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.
HI jo,
I want to start by saying you are in my thoughts,i had my first bad attack about 2 years ago. I was given a prescription by my doctor for Laxido which is a white powder taken with water which i took before i went to bed this loosens your stools to make going to the toilet a lot easier and Rectogesic ointment.
Because my anus was so painful to insert this i put it around the outside of my anus and this seemed to ease the pain,and in time i was cured.
But then a few moths ago it came back i dont know why because after suffering with the horrendous pain it makes you more aware what you eat etc.
I went back to my Doctor who repeated my prescription but for some reason the pain did not go away,he reffered me to a Consulant at a nearby Hospital.
I was admitted as a day patient my Consultant explained to me what was going to happen because they cannot stitch a fissure they use Botox its like a pollyfilla,which last about 3 months. I was given a General Anesetic, i was given pain killers when i left the hospital but have not had to take any at all.
My operation was 2 weeks ago im still taking Laxido which still helps my stools to be much softer,but i will at some time stop taking it.If for some reason i have not gone to the toilet for a day will take Laxido again.But im now pain free fingers crossed .
Just a thought Jo maybe go and have a chat with your Doctor about this treatment like you i felt i had no choice,as i could not put up with the horrendous pain anymore.
Wishing you all the best Jo thinking of you and many others.
Take Care
Clive.
Hi Jo
I hear you and understand... I bet you have a high stress job or you are a high achiever, or you are just scared full stop- this is part of the problem.
Getting stressed and anxious won't help. I have been meditating and getting accupuncture for the spasms (which is the reason mine is taking ages to heal). Believe me- I am a stress head w a stressful job and was very worried about work too.
In short term this is what you need to cope:
A) a day pack full of rectinol, sudo cream, rectogesic, cotton wipes,a bottle of salt water and a hot water bottle. Sit on it constantly. The heat to the area opens blood vessels, relaxes muscles and promotes healing. It's the only thing that relieved my pain. Drugs don't help. I haven't wiped w toilet paper in 6 months. Always use wipes and warm salt water. I made it work.
B) a glass of wine- it helps you relax
C) Start more laxatives and eat less meat and carbs. Smaller meals more frequently
D), 3 litres of water a day and ducolax. Can't have solid bm. If your bm are too big you are still eating too much
E) exercise a lot more- increased blood flow gets things moving
F) coconut oil- it's amazing health benefits will help in a million different ways. Eat it and apply direct to fissure
I was ready to have botox and thought no way- my body can beat this and it can! Remember- this is short term, non life threatening and your body can heal. It's a cut, what do u normally do w a cut? Bandaid and try not to touch or move. Ie loose bm
You need to be strict and above all try to be calm. Download meditation apps on your phone and do it as soon as you wake up. Look at it this way.. You worry you have a fissure, you don't worry, you have a fissure... One is more beneficial than the other. Accept it will be like this for a small period of time.
I was in a very bad way and I'm much better now. Every ones journey is different but no one speaks about the mental change you need. Remember a fissure is a result of something. It's a symptom- think about what made it happen in the first place.
Also- this is your body reacting to something... It won't change over night. You must persist.
Good luck .
Boy do I know that feeling. I managed to stay at work but not sure how I did. Fybogel twice morning and night although I find drinking more water didn't really have much impact on me. I bought a portable bidet - a sitz bowl for the loo from Amazon. Only £6. Best thing I ever bought. It is essential to be scrupulous in cleaning so immediately after going to the loo it's a 10 to 15 minute soak. I did this more than three times a day. Sitting in warm water really helps and negates the need more any further cleansing with paper etc. It really eased the pain. I took solpadeine for pain relief as I found lesser painkillers ineffective. The rectogestic gave me an instant headache and didn't really work. What's worked for me is also Boots own haemorrhoid pessaries containing lidocaine and a non steroidal healing content. Laxatives like dulcolax stimulate the colon and rectum and if you are too loose it makes things worse . I'm sorry youre suffering so much. I really understand the pain. Get well soon
Heal from the inside out. Get a juicer and drink it all day long. To heal fast, no food just the juice. 2 apples 2 beets(good size)and a bunch of carrots. Lots of carrots. It takes about 3 days You will feel better. Depending on the severity of your fissure you will have to do this for a while. But it works. Use a stool softener and an enema. Get a big jar of Vaseline and make sure you don't damage yourself with the enema. In the morning, use either warm water or urine(urine works best because it heals you somehow. I know it's gross) and gently squeeze it into your rectum. Go lay down sideways for at least 20 min. Then let the fecal matter fall out without pushing. Do this every time you have a bowel movement.
If you must eat solid food then have spinach, apples,carrots,Brussels sprout....things like that. Cook the veggies first. Raw may be a little too rough for your system right now.
Also, in the morning before I even drink my water and take an enema, I take ibuprofen. That helps me not faint from the pain.
Next, you must start exercising! It's important. Gently. No weight training or squaring because it might hurt you. Go walking jogging or swimming. Do not stay home. Go to work!
It's extremely important to make sure ALL of your fecal matter is out your system before you start your day. The real pain comes because your anus is spasming and trying to hold in what you didn't defecate out. With this procedure that should work. But don't be in a hurry to jump into the bath if your body is not finished pushing it out.
Last but not least. You must permanently change your diet. No more white flour, red mead ,alcohol, or anything that will make your stool hard. You will be so happy in 3 days but don't be fooled, it takes a long time to heal. Give this process a few months. Never go back to the way you ate before. You are damaged and the fissure can come back. After a few months slowly add food to your diet. If you happen to have a hard stool in the future, use an enema to loosen. No hard pushes ever again.... Good luck
Hi jo. I had my anal figure about a month before I sought help. One of the most important things for pain management is to get those stools soft. Large stools will keep tearing the fissure and it will never heal. If fybogel isn't working you need a different laxative ASAP. I take movicol, three sachets a day do the trick for me, my bms are like cotton wool! I would recommend getting a prescription for movicol and you'll need to take it for a while even after you've healed.i keep in regular contact with my Gp regarding this. Sits baths with coconut oil gave me the best pain relief after a bm. If I couldn't have one after a bm I made sure to have a sits bath twice a day at least. Also rubbing the coconut oil on my anus helped. For my diet after discussing with my Gp i decided to give my system a break and stay off solid food for a few weeks so soups and smoothies have been on my menu. I use myfitnesspal to make sure I am getting enough. Keep away from foods that can constipate and up the fibre and water intake. I am about a month into this and am completely pain free. I hope this helps, good luck!
Hi Jo,
I am so sorry that you have to deal with an anal fissure. They truly are one of the worst pains imaginable and it is almost unbelievable that something so small could cause so much pain. When I had my fissure, I was bed ridden and did do some things to help it that you can try. Apply coconut oil to the area may sooth it. Also, calmoseptine cream which has menthol in it adds a cooling effect. When going to the bathroom, try to squat instead of sitting on the toilet as this reduces the strain that you have to put in when you poop. After you poop, make sure to pat the area with a wet piece of toilet paper rather than rubbing with a dry one. Take a shower after pooping to make sure the area is very clean. Moreover, make sure you take fiber supplements such as Metamucil, and that you are drinking lots of water. Do not eat spicy food and avoid eating anything that is sharp, such as watermelon seeds. The doctor I had prescribed me diltazem cream which apparently helps the sphincter muscle to relax, although it did not really do much in my case.
In the end, I had a chronic anal fissure and had to undergo sphincteronomy surgery on my sphincter muscle in order to allow the fissure to heal. Hopefully, you will not need the surgery but I have to tell you from personal experience that the surgery literally saved my quality of life.
I wish you all the best Jo and hope that you have a quick and non-stressful recovery. I am so sorry again that you have to go through this as no one should have to go through something as painful as this. You are in my thoughts Jo and I hope you get better soon.
Myles
Thanks to everyone who has replied to my original post - I am very grateful for all your advice and words of support - there are quite a few things there that I will try, and just hope that sooner rather than later the fissure will heal. I suppose I should look on the positive side - I have been trying to lose a bit of weight for a while and now it has happened without me really trying!! Best wishes to all of you suffering from this really horrible condition.
Hi Jo. I tried it all. I had suffered 9 years and it was complete agony, I would have to pant during a bowl movement, it ripped me each time. It didn't matter what I done that blasted tear would never heal. I think from my understanding after having them so long they become chronic like mean and then the muscle goes into spasm each bowel movement. I did have the op in the end. Prior I had 3/lots of botox which helped but didn't heal. It was ruining my life completely. I begged my consultant and they done the internal spincterectomy in may this year. I am 3/months on now and healed totally. I've had no incontentence problems and am so glad I went for it now. Try all the things suggested as they may help u. Prior to my surgery I found anusol pesserys helped ease the pain temporary. Since surgery I have found calmoseptine cream very brilliant. Very calming to the use sensitive area. Good luck xxxxxx
Hi Jo - pleased to hear you're looking on the bright side! I think most posts include everything you need BUT in my experience I would...
1. Stop taking Fybogel right now. It makes your stools too 'normal' and you need totally loose stools so you don't have to strain in any way. I used 30ml Milk of Magnesia taken before bed. I just found it worked for me and you can take it every other day.
2. Get some Instillagel from ebay - it's numbs you and it's an antiseptic. Amazing stuff when you are in total agony.
3. Use coconut oil and do not wash with soap. You need to keep your bum moist and coconut oil is a natural healer.
4. Use wet wipes only and have a bath after your morning bowel movement.
5. Buy an electric heat pad and use it all day - it relaxes your bum muscles and that is the ultimate goal. You need to relax your bum so it can heal.
6. Always squat and breath out when you go to the loo. Do not strain... ever!
7. Take garlic and vitamen C and just generally start taking care of yourself. This is the key. Almost everyone with an anal fissure has been through a period of stress or they are not looking after themselves. You need to relax and breath.
8. Eat lots of fruit & veg, drink lots of water and avoid white bread, pasta, white rice or anything that could bung you up!
9. Do gentle exercise like walking or yoga.
It's take me 4.5 months to heal - I had two anal fissures and I knew I could heal them myself and I've done it. You can do it too if you just follow the steps above. I know I will have to be very careful for the rest of my life, but it's made me reassess my life. I've lots some weight and I eat really healthily now and I have massively reduced my alcohol intake. Basically, it's your body telling you that you have to change some things, so listen to your body.
Hope that all helps and good luck x
i have the same problem and maybe not as painful as yours, it still is very painful and I dread the first bowel movement in the morning, after the first poo comes out I know that the pain will lessen but its the starting thats the worst, on some days I nearly hit the ceiling and cannot sit down or if i do, I must sit on my side, what I have found is and I am not saying that this is correct but it helps me I get a hot water bottle and this seems to ease the pain but the hot water bottle sooths also the spasam as well ok this does not cure the problem, but its just getting the right food right as well but I have looked on this forum and finding others with the same problem or who have the problem much worse than me at least we can all help each other by trying different ways of coping , it getting through the days hwne it is bad but I find that husks and cereals help also fruit and veg and water
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 hell
. 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!!!!
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.
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.
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
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.
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.
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.
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
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