Thanks Jeff,
Fissurectomy is where they cut out the fissure in the hope that a clean wound heals better. I have since learned that not all doctors agree it's a good way forward.
I haven't heard of magnesium hydroxide, I'll look it up.
It's just all such hard work, I thought I was getting better but it's going to be such a long process.
Hi Jmc40
So sorry to hear you are still in a lot of pain after your treatment. I'm not exaggerating when I say the things I read on here and other forums about Botox actually saved my life.
I developed a fissure after giving birth to my daughter so not only was I dealing with the usual stresses of having a little one, I was in absolute agony.As others have said, unless you've experienced it, it is impossible for another to gauge this. I initially had the LAS surgery which worked in the short term, but then the agony returned. I was so bad at one point, I was actually scared to eat and my weight plummeted to about 6.5stone. What people don't realise is that you very quickly descend into a state of depression, I feel exacerbated by the fact the pain you're suffering is in a place you cannot openly discuss with others - give me a broken arm any day!!
I had a fissurectomy and Botox injections in 2009, and paid for it privately as it wasn't widely available on the NHS. I feel it saved my life. Following the surgery there was a lot of pain, I had 2 weeks off work, and needed to take Diclofenac painkillers for some time. However, after about 3-4 weeks, I was pain free, and have mostly remained so for over 3 years.
I still need to take care over what I eat....no white bread/rice etc, all wholemeal foods, but along with this, I HAVE to drink a lot of water. If I don't, I notice it straight away. I also steer clear of nuts and seeds, simply as I found they caused pain!! It's very difficult to get the stool consistency right....and it took a bit of trial and error, but listen to your body. I lived largely on brown rice and veg for a little while and then gradually introduced other foods. I steered clear of too much fruit as I found it made me go too often...looks so crude to type such things, but I know you'll all understand!!! I now go once a day at pretty much the same time. I also now find that if I haven't gone, a little exercise gets things moving in a more natural way than any lactulose etc I had been taking previously. (Although not in your current condition I appreciate!!)
Jeff, I'm sorry to hear your treatment wasn't as successful as my experience. I agree it would be lovely to have local support groups. I was so thankful to discover forums like this.
I thought it important to show there is hope out there for any of you who are still suffering.
All my best
I been suffering from anal Fissure for almost 3 months and it started to to get better about 3 weeks ago. My routine is, I drink 1 serving (11.2 oz not a bit more) of 100% coconut water and I increase fruits and vegetables everyday. I got off all my medication after I see myself feeling less pain. Also when you wipe make sure its either baby wipes or moisturizer wipes that don't have alcohol or acid in the ingredients. Use those wipes after every bowel movement. Avoid caffeine, spicy food, fruits with acid, tomatoes or anything with tomatoes, and don't eat too much starch or carb foods. It helped me so much. I been drinking coconut water for almost a month now its high in potassium, magnesium, and zinc.
If you don't mind can I ask how much time gap should be taken between two Botox injection.. ???
Hi everyone,
Im in desperate need of some advice! I too am an anal fissure sufferer! I have gotten a fissure from recent child birth and i feel at a complete loss what to do. I have exhausted all options out there in terms of creams and laxatives. Has the rectogesics worked for anyone?? Although it has only been 3 months it feels like a life time. I thought child birth was bad and then came along this killer pain i found out was a fissure. I dont think i can handle the pain anymore, i spend 8 hours in agony pacing around my house and with a newborn baby i feel im slowly sinking into depression. Can anyone recommend the quickest and most effective solution for this before it gets anymore out of control? Im willing to pay private or fly abroad for the da vinci robotic surgery! help anyone please?!
My advice, having suffered for a long time, is to use vitamin e oil directly on the fissure. I found that is has really helped and I am in the best shape in a very long time (after a failed fissurectamy and now two lots of Botox). I think hat the oil helps in two ways, firstly to lubricate the whole area pre and post bowel movement, secondly, vitamin e will help the skin heal. I also take two vitamin e tablets a day together with a whole host of other vitamins including zinc, vit c, garlic, magnesium and linseed/flaxseed oil.
My Consultant also said not to worry about taking more than the recommended dose of stool softeners as they won't do any damage. You need to find a combination that works for you. I take dulcolease in the morning and lactulose and night as well as two lots of fybogel a day. lactulose is great and really works but is too strong for me during the day. Also, the fear of the pain of going to the toilet stops you from going so you need to try and heal the fissure as well as keep things moving so definitely invest in some vitamin e oil. Sits baths after a BM also help, although not always practicable.
Hang in there, eat well, look after yourself and drink lots of water, eat oats rather than bran as its too harsh and limit nuts for the same reason. Lots of fruit and veg and food that's easy to digest.
That's the bestbimcan offer in advice after a year of trying to heal myself!
I have had an anal fissure for what seems like forever (at least 5 years), as a result of banding to some piles in 2008 at the age of 28. I am going to be very graphic and open about my experience, firstly to get things of my chest and secondly to hopefully help others with my treatment, condition management suggestions as it helping me to read your suggestions.
I have to say this is the first time I have reviewed a forum and it is helping to read all of your postings, it makes me feel less isolated regarding the curse that has been inflicted on us and can totally empathise with all of you.
I am a 33 year old man with what can only be described as a chronic anal fissure/spasm. Every day is a horrific ordeal of blood, pain, misery and I am becoming increasingly depressed.
I have been under the care of St Thomas' Hospital in London since April this year and have had various appointments, the most recent was last Thursday and I had some tests that involved various devices being inserted into my rectum (which only lasted about 10 mins and wasn't actually that bad. I have been using Diltiazem Hydrochloride 2% Cream which relaxes the anal muscles making it easier to go to the toilet and promotes healing. I was told that this has a 70-80% success rate, unfortunately I fall into the 20-30% failure bracket. They will be sending me a letter with the test results and a treatment plan that could involve Botox injections but I will wait and see what the plan is. The consultant said that the Botox may cause wind and skids marks (lovely!) and again has a 70-80% success rate, I just hope I'm in that percentage and not failure, I need the torture to end and to return to normality!
I have also had appointments with a physiotherapist who taught me a technique to avoid straining, you rest your feet on something akin to the width of 2 yellow pages, elbows on your knees, back straight and puff out your stomach, this is the optimum position to empty your bowels reducing the need to push or strain.
I have been taking Movicol and Fybogel both twice daily to keep me regular and soften my stools, also glycerine suppositories make me go quicker and limit straining, I use them twice in the morning to get my self empty so I can get on with my day, the only drawback is needing to go a third time which can cause a bleed if i'm not careful. I eat a high fibre diet with porridge and fruit using alpro almond milk with honey every morning. Fish, potatoes and high fibre vegetables such as cauliflower, courgettes etc and plenty of non acidic fruits. Nothing unnatural or processed. I am going to really make an effort now including no bread, which I will now be cutting out of my diet completely. Also starting using coconut oil after my final bowel movement and taking daily baths to soak the area. I've also started jogging as regular exercise is supposed to be helpful, so hopefully all these extra steps will be beneficial.
I think the fissure would of healed by now if it wasn't for the spasm, more often than not now there is no blood dripping into the toilet but (I apologise that this next part is graphic but it's best to be open) I have to push the spasm back into my rectum using toilet tissue, this is unavoidable as it won't go back on it's own which causes the fissure to bleed, I'm certain it would heal using Diltiazem if it wasn't for that! I think there is a severe internal fissure.
If I had the time I would take a bath after every bowel movement but that's impossible with a busy life and living in shared accommodation, I could possibly afford a place with my own bathroom but I am only in a temp job, even though my contract has been extended twice I can't risk leaving my myself stranded in a place I can't afford if I become unemployed.
I have to stay positive and hope that all of this will be a distant nightmare, as I'm sure you are all aware until you have experienced this do you realise how it can ruin your life!
I hope you all have positive outcome also.
I have had a fissure for 18 months. It comes and goes a little but I can't remember the last time I had a pain free BM with normal action. I have to use my hand and the pain and spasm is pretty bad sometimes. I did try , duculose and the gtn cream, but gtn gave me dreadful headaches and turned my face red.
So I am having Botox later today.
I suspect the menopause is to blame but no physician listens to me.
I'm scared of General anaesthetic and becoming incontinent- but also that it won't work!
Hi All,
I had been suffering for 3 months after the birth of my baby with an acute anal fissure. All the GPs advice was completely useless, they even misdiagnosed my fissure for haemorrhoids. After seeing 4 different GPs and pleading with them that i was in agony and could not look after my baby because of the 8 hours of pain after bowel movements, they prescribed me the rectogesic ointment which is NOT licensed for breastfeeding so I didnt use it. I ended up being referred privately to see a superb colorectal specialist. The key is to been seen as soon as possible otherwise it only gets worse!! I was told that BOTOX was the best option for me as recotgesic is not suitable for breast feeding. BOTOX has no horrible side effects eccept for slight wind the first week. I have to say I was terrified of going under general and the after pain. However It was the most simplest of procedures. NO pain after and immediate relief!! I was told i had a very deep fissure and the botox definitely stopped any pain for 4 weeks afterwards and gave the fissure a good chance to heal. Howafter the botox wore off it had not fully healed but almost and by that time i decided to stop breast feeding and use the rectogesic. The side effects were quite unpleasant; racing heart beat, faintness, headache and red face. I had a 6 week follow up after the botox and the rectogesic and im pleased to say my fissure is fully healed. My personal recommendation to all suffering with anal fissures is:
1. TAKE LACTULOSE 4 TBL SPOONS TWICE DAILY
2. TAKE 2 FIBOGELS TWO TIMES A DAY
3. DRINK PLENTY OF WATER
4. SEE A COLORECTAL SPECIALIST ASAP
5. USE BOTOX WITH RECTOGESIC (If you can handle side effects)
6. HIGH FIBRE DIET
BREAKFAST: ALPEN, YOGURT, RASPBERRIES
LUNCH: LENTIL SOUP
DINNER: STUFFED PEPPERS WITH BROWN RICE
GOOD LUCK EVERYONE!
My doctor won't give me the Botox as he said it would cause anal leakage. Anyone agree?
I have since had anoheal cream and also Macrogol (2 per day) and I am finally (fingers crossed) in no pain and long may it last.
All on NHS - worked for me and I can pretty much eat what I want :-)
Sorry to answer your question: I had two rounds of botox (did not do much at all for me - but everyone is different) - it certainly did not cause anal leakage - then again consultant said me anus was like a vice :-( (tight - not the other kind ;-)
BOTOX does not cause leakage. It can only cause passing uncontrollable wind for up to one week when the effects are most potent. Botox does not cause any lasting effects. It works best up to 3 or 4 weeks and then the effect where off and you hope that the fissure has had the chance to heal. It stops the muscle spasming (tightening) which causes painful bowel movements as each time the fissure is torn open. You MUST make sure you drink plenty of water all of the time and use stool softeners to aid the recovery process. It is about getting the right consistency. IT can take a long time to fully heal but the Botox definitely relieves the pain greatly. Rectogesic helps after the botox wears off after 4 weeks. I had a very deep fissure which i never believed would go but after the Botox and 1 week of using the rectogesic I am pleased to say i am fully healed! Botox works for around 70% of patients so its quite a good first port of call. The other procedure which is cutting into the muscle to relieve the spasm causes permanent damage and soiling in 20% of BM times. So best to avoid if possible! Botox sounds scary but really was very simple and saved me from turning into a mad person!
I had Botox on Monday, no leakage or uk controllable wind. I have been able to pass stool normally rather than dig out with my hand for first time in a year. Pain better, hope fissure now heals.
Had botox and operation on ky fissure on Thursday,didnt have any bowel movements on Friday and now its Saturday morning and its like trying to part with a brick already had 3 goes and thats after taking my lactulose and just now a senekot tablet and have drunk lots of water.Had no pain since operation but iam back in pain now and stinging very badly.
Hi Damon
This sounds familiar to my Botox experience afterwards.
I would seriously recommend getting onto Macrogol (are you in UK) - until I used Macrogol my BMs were not great - either I was overdosing on Senokot and Lactulose etc and it was either far to runny/water or the other way. Since being on Macrogol (2 sachets a day) I have not had a sore trip to loo.
Keep us posted on your progress.
BTW - Macrogol acts differently to lactulose in so much as it draws more fluid into the bowel area - I know everyone is different but for me it was nothing short of a bloody miracle - that was after almost 2 yrs of bloody hellish pain going to loo and for hours after,
Damon, don't strain, it's the worst thing you can do because it will re-open any healing that has take place. Don't bulk up too much on food. I have found that light easily digestible food is best with lots of warm water And lemon. I still take two fybogel a day. Lactulose at night 45ml and if I need it dulcolease in the morning. (I might also try macrogol as an alternative). Senacot was awful for me as it was too harsh.
I also now use a product called Dr Wheatgrass superbalm applied to the fissure after every BM. It's worth reading the Dr Wheatgrass website and the comments there about fissures. I know my fissure hasn't healed as confirmed by my consultant. I have been offered further surgery but have declined at present because my symptoms are manageable and I am hoping it will heal soon.
I hope you get you life back soon. Xx
Hi Jeff and Jmc,Thankyou for your advice I had to go somehow so I ended up either having to make q 40mile round trip back to York hospital or I was advised by a local doctor to maybe try glycerol deposits to make me go which helped a little as the lactulose and senokot were not loosening anything and eventually I was able to go for a BM without too much straining.I was a little sore after but my prescription for diltiazem hydrochloride ointment arrived and this seems to have helped ease the pain.Just dreading today and any BMS again,going to drink water and small amounts of fruit and veg and no big meals and see how I get on.Thankyou for getting back to me both of you.I was 35 years old and fit then I was diagnosed with coeliac disease and 2 years later I now have a mild form of psoriasis also I have had colonoscopies and endoscopies with the camera down both ends but the constant pain a fissure can cause I would not wish on anyone.
Hi Leland,I had a team of six waiting for me in theatre and was looked after really well,i was even fully awake half an hour later and in no pain,of course that wears off in time.Iam still tender after my op on Friday and get some pain if i sit on my bum,iam currently looking into stopping using the diltiazem hydrochloride ointment also which iam ment to put on around the entry of my back passage as it is causing a stinging sensation of 9 out of 10 pain for 4 hours after applying and that tells me something isnt right.My BMs are getting better though after continuing the lactulose and buying some dried apricots and prune juice.Iam okay at the moment when i sit on my side letting my hips take the pressure and weight or lying down on my front when i sleep is bliss as there is no pressure on your bum at all.