So depressed with anal fissure for 2 weeks, please help

Hi Serina,

Thank you so much for your very helpful reply. As I type this, I'm back at work (thankfully I can work from home) but just for mornings only at the moment and my poor bottom is hurting so much after this mornings BM! Ah, the aching and stinging, I've taken painkillers but they're not really getting to grips with it yet! I know my fissure is new, but when the GP saw it she said it was quite deep and since my relapse last week after it started to get better, I am worried it has become chronic in a short space of time, I can feel a lump there and it is painful for several hours after any BM. I am struggling with fasting, although I am definitely not eating my usual amount lol. I am also struggling with a thyroid issue which makes me lightheaded and gives me heart palpitations, so I don't know if I fasted if that would make me pass out! My main problem is keeping my poo soft. I managed it well last week and thought I had a winning formula, only to repeat it the next day but then had a harder BM! I suppose some of the thyroid drugs I am on may muck about with the BMs, but not much I can do about that. I think I need to get the botox done, I can't see this getting better without it. I'm finding it such a struggle it's very depressing and embarrassing. I hate that my husband has to hear me crying out in the loo. So not sexy!! How long did you suffer from your fissure? And so difficult with little ones to look after as well, I'm struggling with just hubby and the cat! How did you find the botox procedure? Was the recovery OK? I really hope your surgery now has sorted your fissure for good, it's so not fun is it and not really the sort of thing you want to explain to your friends when pulling out of social events! Thank you again for your kind response, Paula x

oh, no, it's honestly impossible to be able to concentrate on anything while youre dealing with pain. So glad you are able to work from home, though. When I was in pain and had to work, I sat on this electronic heat pad. It made a huge difference for me.

Did you try to insert the vaseline jelly inside before the BM?

I struggled with having the "perfect" BM as well. I never had an issue with not having soft stools before the fissure but after the fissure, I think I was putting way too much thought into what I shouldnt eat, and should eat and I think it was just making it worse! lol but then i added lots of water and they were okay after that. I can definitely see the medication affecting the BMs. That's very common with lots of medications. Maybe try taking a spoon or two of olive oil.

I honestly didn't want to do the Botox. Mostly every post on here I read about it, and a couple other people I talked to, said Botox didn't work work for them in the end. My surgeon at the time said he would only do the Botox first before surgery so I ended up doing it. It didn't help me at all. Just made things harder. I couldnt hold in my gas for three months so I was always so nervous at social functions, and I had urgency with BMs. That all went away though but did absolutely nothing to help my fissure. We then moved and I found a new surgeon and he told me Botox never works and he doesnt even recommend it in his practice.

I would focus on the ointment, sitz baths, keeping stools soft for at least a month and then if that doesn't work, you can speak to your doctor about your next options.

Surgery wasnt as bad as I thought it was going to be. It was so quick. I did have pretty bad pain for about four days after which I used painkillers for so it wasnt too bad. now i'm just waiting for the surgical incision to heal which the doctor says could take up to 6-8 weeks. So my BMs don't hurt with fissure pain but I get stinging and burning right now until I wash up and then it disappears so I know it's from the incision. I also stopped getting the spasm after BMs.

I got this fissure about three years ago, but it wasn't painful. It was just a bit itchy after BMs. My doctor didn't tell me to do anything for it (worst advice ever) so I just went along and it would disappear for months. Then 17 months ago, I delivered my baby and after I had severe after birth contractions causing a bit of diarrhea and it tore open, and that's when I got that "pooing out glass" feeling. Doctors prescribed me nefidipine and it worked well for me to be able to live mostly normal life.

I know, it is very embarrassing. I can't wait to be past all this. We will both get past it! This experience will just make us appreciate our pain-free lives even more. Hope you feel better today.

Thanks Serina. I'm really trying to get my BMs soft, but it's trial and error. Yesterday I managed to get a nice soft BM at the end of the day, from drinking lots of water, fruit juice, eating sweet potatoes with avocado and soup, porridge for breakfast. Plus I'm taking stool softeners. BM at end of day was a 5/10 on the pain scale. But then this morning I had to go again, not much left, but I had taken a small amount of Movicol as per my dr advice and it was just too big and the pain went back up to 10/10! I just don't see how I'll ever heal if that keeps happening. I got in contact with my CRS and am booked in for Botix on 28th October. I know it has mixed reviews on here, but CRS said it works for most people and they are his most grateful patients as they're not in pain anymore! I need that to be me, as this level of pain on a daily basis is taking a huge toll. I'm not eating very much, what I do eat is a lot more liquid, which makes me want to go more often but I don't want to be going more than twice a day really, preferably once, but if I feel the urge, I don't want to hold it as that makes it worse. I'm literally living hell here and desperate to get better. Really hoping this botox works for me and in the meantime I'm hoping i can start to heal, but it's so difficult when I have a bigger BM each morning despite all the softeners and liquids. Just feel very hopeless.

ah it's all so frustrating! I completely understand. It literally consumes your life, thinking about it all day, and then feeling in pain. I really hope the botox works for you. I believe it didn't work for me because I'd had the fissure for too long at that point. The procedure itself is super quick, like 5 minutes. Hurts when they inject it but it is super quick.

The one thing I can suggest if you want soft BMs, is to drink pineapple juice. It should work like a charm! I used to make fresh pressed juices and pineapple juice always made my BMs really soft. Worth a shot!

Hi Serina, thanks for that tip, I'll be investing in some pineapple juice! it's a week until my botox injection, im really nervous about it, they'll put me under a general anaesthetic and do it as well as an investigation to make sure there's nothing else going on. im kind of hoping the fissure will start healing of its own accord before then.....such hard work to keep up the regime and hope it still works!! Pineapple juice is on my shopping list.

no problem! let me know how it works for you. Also I would probably start with half a cup first day and then work your way up.

That's great they are putting you under. you have nothing to be nervous about! it is such a simple straightforward procedure with no recovery time. You will do great.

Thanks Serina, i am hoping it will be the solution, especially as I haven't had this fissure very long, although it feels like a lifetime! Thanks also for your reassurance, it's very helpful. I was actually starting to think I was healing the last few days as the pain during BMs wasn't so bad and the pain after and during the day seemed to diminish quite a lot. then I had a setback today where I had diaorrhea, probably due to having too many liquids in the morning and then my laxative. It's so difficult to strike the right balance! Anyway, ended up having the runs, not a long session but more painful than it has been, so am now really scared I've set myself back. Such a difficult thing to deal with. I honestly don't know how anyone deals with this awful affliction long term. Here's hoping it gets better from now on. How are you doing after your surgery now?

Yeah, I completely agree. It's so difficult to make the perfect stool lol You really have to figure out the right amount of low fibre foods and high fibre foods to eat, and on top of that, the right amount of water intake and then factor in things like stool softeners and medications. So many factors and variables, I guess 😕

I'm just over 2 weeks post surgery and although I've improved a lot, I'm still feeling a mild burning after BMs. The doctor said it takes 6-8 weeks to heal but I'm just getting so impatient! It's so much work with all the sitz baths, and then feeling the burning pain afterwards. I have two little children and need to get back to regular life asap!! Hanging in there and staying positive!

Oh, i hear you on all the work and sitz baths! Having a poo now takes me in total about 40 minutes including the sitz bath, cleanup and then applying coconut oil, GTN and vaseline! then I have to clean the sitz bath! It must be so hard with 2 little ones as well, plus dealing with the pain after BM. I am keeping everything crossed for you that it soon goes away, I totally understand your need for it to just hurry up and be gone! Good on you for hanging in there and staying positive! I'm struggling with that a bit as this has come after a series of not very nice things including the loss of twins when I was 5 months pregnant on our 7th round of IVF about 18 months ago. We've had 2 miscarriages since and no living kids. So my resilience is pretty low to deal with this horrible affliction now. Trying to hang in there and tell myself this will pass...it WILL! One thing I am really missing is food. My hubby and I are real foodies and love going to farmers markets and picking up stuff to eat and have the odd takeaway.....I can't have any of that as I need to stick to soft and liquid and high fibre stuff, which sadly doesn't feature too highly in farmers markets or takeaways! I so miss being able to eat what I want, when I want and the amount I want. I'm finding I'm eating less because what goes in has to come out and I don't want more to come out than absolutely necessary! Am still scared of my botox under anaesthetic this Friday, they're also doing an investigation of my bowel to check there's nothing sinister going on that may have caused this fissure, since I didn't have any major constipation or anything. Just desperate to get past this! Here's to both of us resuming normal life!! xx

oh, my, Paula, my heart just breaks hearing about what youve gone through. I can only imagine the pain that has caused. And now this on top. Life sure can be so unfair. I hope 2023 is an amazing year for you and your husband and hopefully you can move on from some of these things in your past. All these experiences will shape who you are and will make you so strong.

I feel the same way about food too. I've lost 10 pounds because just like you, I just dont want to deal with the exhausting process and pain. I'm hoping I feel myself by Christmas time!! And I hope you get some relief way before then!

I understand you'd be nervous before the procedure but I think you will be so fine. My fissure was not caused by constipation either. It was caused by the opposite 😕 I will be thinking about you on Friday. Let me know how it goes! I'm here if you need any support!

serina

Ah, thank you so much for your kind words Serina and for being there, albeit virtually! I teared up reading your post! And thank you for your kind wishes for the future, I hope so too!

It really does help knowing someone else understands this condition. Life has definitely been difficult recently, I'm starting counselling for it and this fissure and how low it has brought me, because when it started I also developed a load of mouth and tongue lesions and my gums were painful and peeling (which has thankfully cleared up now!) but I am convinced that these physical issues which have come on so suddenly are my body's way of expressing emotional pain that I haven't dealt with and repressed anger at what happened. I really just want to find some peace with where I am now in my life, not where I wanted to be or thought I should be. Ah, food! I'm trying to stick to eating much the same thing every day, as the last few days have managed to keep BMs quite nice and soft, then this morning had an awful BM, so painful. Think it may have been due to not drinking enough yesterday so set a timer on my phone every 30 mins to gulp at least 5 gulps of water! Hope it helps make tomorrow's BM better.

I so hear you on hoping to be better by Christmas time! I want to be able to indulge in at least a few of my favourite foods, although even if I'm better, I think for a while I'll be scared of eating anything too spicy or potentially constipating for fear of a relapse. I've lost weight too, not sure how much, but I can see it and feel it. Am preparing for Friday and desperately hoping it helps me. My consultant says it does help most of his patients, just hope I'm one of them!! Thank you again for your support, it really means the world to this downtrodden lady xx

Hi Paula!

Hope your procedure went well! You are probably so relieved to be finished with that Hope your healing begins quickly!

Serina

Hi Serina, thank you so much for thinking of me. I am just about to leave the hospital, its about 8.20pm. I did type a long reply to you about an hour ago and it got lost! Basically, I have 2 fissures, not one. I was really quite upset about that as feel it worsens my chances of this working. Consultant said this works in 60% of cases, which again I felt very disappointed about, as when I first met with him he said botox works in 'most' cases. Anyway

sorry got cut off and accidentally posted! Back home now. Anyway, I am now scared of the pain and the fact this may not work. I desperately want to be positive about it, but am so scared I face more pain and more surgery. Trying not to focus on that and just hoping this heals. My consultant did say it looked like the fissures had started healing, which was good I guess. Now scared of trying to keep stools soft and regular as this has been proving tricky for me as every time I think I've nailed it, my.body seems to get used to what I'm eating and still get more difficult! I followed your advice and got some pineapple juice. Drinking it last t hinged at night to try and jig bowels into action in the morning. So scared of first few BMs! How were yours after your botox? And how is your recovery after LIS going? Paula x

Sorry Serina one question, I was going to ask my consultant this and forgot as when he spoke to me I was only just coming round from the anaesthetic. Did you continue with your creams like coconut oil, vaseline and rectogesic after your botox injections? I guess I should but don't want to disrupt anything and make it worse!

hi!

So glad you are trying to be positive. You will really have to believe the Botox will work for you. Our minds are so powerful! Did the surgeon indicate whether both fissures were on the same side, or opposite? I know one fissure is super painful, cant imagine the pain from two!! that's great he said one looked like it was healing! I think you have a great chance! keep up with sitz baths and yes, I continued with my nefidipine ointment - so your rectogesic I would definitely continue. You won't disrupt anything. Give it everything youve got - ointment, Sitz bath, drink lots of water, and just try your best to keep stool soft. dont be too hard on yourself when you cant. you can only do your best and the rest is just up to our bodies. the good thing is your muscle will be way more relaxed so it will come out easier for sure. I just hope your pain abates and you can finally get some relief and live a normal life!

im doing ok - healing has changed. feels different now and less pain. This healing process is all new to me so just trusting the process. i am 3 weeks post today. i think i will feel my normal self by 6 weeks, like the surgeon said but we will see!

my stool didnt change after botox but i did get a bit of urgency at times. hopefully you dont get that! you might have a hard time holding in your gas as well - that was hard for me but i was able to hide it lol i would walk away from situations if i felt anything coming! oh, boy, loving our conversations hahaha!

Hi Serina, ooh so glad to hear you're finally healing properly! That sounds really promising. So pleased, it sounds like it has been a very long road for you. Gives me hope that someday I will also heal.

Woke up today not much pain, not sure if it's my painkillers or if there's still some local anaesthetic at play. My consultant did say the first 2 days would be the worst. Haven't yet had a BM, but tbh there can't be much in there as cleared out before procedure yesterday and couldn't eat much afterwards. Taking docusate sodium and lactulose. Had a smoothie and yoghurt for breakfast this morning, got hubby to buy a load of veg and soups for me so that should hopefully stop me getting bunged up. Not that I did before, but just super paranoid now! Having a bit of bleeding, but consultant said to expect that. He did also mention about the incontinence to wind, hubby had a little taster of that this morning, lol. He has a rule that I have always objected to: men can fart at will whenever they like, but women shouldn't fart. Ever. When my consultant mentioned it yesterday I looked over at J and he just shook his head at me, lol. Yes, I love these conversations too, haha!! I'm sharing a lot more with you than I am with some of my close friends haha! Haven't had my fist BM yet, scared of that but want to wait until I get the urge. Feels a bit bubbly in there so hopefully that's a good sign and it will be soft. Honestly. The things we pray for when afflicted with this horrible thing! Xx

haha, definitely loving these conversations lol! I did reply but for some reason it's being moderated, so having another go! Well, had first BM yesterday, it did hurt, but only bits of it hurt if you know what I mean? Like there were a couple of times it was. 7/10, but then it was soft and OK to pass. Was quite sore afterwards, did all my creams etc. Was a bit tricky to go, as think the anaesthetic has a slightly constipating effect, so went twice in the end, first one was bot painful, but was only a little bit, then the second one was the main event so to speak and was as I described above. Haven't really had the wind incontinence yet, but its only day 2, so that still has time! I'm still so scared this may not work. Overall I do feel better than before though, so after BM I was sore for a couple of hours, but it went away, although that could have been my painkillers. But then during the night I haven't felt it so much and the painkillers would have worn off by then. I can definitely still feel I have the fissures if I move to fast or walk too fast though. Just hoping the fact it doesn't seem to hurt as much as before is a good sign. Still not looming forward to next BM though, struggling with what to eat, as so sick of soups and smoothies, they literally make me feel sick. Didn't eat dinner last night, so very empty this morning, but just don't know what I can eat that I actually want to eat if you know what I mean? Porridge has been my go to, but am soo sick of it. However, not sure deviating from it would be a good idea........don't want to end up in more pain come BM time. I'm just desperately hoping this is going to work.

haha thank you for sharing!

Ive been dealing with this issue for so long, so my poor hubby has seen it all lol. I just see it as bringing us closer together lol

how have you been doing now, few days since the procedure? It's still so soon, so definitely have to be patient I think. The surgeon who did my Botox said it could be like six months before the fissure heals, but I'm sure he meant long-term healing and short-term healing so you won't feel pain anymore would be much less of a time. I'd say at a week I really felt the effects of Botox, so I would assess at one week and then again at 2 weeks.

totally understand how you feel about meals. i'm getting SO tires of limiting myself. Really just cant wait to not worry about how much and of what I am eating! ugh .

Hopefully very soon for both of us!!

Oh, wouldn't it be amazing if we were both fully healed by the end of November! No more limiting foods, no more sitz baths, no more zillion ointments to put on, no more laxatives to take (and the subsequent cramps if you've taken a bit much) and no more dreading the BMs! Wow, that feels like something amazing now and until 5 weeks ago, it was something I took completely for granted. Anyway, my progress so far (day 5 after botox) is good. First BM was a bit painful in places, but not all the way through if you know what I mean. And since then, they have been a lot better, like mostly 3/10 inches pain scale or lower. I'm managing to keep BMs soft by taking 5 docusate sodium throughout the day, plus 2 doses of lactulose am and pm. It does mean I tend to go twice a day, but if it keeps the BMs soft and relatively pain free, I'm OK with that! Branched out into eating grilled vegetables (courgettes or Zucchini as you say in the States!, mushrooms, peppers and spinach) with some cheese on, plus I can have that with brown rice if I need something more substantial. So lunchtime doesn't just have to be soup anymore, yay. Dinner is homemade smashed avocados with lime juice, olive oil, salt and pepper and mashed sweet potato with (again!) a handful of grated cheese. I'm looking into maybe some wholemeal pasta with pesto (minus the pine nuts!) as well to try. Haven't had the guts (pardon the pun) yet, as pasta can be bulking, so a bit scared to give it a go. But on the whole, things seem a lot better on the pain front. Which is good, I'm just hoping it stays that way and doesn't revert back. Fingers crossed for us both!