn't going to miss what I thought could be my last time of seeing my favorite artist of all time! Flew back to Northern California the next day, feeling a little better when I returned home, but still blood in my bowl. A week later I called my GP and asked for a proctologist reference, fearing the worst. Was examined, a chronic anal fissure said the doctor, and that she could see all the way to the muscle! She prescribed nifedipine cream and sitzbaths. The cream made me sicker than a dog, physically. So I went online to forums such as this and found my own treatment path, took me about 2-3 months to feel much better. Was taking 2-3 sitzbaths a day,(would come home for lunch and take one), cleaned my butt after every bowel movement with cool water, then hydrogen peroxide with a cotton swab, then swab with a generous amount of petroleum jelly. About three weeks into this, I was at the drug store and saw this pillow called the total pillow, basically a daisy shaped pillow with a hole in the middle, and I'll tell you, I will never sit without one of these the rest of my life. Fissures need blood circulation to heal, and when you are sitting on a hard surface, or even a not so hard surface, you are pushing the blood away from the fissure area. I believe that helped a good deal in my healing and staying healed.

     Ok, fast forward to July of this year, went to North Carolina for 10 days, (my other half was working and I tagged along). Came home and 4 days later came down with something called travelers diarrhea, fever, and HORRIBLE diarrhea, doctor gave me antibiotics, but the sickness had already broken my fissure wide open. I was so sick I didn't even notice the fissure much, until I flew the next week to Las Vegas to help empty out my other half's home that was sold. My proctologist had told me the first time around that flying is a lot of pressure on your rear end and fissure. Forgot my pillow for this flight as well.

    I still felt pretty decent on that Friday when I got to the house near Las Vegas. We got ready for a garage sale on Saturday, I drank beer,(only about 3 as it was hot), and sat on a hard chair all day, and did the same thing on Sunday, sunday night we had two beautiful filets, a fabulous dinner and a bottle of wine. All a Big Mistake!!! Monday morning my first bowel movement was excruciating, my second bm, I was crying, my third, I damn near passed out. I then laid on my side on the bed for about two hours. Later that night I searched blogs, this tear was 10 times worse than the 2012 episode. 

    Within a week, I was feeling MUCH better, thanks to blogs like this. Here is the regiment I used.

    1. Took three baths a day for five days, with about a 1/4 cup of coconut oil,(fabulous stuff, and thanks to the blogger that suggested it),1/4 cup of epsome salts, and a couple tablespoons of extra virgin olive oil. About 6-8 inches of warm water in the bath, and sat in the mixture for 30 minutes.

    2. After the bath, a cotton swab with hydrogen peroxide all around and in my anal fissure area, then a cotton swab with a generous a,out of coconut oil, then a cotton swab with a generous amount of vasoline and a little triple antibiotic ointment. And an ibuprofen after dinner.

    3. No alcohol, no red meat, no plug up food, even though this tear was caused by diarrhea.  just fruits and vegetables, and a lot of fluids, water,  a lot of Popsicles.. Didn't eat much the first three days, as I usually have three bowl movements a day, (usually all  in the morning) and wanted to try and decrease that to one or at least two. 

    Within 5 days,  by Friday, I felt about 75% better. We are home now and I am still treating the fissure, 1 bath a day now, no liquor, no red meat, no processed food,(which I didn't eat anyway), getting enough good sleep, not sitting anywhere, even the car without my pillow, and trying to keep the stresses of life at bay.

    well, if you made it this far, thanks for reading my novella! And thanks to the all the bloggers!!!!

  • amber85
    amber85 jo79024

    Edited

    I'm very sorry you're going through this, first of all. I know the pain all too well. I suffered with mine for nearly 6 years after having a baby. Although this wouldn't be the dr's advice, this is mine... try not to eat too much fiber. My experience with this was that as well as making stool soft, if eaten too much, it can give it too much bulk. Try to stick to fruits if you can. Miralax is an over the counter supplement to add to any drink, it is a miracle worker for constipation. My surgeon told me you can take it safely up to 4 times a day if you need to. Also, soak in a bath for 15 minutes or so with Epsom salt. This greatly relieves the immediate pain. I saw several threads on my road to "self cure" of those who had great luck with inserting Manuka honey in the morning and evening, and rinsing with olive oil after each BM. Lastly, if you are in that much pain, it might be time to consider surgery. I just had the lateral spincterectomy on December 3, and I have never taken a pain pill. The pain is extremely mild, surprisngly, and Tylenol knocks it out. The surgery has really taken away the fissure pain. If I had known it would have been this easy, I would have done it years ago. Best of luck to you.
    • jo79024
      jo79024 amber85

      Edited

      Thanks to amber85 and everyone else who has offered advice. After 9 months of repeated visits to my GP, I have finally been referred to a Colorectal Consultant and will be having an exploratory procedure in two weeks. I have mixed feelings - not looking forward to it of course, but on the other hand I want an end to this and if I get a proper diagnosis (from GP it has varied - fissure, piles, skin tag, fissure again, piles again...) and treatment it will be worth it. I am getting much less pain now, but am not completely pain-free. Dulcoease has been my saviour - finally got those BMs softer! I just want a proper end to this and not have to constantly worry about what I eat and arranging social events etc. - will I be in pain, won't I, etc. A big thank you to all who post on these forums - you have all helped me with advice and just knowing there are others out there who know how debilitating this condition is. How do you explain to others just HOW much it hurts?? Best wishes to anyone dealing with this - you are not alone.
    • muto74538
      muto74538 jo79024

      Posted

      Hi, 

      I have been suffering from on and off over a year. It happened after severe constipation that followed diarrhea because i took too much leparamid. Anyway, the best thing to do apart from taking plenty of fiber and fluid is to be mobile and not sit too much. Person should not stay late and should get plenty of rest during the night. No alcohol, no processed meat, no spicy food, and not too much fiber as you said it may cause the bladder work too much and would make things worse. 

      And to be honest, one should be lucky to have a good GP because mine had no idea, and wanted to stick his finger in which is absolutely not recommended. I would not recommend too much laxative over the counter. Apple, orange, water, and long walking. and don't sit too much on. By the way sea water and sun works perfectly. I had nothing in July and August.

  • sherlyaje94
    sherlyaje94 jo79024

    Posted

    Haii,

    In this one month i got pain during bowel movements. I got confused because i go to two doctor, and the first one said i got fissure, and the second said internal piles.

    First time on october was bleeding for 3 days from that days until now its still pain for 2 - 5 minutes.

    Can you all tell me, that is a fissure like that?

    I afraid that fissure cant be healed.

    Because i already use all doctor predictions and all cream and still in pain for this one month already.

    Thanks.

    Regards,

    Sherly

    • jo79024
      jo79024 sherlyaje94

      Posted

      That sounds similar to my diagnoses - until I have an exploratory procedure at hospital in a week's time I am still not sure what I have got as seeing three different GPs over nine months hasn't led to agreement on whether I have a fissure, piles or both. All I can say to you is that at the moment it is still a little painful during bowel movements, sometimes with a little bleeding, sometimes not. Again, sometimes I have a little pain afterwards, sometimes not. I believe that earlier in the year I did have an internal fissure, as the pain then was unbelievable and went on for hours. This may have healed now, as I don't get that kind of pain anymore, but there is still something wrong in that area as I am still not pain free. I must have visited the GP around five or six times, and received different diagnoses each time. Like many on this forum, I believe that you need to insist on a referral to a Colorectal Specialist to get a proper diagnosis, but it may take time. I have used various medications and found that none really take the pain away. I have changed my diet and take Dulcoease once or twice a day to soften my bowel movements to minimise pain. I wish that I could offer you more help, but as I still don't know exactly what is wrong with me I can't really advise you further. If you can, go back to one of your doctors and ask if you can see a specialist. Until you have a proper examination from a specialist you probably won't know for sure. If you do have a fissure, it will heal, but it could take time - the best way to help is to have a look at some of the forums and advice on here, try a few things and see what works best for you - it is trial and error, and what works for one doesn't always work for another. Dietry changes are probably the first way to go to try and minimise your pain. Hope this helps - post again if there's anything else you'd like to know.
  • sherlyaje94
    sherlyaje94 jo79024

    Posted

    Haii Jo,

    How about you right now? Its not pain anymore?

    Sorry for ask you something weird, but its really important for me, 

    I want to ask its there a muscle in your anus?

    Its above top side behind vagina? (If your a girl) / in anus top side.

    Because when i use cream i found that muscle at that area. When i touch its feel pain, But i dont understand two doctor dont said about that muscle. 

    So, i have same condition with you, the pain not really hurt, but everytime bowel movemnts its burning pain for few minutes. Huhu.

    And now i try many creams but still no one doesnt work and still pain.

     

    • jo79024
      jo79024 sherlyaje94

      Posted

      It's not the really horrible pain that went on for hours and hours. It still varies, but generally it hurts a little bit when I have a bowel movement and sometimes now there is a stingy pain comes and goes for a few hours after, but not always - it is unpredictable. There is a sphincter muscle in the anus, which in some people can be tighter than in others - when my pain was really bad I just had to put the cream on the outside as it was to painful to insert the cream. I understand that this is why in some people the pain is worse - if the sphincter muscle is very tight it goes into spasm, which makes the pain worse. I just got fed up after nine months of pain and confusing diagnoses, which is why I am glad I have an appointment at the hospital. It won't be pleasant but at last I might get a proper answer and know what treatment to have. Sometimes heat helps if you have pain - have you tried a hot bath? Some people on this forum recommend that or a hot water bottle - heat can help to relax the muscle which eases the pain. Try really hard to change your diet to help soften your bowel movments. Also, if the pain carries on, go back to a doctor and ask if there is anything else you can try - you may just have to keep bothering them until they agree to refer you for further treatment. Good luck.
  • abdoudiop29
    abdoudiop29 jo79024

    Posted

    Hello all

    my name is Abdou. I just had an anal fistula surgery (September, 22, 2016)

    my pain after bowel movement horrible. I am taking ibuprofen 200 every 6h. Please help me soothe my pain. I am very desperate and stressed out. Thanks

    • mmarcus151910
      mmarcus151910 abdoudiop29

      Posted

      Here are some suggestions I have for you to help you through:

      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.

      5. 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

  • UnionJohn
    UnionJohn jo79024

    Posted

    To any and all who are willing to listen and hopefully help. I have been dealing with a fissure for 3 and half months, first because the doctor said it was this then that then hey its a fissure. Anyway, two weeks ago I had a colonoscopy and endoscopy to rule out any other issue and thatnk God all seemed normal except for a few non cancerous polyps, during the procedure and after is when they confirmed the fissure. I am in constant pain from the time I wake up until I go to sleep; I have tried many things including some that are mentioned here which I am very thankful to all but nothing seems to help, especially with the pain. One thing I had always said, with mine at least there was never any bleeding so I thought mine was better than most, well today after again thinking positive, I had blood for the first time and it has put me into depression mode, thinking now its gotten worse when I thought it may be getting better, tired of hurting every day and being a burden to others, not living life, can't work, don't want to eat, don;t want to use the restroom, cry and cry with pain, feel like a wuss and this is most imbarassing thing ever which makes it difficult to talk to anyone about it, anyway, I really am into natural living and healing but at my end trying, I can do surgery but really did not want to but Im going crazy and my job is high profile and non stop, just cant deal with this anymore. Really thank all of you that post, you help more than you know, if anything  its good people to be able to at least talk about the issue, thanks again and if anyone has suggestions for pain please let me know, sincerely, emotional wreck

    • mmarcus151910
      mmarcus151910 UnionJohn

      Posted

      Here are some suggestions I have for you to help you through:

      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.

      Best of luck and hope you get better soon!

      Best,

      Myles

       

    • felly
      felly UnionJohn

      Posted

      I agree utterly, it's very difficult.  Am very frustrated 3+ weeks after undergoing balloon dilation, I too found blood on the toilet paper... Ironically I felt great after the surgery.  I consider my BMs to be amongst the best of my life currently, what with help of the 6 Citrucel, 2 Colace, 1 Miralax dose/day... doesn't help fissures.  (Ironic that multiple BMs/day are supposed to "stimulate blood flow in the area", as it's also "the primary chance I get to tear myself open again, and I do, what seems to be every time".)  Sadly to say a lot of it is probably your work - I found that at my job once I paid attention, more times than not, I was bearing down and putting a lot of pressure on "the bum area", in my desire to shrink down behind the walls of my cube to the point where people would stop pestering me.  It might help to do some research on methods/exercises to relax your sphincter... I thought I knew what "spasms" were, and that I didn't have them.  Well, funnily enough, post surgery I started experiencing unquestioned spasms in the sphincter area.  Who knows how much of them are going on when I am asleep... hope that you have found some relief in the interim though!

    • abby54934
      abby54934 mmarcus151910

      Posted

      Hi there, I feel like talking to you because like everyone in this chat, I too have an anal fissure.

      But there is one thing different in contrast to myself and the rest of you.

      I am only 14 years old. I don't go to work, I go to school instead. I sit in a chair for 9 hours a day, and lately I just cant get out of my bed anymore. In fact, I dont even go anywhere anymore.

      I am suffering with not just an Anal Fissure, also Pinworms and a yeast infection which have all led to some sort of burns? around my anus and vagina which makes the pain even worse! And the Anal Fissure just gets worse and worse to the point I cannot go to the toilet to have a BM anymore. I cant even go to urinate otherwise It aggrivates a painful BM. And I cant take this anymore. The pain and itching keeps up at night, and the pain itself is just unbearable! I've had to do BM's manually (disgusting I know) to reduce the pain, and the soft stools seem to be even more painful than the hard stools which doesnt even make sense!

      Problem is, no I haven't been to the doctor about this because that involves telling my family...and that is something I cant do since they will take it as a joke and do nothing about it because they are too busy and will just tease me about it every day. I take hot/warm baths every single day, but now I just don't know what to do. I can't buy anything because I am only 14 etc. I've had this for a year but now i just cant deal with it anymore...It just makes me want to cry. It just hurts too much.

    • mmarcus151910
      mmarcus151910 abby54934

      Posted

      Hi abby,

      How are you doing? I do not know why, I was going through this thread from another email and saw that you replied specifically to me.

      How are you doing since last time you replied to me?

      I know it will be tough telling your family, but at some point they have to know. You need to get medical help.

      Best,

      Myles

    • jerry98749
      jerry98749 abby54934

      Posted

      Hi abby, read your post just today. I hope you have since solved your medical condition. Too young too undergo such a condition. Best wishes for a speedy recovery

      Regards

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