How do i heal this fissure when nothing is working?

Digestive health
1

I've been struggling with a fissure since July, and I've developed hemorrhoids along with it...oddly one in the anal area beneath my tail bone, and one in the opening. I went to the doctor and came away from the exam with even more pain. I was prescribed nifedipine (sp?). The nifedipine started to heal the fissure, but then it began to cause swelling in the tissue down there. It swelled up so badly that it hurt to walk or sit, and it literally felt like my insides were protruding outward. It also caused a dull, chronic ache inside my lower intestines that went away both times I stopped using it. Unfortunately the swelling made the fissure worse.

I began using zinc oxide instead, and even a little manuka honey in an effort to keep the area clean. I take two warm baths a day, and reapply medication twice a day. But the fissure, or what I suspect is more than one now, given the pain, will not heal. I'm taking miralax in the morning, but my stool is never the same. I can't seem to regulate it, which I'm sure is exacerbating the problem. I've just transitioned to a gluten free diet after we realized gluten was making me sick, so I'm trying to fumble my way through that as well.

I know increasing blood flow to the area aids healing, and without the nifedipine to help with that, I tried taking slow walks around the apartment complex, but again, it causes incredibly uncomfortable swelling. I've done So much research, but I just don't know what to do. So, at the moment I am sitting on a heating pad at work, and hoping no one asks me why! I would love some advice...I'm at the point where going to the bathroom makes me anxious, because I know how much it will hurt.

2

Oh I am sorry to hear you are struggling so badly.

I am still in the grips of my issues- have been using rectogesic which in essence is glueing me back together and thankfully (touch wood, fingers crossed etc) it is finally beginning to work. The pain is still monumental, but the time it lasts is lessening.

I dont know if it will help but this is what I had to do to get to this stage: Rectogesic every eight hours. Religiously, and without fail for as long as it takes. You unfortunately have to take a deep breath and be intrusive with your application of it. 

I would say you are unable to regulate because you are so scared of the pain and that is not a criticism, i am completely in agreement. Problem is, when you worry about it all the time, your digestion is interrupted (I highly doubt that is scientific fact but i Know, for sure, that when I am nervous, I sieze up in my gut). So, I have trained myself to only go to the loo when I am at home so I dont have to worry about being gripped in agony when out or having to return to my desk at work, and then I take something with me to watch. Call it crazy, but if I am listening to music or watching something on my tablet, the pain, I still feel it, wow do i feel it, but it is less terrifying because I am being distracted and so i relax just a tiny bit more.

Anything you can take to soften your gut, like fybogel or lactulose, just until you have healed, is a must. Eat non sugared fibrous cereal in the evening, and it will keep everything soft.

Topical nifepidine is good, but not always suited to everyone. I mentioned rectogesic, and the only downside is the light headedness after application and the headaches. They pass quickly, but you need to apply when at home and have time to settle down.

Other than that, baths, heated pads, and lying down whenever you can, rotating from one side to your back to other side every twenty minuts or so it keeps the blood flow going without putting too much pressure on your lower parts.

Patience. Its impossible with this kind of pain, but your body will not go any faster than it wants to, so any distractions you can find to just let you relax for a bit, away from the pain and the exhaustion that goes with it. if you have hemorrhoids and the walking angers them, make sure when you are at home to be wearing loose trousers and cotton undies, so the poor area can breathe.

Water. Drink water until you hate the sight of it because nothing works better.

I would say if nothing is better by this time next month, you need to go back to the doctor and tell him/her that your life has now been put on stop because of this and something has to be done.

 

3

Thank you for the advice, Caroline! Where might I find rectogesic? It's certainly worth a try!

4

I get mine on prescription from my doctor smile if you go and see them and say the name, they will know it.

5

Hi - my sympathy is with you - I have had problems for over six months now and have been where you are now. I think with this problem, we all find, by trial and error, what works best, but you do have to try several different things before you hit on what works best for you, which I know sounds difficult, but from reading the posts on here there doesn't seem to be one particular thing that works for everyone. Here is what I tried: a hot bath after going to the loo - it didn't take the pain away, but soothed it to a degree; the best stool softener I found was Dulcoease, which contains Docusate - I take between one and three a day and it is the only thing which softens my stools enough to make going to the loo even slightly bearable; as Caroline said, water....as much as you can drink; a tablespoon of linseeds with my breakfast yoghurt; and Rectogesic, which worked a bit for me, but unfortunately I was in too much pain to insert it, so had to put it on the outside, where it isn't as effective. These helped to an extent, but even now the pain is recurring, so finally I have been given a referral to a specialist. It has taken over six months of repeated visits to my GP and a great deal of pain and anxiety. I wish I could offer you a quick and effective solution, but sadly I don't think there is one. It did help me by posting on this forum and finding that other people know what you are going through, so I can only wish you the best of luck with finding something that works for you, and please know you are not alone.

6

I too have had a fissure since June this year. I read many of the suggestions here in this forum and found them very helpful. I have now got some balance in my life using some of these tips and discovering some of my own. For the use of others I give some of these lifestyle changes below:

1.  As everyone says I do put coconut oil every night before going to bed. I put some coconut oil in a small container and put it in the fridge or freezer. I do this when I travel also. At night i cut out a small wedge and insert into the anus. I put a little natural/organic turmeric also into this oil when I put in the fridge.

2. I ensure I have some natural cereal not processed in a carton every morning. This is either quinoa or some millets made into a porridge. I add dried fruits into this. And avoid sugar or milk. I add raisins or/and dates.

3.  I make sure i eat some fruits during the day. At around 11am before lunch I have some grapes or a banana or some kiwi fruit and the other fruit I have around 3pm. If I miss this I usually regret it.

4. I have cut out gluten mostly. The few times i had some bread or pasta I felt the familiar twinges reappear!!

5. And then the motion itself. I prefer not to use any chemical medicines, suppositories or creams. I  tried them all and it sort of worked but not really. Sudocrem worked the best but even that when there was a relapse it took two to three weeks to recover.

So I moved to taking an enema. I bought a fleet enema bottle from the pharmacy and removed the liquid in there. I then use room temperature water and take an enema before a motion. The  water helps to rejuvenate the area and the motion with the above mentioned diet becomes soft and passes through without any pain.

It took just a few days of this regime to make my pain go away. But it has not healed i know. I have been on this regime a month now and nearly pain free but have had relapses when my diet changes a bit and I cannot eat the fruit or have more gluten. But the good thing is when I move back to the diet and the enemas I am fine much faster. In a few days rather than a few weeks.

6. Of recent I also got some homeopathic medicines. I feel that this too has helped. The problem is to find a good doctor and good medicines.

I feel for all who suffer from this. I hope this helps. Its a long process. But worth it.

7

Dear Cici2012,

I first want to say how sorry I am, and how much we al are that you have to go thorugh this. We have all been through the same type of pain, and can sympathise with your situation. A lot of the problem with an anal fissure is its not jsut a physical problem, but a mental problem as well. Thinking it is getting better and then to be in writihing pain the next day to through your hopes down the drain ruins your day and your hope of getting better. However, since we have all been there, we can probably agree that despite all of the downfalls that can occur, you will get better given time, rest, and proper treatment. 

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.

Besides that, I applaud you very much  for going to work. 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.

Good luck, and we are all here to help you and care about ho you are doing so let us know. I really hope you get better soon!

SIncerely,

Myles 

8

dear  mmarcus151910

Thanks for your post . I have some question ,can u please anwer me ?I'm going to have sphincterotmy next week ,but so much worry about pain . can u tell me something about pain after surgery ?

And how did u   change your gauze is it every 2hrs ?

Does your doctor put any numbing injection on your fissure area before procedure ?

And what about your food after surgery / madicine ??

Reply will be appreciate .

Thanks.

9

Dear mm86525,

I first want to give you a lot of credit for deciding to do the surgery...It is not an easy desicion, as there are some stories online that can discourage you from getting it, but in the end in my opinion it it better. 

So basically, this is how it went down with my surgery. I had to fast the day before the surgery because they had to put me under anesthesia. I went in, waited, and then they put me under and the surgery was done. I woke from the surgery with morphine in my system, although once I woke up it had worn off for the most part. They basically told me I could get another dose of morphine, which would basically knock me out again, or I could stay up and move to the other room to wait until I was ready to leave. So, i skipped the next dose of morphine and went to the other room. As I was laying on the bed, the pain bagan to set in. The next part may scare you a bit and discourage you, but getting through this part is just part of the process of gettting better. So when the pain started to settle in, the paiin almost flt worse then the fissure pain itself. I was not only dealing with the pain from the fissure, but from the incision and cuts that were done form the surgery itself. This being said, you have to take into consideratino that the surgery is cutting into your sphincter muscle, so pain will come, but this is with any surgery. Unfortunately, with this surgery, it is in a very sensitivie area so the pain will be a little more intense. Some things I did in the hospital to deal with the pain was put ice on my butt, I bit down on a washcloth to decrease the tension that I would put into my butt area and to transfer the tension to my jaw biting into the cloth. They did give me percoset, but honestly it didn't help me a bit. I still felt the pain until I was able to fall asleep. The lady next to me said that the percoset made her feel that the ceiling was the floor and the floor was the ceiling, so I guess it affects some people differently than others. I also will recommend listening to music right after or watching a movie to distract yourself from the pain. SO that was basically it from the hospital. I couldn't leave the hospital until I could pee though,  which was not easy since I had so many drugs in my system and could  not really push to hard as it was painful and I did not want to upset the area.

Eventually I peed and was able to leave. Then, I took some percoset that night and slept. The next day I felt no pain, as I did not poop at all, and as with before the surgery,  the pain  only comes when  you poop. 

So the day after that I had to go to the bathroom. The first time you go to the bathroom will be very painful, almost more painful than pooping with just the fissure because you are trying to poop through a fissure and a surgery, but that comes with  the territory. I will not hide that I felt like I was going to puke the pain was so bad WHILE pooping. I also recommend listening to music while pooping as this distracts the pain  and gives some motivation  not to be afraid. The reason on put emphasis on the WHILE is beause after the pain is very dull and nothing compared to the throbbing unimaginable  pain of an anal fissure. Within  the next two weeks, I progressively felt myself getting better, and by the 2nd week I went back to the doctor and he gave me the ok that I was all healed up.

I never had any incontinence, although the only thing I still have is that its a bit harder to hold in my farts sometimes, but that is it....As far as the gauze, I only changed it because I would leak sometimes..I ended up just buying adult diapers at the store and used those until I stopped leaking. 

As far as numbing injectino you asked about, the only  thing I was aware of was the anastesia I was on.

As far as food after surgery, I just kept to a well balanced diet. I take metamucil fiber supplement every day since, and I squat on the toilet all the time now. Make sure not to take too much fiber as this can irritate the area.

Hope this was enough information for you, and I really wish you the best of luck with  your surgery next week.....Noone should  have to go thorugh anything like this, but thank god we have means to take care of it with surgery....

Send you my thoughts and keep me posted how it goes!!!

Sincerely,

Myles 

10

I'm curious what homeopathic medicine you use. I've heard horror stories about miralax and how it's toxic, but I don't want to use something that leads to dependency either. As boring as it sounds, I've decided to try and find a day where I have a healthy bowel movement and then eat the foods that produced it every day for a month. I can't figure out how else to stop the flipflopping between constipated, diarrhea, and just right. I'm hoping I'll see some improvement from that, but I still need a natural laxative to make it a little bit softer, or if I just can't go for a day.

11

Hi

I wanted to give you a glimmer of hope...

So I think I am healed. Dont get me wrong, I still have burning for several hours post movement. But there is no blood, no agony, discomfort is minimal and I can sit down again.

By no means out of the woods, but it is getting better. So, you can heal too (I sound like a preacher from the deep South, and I don't mean to!) but if you continue to take in fibre, eat things that are easy to digest, use laxatives if the fibre is not helping you out, and relax as much as you can when the time comes for a movement.

Find some rectogesic!!

I hope you are okay.

12

I would like to thank everyone for their helpful posts. The information provided has helped me heal physically, emotionally, and mentally.

My journey started in late August and I am just now starting to feel better. Like Caroline, I am at a point where the BM's are easier and all that remains is the burning sensation. (Burning lessens with each passing day. For me it's taken nearly 12 weeks to get to this point.)

I just want to share a little of my experience and what I feel has helped me.

1) what you put in your mouth can make you or break you... Eat fruits, veggies, nuts, and lots of water. ( no starchy veggies). Chew your food until it is completely mashed

2) no spicy or acidic foods

3) no gluten (no bread, tortillas, rice, cookies, cereal)

4) no meat

5) water water water

6) sitz baths and warm butt pad

7) incorporate stool softners and fiber ( I have found that prunes have helped)

8) no alcohol

9) rest

10) consistently use the prescribed ointment

11) avoid lifting, pushing, or pulling heavy items

12) no cheese or milk based products (harden stools)

Be sure to seek medical help from a reputable colo-rectal surgeon. I first went to the ER then my GP and both mis-diagnosed the fissure. I then sought advice from a general surgeon and she said it was a fissure that was not very deep. I wanted a fourth opinion and found a very reputable colo-rectal surgeon who said the fissure was deep-into the muscle. She explained all of my options and I held off from surgery in hopes of having this heal. I believe I made the right choice, because it is healing. It has been a long and painful recovery. I still have the burning annoying sensation and minor pain, but it is tolerable. I can once again sit, walk, and be productive.

Please note: my fissure journey changed weekly. At the beginning I had to wear adult diapers because when my body wanted a BM I had to let it out. Some weeks walking helped with the spasming of the sphincter, and other weeks I couldn't even stand up without my sphicter feeling like it was going to pop out. Another week I felt like an ice pick was pushing down on sphincter. A few nights the pain woke me up at night. Other weeks urinating triggered spasming and the dreadful broken glass tearing pain. Now it just burns after the BM.

I know my eating habits have changed forever. I always tell myself, "I am one hard BM away from months of excruciating pain and possible surgery."

Foe those of you contiplating surgery, look for a doctor that has a lot of experience. Do not settle for a general surgeon. I read about so many surgeries gone wrong and I wonder, was their doctor experienced? Did the patient follow a good post surgery care routine?

I will continue praying for all who are suffering from this debilitating and excruciatingly painful condition. I wish you all the best in your recovery.

13

Amazing and inspiring post!!!

Thanks for sharing for other can benefit so much...

Myles

14

So, I'm nowhere near healed, but after dealing with ever changing bowel movements that were preventing healing, I decided on a regimented diet. Yes, it's boring, but the pain is almost completely gone when I go, and my bowel movements are regular. This may not work for everyone, but here is what I do:

Breakfast: 1/4 cup of certified gluten free oats, 1TBS ground sesame seeds, 2TSP of coconut sugar, 1/2 cup plus 2TBS water (microwave 3 minutes) 1 small banana sliced on top.

1/2 TBS of miralax immediately after breakfast

Snack 1: 1/2 cup of powerful yogurt, 1TBS all natural jelly, 1TBS almond butter (mix together for peanut butter jelly yogurt)

Lunch: 1 Ezekiel rice tortilla (warm) with 3oz of chicken or 4oz of all natural turkey, 1 cup of spinach, 1TBS of wild oats honey mustard

Snack 2: small Apple (i like honey crisp), 2TBS all natural skippy peanut butter

Dinner: 4oz of chicken or fish (batter with 1TBS ground flax seed, favorite seasonings and bake), 1/2TBS of fat (olive oil, coconut oil, or all natural butter), 4oz of red potato (sometimes baked, sometimes mashed with butter, sometimes sliced into homemade fries), 1 cup of steamed broccoli (or substitute 1 cup of carrots. Sometimes I make a mix of carrot fries and potato fries. Substitute cauliflower. I like to bake this in foil and then mix it in with the potatoes to have a nice heap of mashed potatoes), 1TBS of ketchup if needed.

Once I got this down, I had no more problems staying regular. I have a gluten intolerance, so,everything

15

Get to a colorectal surgeon and have a sphincterectomy.

Tried all cream and Botox. All failed. Don't bother with stupid diet. Just eat less.

My life is back to normal now. Immediately after surgery......... No pain!!!!! Amazing. Very active normal life now! God bless my surgeon

16

Dear  mmarcus151910

Thanks for your post . I had Sphincterotomy and Fissurectomy at Nov-16 .My post surgery pain was not too bad .Doctor gave me percoset but my pharmecy gave me Oxycodone , So I took only 2 Oxycodone that night . next day I went to the bathroom  for 1st BM . I did it with out pain just little discomfort with small blood . Thats all . Its now 20 days and Im feeling better .only the thing is each  after BM there is a very little blood on toilet paper . I called  my doctor office and another doctor gave me answer due to my doctor was out of the office ,So when I asked that doctor about the blood ,He told me its normal for 3/4 weeks .

Any way Im little worry about this . Hoping soon everything will be ok . I have post surgery appiontment with my doctor next week Dec-10 .Maybe doctor will remove the stitch .

1more thing is my skin tag was removed and I saw the small blood coming from that site ,So i dont know how long do I need to feel normal .

So any 1 has any experience about bleeding after 2/3 weeks post surgery?

Again Thanks for all reply . 

17

Dear  mmarcus151910

Thanks for your post . I had Sphincterotomy and Fissurectomy at Nov-16 .My post surgery pain was not too bad .Doctor gave me percoset but my pharmecy gave me Oxycodone , So I took only 2 Oxycodone that night . next day I went to the bathroom  for 1st BM . I did it with out pain just little discomfort with small blood . Thats all . Its now 20 days and Im feeling better .only the thing is each  after BM there is a very little blood on toilet paper . I called  my doctor office and another doctor gave me answer due to my doctor was out of the office ,So when I asked that doctor about the blood ,He told me its normal for 3/4 weeks .

Any way Im little worry about this . Hoping soon everything will be ok . I have post surgery appiontment with my doctor next week Dec-10 .Maybe doctor will remove the stitch .

1more thing is my skin tag was removed and I saw the small blood coming from that site ,So i dont know how long do I need to feel normal .

So any 1 has any experience about bleeding after 2/3 weeks post surgery?

Again Thanks for all reply . 

18

No problem... Glad to hear that your surgery went well. Although I did not have any bleeding 2-3 weeks afters, as far as I remember, I can tell you a bit about the skin tag. 

SInce you just had the surgery, it will probably be protruding from your anus which is normal. No need to worry, its like having a scar on your arm just in your but it looks like a skin tag and has a mark on it where the surgery was done. 

Post back what your main doctor says and I will give you my feedback. As long as the pain is gone thats all there is too worry about and be thankful for at the moment. 

Glad it went well!!!

Myles 

19

Dear  mmarcus151910

Had 1st post surgery appiontment  yesterday after 24days . so , my doctor checked  everything and said  its looks good and healing . I asked him about small blood on toilet tissue . He said its normal and it will be ok within weeks or so . He also told me he dont need to see me again . 

But I still fell bad when i saw that small blood on toilet paper .Dont know what to do ?

Thanks.

20

Do you see the blood every time you poop still?