Question:
Extremely painful Analfissure - Any suggestions
I developed an anal fissure 7 days ago- probably due to low fiber and water in my diet (and spicy buffalo chicken bites..grrr), MD gave my xylocaine ointment and nitroglycerin 0.3% ointment- I am soaking in hot baths and am sitting on a heating pad and am still in EXCRUTIATING pain! Has anyone had this problem and do you have any helpful suggestions? — ~~Stacie~~ (posted on January 4, 2003)
January 4, 2003
I had this problem several years ago -- however, it went improperly
diagnosed for over 2 years. They thought I was "merely" having
sphincter spasms or a levator ani trigger point, and I can't even describe
for you the cortisone injections and (omigod) physical therapy I had to
endure (if you think YOUR job is bad, imagine the PT's job!! Yes, she
massaged the levator ani and surrounding muscles from the INSIDE!). Then
they thought is was internal hemerrhoids, and I had those removed in
several excruciating office procedures. Finally, they decided they had to
take a good look inside, and by that time, it was necessary to knock me out
to even do the exam, so I went in and when I woke up, they had found the
fissure and treated it by slicing the sphincter muscle, to prevent the
spasms and give the fissure a chance to heal, plus they removed all the
rest of the internal and external hemerrhoids. Needless to say, the reason
I am not fearing WLS is that it COULD NOT POSSIBLY be more painful than the
fissure and the surgery for it. For about 7 days afterwards, I was in the
worst agony I have ever experienced -- finally got the doctor to prescribe
demerol pills (demerol is a godsend!). The good news is that after that,
despite having a bit of "anal leakage" for a few weeks until the
sphincter healed, the pain was finally, for the most part, gone. Now, 7
years later, I am feeling some of the same symptoms, but I think it is just
scar tissue and the excess weight I have gained in the past few years. If
you have a fissure, and you do what you are supposed to (soaking, laxatives
to soften your stool, etc.) and it doesn't get better, you may have to have
the fissure surgically treated. Be prepared for the pain (get the drugs
ahead of time, and NEVER let the pain get ahead of the medication!) but get
it taken care of -- it will get better.
— [Deactivated Member]
January 4, 2003
Stacie,I have had one for years that keeps recurring. My Dr had me do the
warm water baths,and nitroglycerine..the nitro gave me instant
headaches..but the Dr said this heals the fissure the fastest. The only
other thing my Dr had me do was to take stool softeners..I ended up taking
5 per day for a long time..but if you are having diarrhea this probably
wouldnt be a good idea!!!Also before BM use vaseline around and inside as
much as you can..it helps some...Good Luck Nancy Poe
— NANCY P.
January 4, 2003
I was diagnosed with a fissure during the pregnauncy of my twins. Nothing
worked. Finally I just decided to not complain figuring it would go away
after they were born. It didnt but by then I was so tired of doctors and
busy with the children I just kept on NOT complaining. About 6 months ago
it got so bad I started complaining...lol Still my pcp couldnt seem to
find anything to take care of it. Just recently I saw a specialist who
thinks he might have to go in and "cut" it out. Not sure what it
means but I better get good drugs. lol While there he decided I might have
irritable bowel syndrome so I have to have a colonscopy to rule out stuff.
He assured me I will be heavily sedated but I am sooooo NOT looking forward
to this. So, in the end, what I guess I am getting at...do what you can to
take care of it, be persistant with your doctor, dont let it wait almost 2
years like I did. This itching and pain is some of the worst I have ever
gone through. Good Luck!
— TheresaC
January 4, 2003
Anusol, rx cream. So far, I have avoided surgery by hitting it with this
the MOMENT I detect it.
— vitalady
January 4, 2003
I know what your are going through. After having my son, I developed two
anal fissures. Had no idea what it was, without examination the doctor told
me I had hemmorhoids. I used creams, inserts, etc. and nothing helped me.
Finally 11 months later (yes, that long because I was way embarrassed) I
went to a surgeon to get my hemorrhoids "fixed". He said good
news, you don't have them you have an anal fissure. He said sitz baths,
take fiber tablets or stool softeners everyday and try to eat a lot of
fiber all of which will enable it to heal. Although, he decided he would
operate on me instead since I had been suffering for 11 months. I was
terrified but was in excruiciating pain I would stand at the sink in the
bathroom crying because I couldn't sit down. So, I had the operation,
wasn't any kind of big deal at all. Called a sphincterectomy or something
of the sort. They make a tiny incision and locate your sphincter muscle and
cut it and loosely sew it back together. This allows the muscles to quit
spasming and will enable healing. That was in April 2002 I had it done and
still to this day I take fiber pills for fear of a reoccurance. I healed up
super and have yet to have one problem except I beat myself up for being
such an idiot about not getting help sooner. A doctor would be able to
develop a plan for you or examine to see how bad and make a determination.
I found a lot of info on about.com about the problem and procedure. good
luck!
— Dee ,.
January 4, 2003
I had (and have) problems with hemorrhoids and anal fissures mainly because
of pregnancies and being overweight. My doctor prescribed a foam that you
use (cortisone based), and recommended using baby wipes when cleaning
yourself (more thorough as well as gentle), and stool softeners per
instructions on bottle. He said if all that didn't help, then I would be
looking at the sphincter cutting procedure already mentioned. However, his
instructions seem to work very well, so when I have a relapse, I just
revert to using those methods. Good Luck!
— Angela R.
January 4, 2003
I ended up having surgery for a really bad fissure after two or three years
of trying to self-treat what i thought were hemorrhoids.
— Delores S.
January 4, 2003
Original poster here- thank you all for the information and suggestions and
openess(I know this is knida embarrasing)- heating pad feels good wish I
could figure out how to carry it around with me....oh well. pray for speedy
healing.
Thanks
— ~~Stacie~~
January 4, 2003
If the pain stays excrutiating, see a surgeon. I had an anal fissure 7-1/2
years ago. My doctor saw it and prescribed medicine. I kept using it, but
the fissure was excrutiating. I called the doctor and told her, she told me
to continue with the medicine. I called again, in agony, she sent me to a
surgeon. He took one look and told me that he could see the muscle--it had
just gotten deeper and worse-- and he scheduled emergency surgery. I
learned from that to trust my body more than any internist-- if you are in
terrible pain, see a good specialist. Good luck!
— Beth S.
January 4, 2003
Stacie,
I really sympathize with you. I had an anal fissure 4 yrs ago, and I would
literally cry every time I went to the bathroom. I saw a colorectal
specialist, and he recommended the same things you're doing -- high fiber
diet, soaking in warm water, etc., but nothing helped. I went back to the
doctor & he said the next step was surgery. I had surgery, which was a
day surgery, & the relief was almost immediate. It really wasn't that
painful -- the pain trying to go to the bathroom was worse than the pain of
the surgery. It was worth it to be rid of that agonizing pain. Good luck,
and I hope you feel better.
— Dana B.
January 4, 2003
My mom had this probelm a few years ago, and was in excruciating pain. The
only thing that worked for her was Metamucil. She still swears by it today,
and is completely healed and pain-free.
— Patricia E.
January 4, 2003
I also have a fissure that opens up occassionally and you are right,
painful it is. I don't have anyting to add as far as basic treatments
(fiber, soaking etc.), other than prescription suppositories might work
better than ointment.<p>I also saw a surgeon about 18 months ago but
he advised me not to do surgery due to my weight. He said that very
overweight people (I probably weighed about 375 at the time - 5'9) can end
up with too much pressure on the sphincter and end up with bowel control
problems. He did not want me to live that kind of a life. This is the
surgeon who did my galbladder removal and I know he truly had my best
interest at heart. I have been doing fairly well without supplement but
occassionaly it flares up. For about 3 years I took Metamucil at night, I
never found it bad. Used the sugar free kind and you must mix in COLD
water. Then it dissolves well and isn't as gritty etc. Personally the
orange flavor was fine. I already have decided I will be going back on
fiber supplement after surgery. My bowel does not do well if it isn't
working daily. I have a lot of colon motility issues as it is. Just using
the prep for a colonoscopy sends my colon on a trip. I have to get back on
food right away and get the bowel working or I am miserable. I am somewhat
concerned how it will be after surgery because I can't eat anything solid
for a week but I will most likely ask the surgeon to prescribe something in
the hospital. Not an embarrasing question! Something you needed an answer
to and I'm glad all of us had some advice for you.
— zoedogcbr
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