Anal Fistula or not, & Unanswered Questions

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Anal Fistula or not, & Unanswered Questions

Postby mindfulnesshealing » 13 Oct 2012, 17:05

Before I begin, I want to thank the people who put this site together. Without your help, support and recommendations I'm not sure where I'd be today. Thank you to everyone for your thoughtful words and details remarks. There are so many questions regarding procedures, treatments, pain remedies and diet, and being analytical I have put myself through them all. My focus has always been to heal myself naturally and develop a diet for life, not just for now. I believed that this would help my healing, as well as give me better habits for future health as I realize this is a long term affliction. I suffered from constipation and hemorrhoids since my early 20's and I decided this wasn't going to work for the rest of my life, especially when I realized what anal fissures were. I had no idea this condition existed!
I've had anal fissures since March 2012. Since March I have never spoken so much about stool, diet and treatments in my life. My husband has been my dearest friend and life partner and his support has helped me through the darkest days, the rest has been shear patience, tears, will power and more ointment than I ever wanted up my ass. My physical and emotional strength have been battered and I am not sure what's next.
Today my pain subsides daily around 2-4pm, however this is not as good as it was in July when pain was minimal by 12 noon and I felt I had improved to being 80% well.
Now, a part of my bum pops out with every BM (since August) and I have to ease it back in with a wet tissue. I also have had puss on the TP every day following a BM and this has been happening since Sept 3rd, and it is now October 13th. I do not have blood which I did have at times in September, but the puss worries me as its new and it means infection.
A recent Dr's appointment suggests that I may have a Anal Fistula. Without an examination under anasthesia they cannot say for sure. I was prescribed to take Proctosone daily, following a BM and before going to bed and see if the condition improved within a week. I supplemented with Niphedipine 0.9% which has worked in the past and after a week I have not had much change, but maybe a little.
An examination under anasthesia scares the shit out of me. If they find something they will want to perform the necessary procedure and I could wake up with less of a bum.
I have had difficulty finding answers to some questions I have. If you can help, please do:
-When using Niphedipine ointment, how far into the anal canal do you insert it. Is 1" deep enough? I understand it it to go into the inner sphincter. Any advice? I usually apply this 1-3 times per day.
-Has anyone developed an anal fistula from a fissure and do you have any advice if it can be healed without surgery and how you can tell if you have one?
-What kind of an examination did you have to undergo to know you had a fistula and not a fissure?
-Has anyone else had puss with a fissure? No one has spoken of this anywhere. If so, were you able to heal it and what helped?
-Has anyone had to manually ease part of your bum back in following a BM and if so do you have any recommendations on what may help this condition? I assume it is weak and inflammed veins around the fissure which may also be a source of puss.
-Did anyone find that daily but firmer stool (not hard, but ends with a clean cut and not a messy wipe) made the fissure heal quicker? I believe that a period of time when I had messy loose and explosive stools made mine worse and I'm trying to decide if I need to add more fibre to my fibre rich diet of 30-40grams/day or take out some water.
-If you are 125 lbs, how much fibre in grams do you take per day in your diet, and does it help?
-For those who have had surgery, did you have a general surgeon or a colo rectal surgeon perform the operation and what are your results today?
-As I normally choose the natural approach to healing, I have chosen not to use a stool softner or a laxative and instead followed a very strick diet. I have had daily bowel movements since April 2012 and they have not been large or hard. Does a stool softner make soft stool not as wide to pass or just watery? I would consider taking a stool softner if allows passage of stool without making it loose but I'm not sure I need one. Any advice?
At this time I am willing to try anything that may help with healing before deciding that surgery is the only option.
Thank you kindly for your feedback. Image
Mindfulnesshealing (or Jbird)
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Re: Anal Fistula or not, & Unanswered Questions

Postby Ever the Optimist » 15 Oct 2012, 15:23

Hi again JBird,
I responded to your posting on another thread but I'll try and help you out here too with some of your questions.
Always get referred to a fully qualified CRS as they are the specialists in this area! I wouldn't recommend a general surgeon and I think a lot of people would agree with this.
An EUA is one of the best ways of getting a good look at the area causing you NIL pain as you're out cold, which I add quickly, is NOTHING to fear I promise! It's a very quick minor procedure and the GA and local anaesthetic they generally use actually keeps you pain-free after for a few hours. I've had two so far and no issues at all - so glad it was done this way!!! This method will detect pretty much anything going on - They found my fissure first and then fistula and internal piles in using this method.
If you do have a fistula, it will need surgically treating and I recommend you just do it asap and get your life back to normal. Fistula tracts can grow and you want it sorted as early as possible. They do NOT go away by themselves. Fissures, on the otherhand, can be treated by creams and more conservative measures, such as hot baths/ good diet and lots of fluids unless they become really chronic and then people start begging for surgical intervention because they just become too much of an intrusion on their life!!....
You mention the part of your bum that "pops" out....Could this be a prolapsed internal pile? possibly a skin flap/ tag? but I don't believe these generally ever pus. I think you need to get that pus issue discussed asap with a GP maybe?
With respect to your diet sounds like you have a good regime going on there. That's really a personal thing as you know your body and BM's best. I do take Lactulose every evening and a big tablespoon of extra virgin olive oil before bed and these act as my stool softeners.....They don't make my stools any bigger just ensure they are well formed, soft, lubricated and smooth, especially for my first BM of the day, which is never an issue. Too much fibre intake on the otherhand will bulk out the stool making it larger and harder, so just don't overdo the fibre and go for the soluble fibre rather than the insoluble (soft tinned fruits/ beans/ veggies/ oatmeal etc. rather than the harsher "All Bran" type/ too much bread (wholemeal) etc....) I would add however that too much of certain fruits can make my stools really loose and chocolate too, so I don't overdo things like plums/ grapes/ apricots etc. Apples and pears work great!......
Here's hoping this has helped and you get it all sorted soon and back on your way to normality :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Anal Fistula or not, & Unanswered Questions

Postby Ever the Optimist » 15 Oct 2012, 15:30

I also wanted to add that this stuff certainly takes it's toll mentally. I ended back up on anti-depressants to help get through it and it's wonderful you have the support you do. I'm very fortunate too.
It might all seem that it's all you think & talk about at the moment but believe me, you will get better. It just takes a bit of time and a lot of positive thinking but week by week and as you get it sorted and start to feel better, you'll start focusing on it less and more on other stuff, and in turn won't feel you even need to mention it so much anymore.
I got my fissure last December (great Xmas!) and then an abscess followed by Fistula in March. Fissure had gone by end of March and I'm now 3 months post fistula op and honestly, feeling better by the day. I'm almost normal again!!! Hang in there. You WILL get better!!!!!!!!!!!
Image
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Posts: 1625
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Re: Anal Fistula or not, & Unanswered Questions

Postby mindfulnesshealing » 17 Oct 2012, 12:28

You are so kind and what an appropriate name, "Ever the Optimist". I appreciate all the information you shared and your comments on a good diet. This has been the worse time of my life and as I came back from being in such a whole, I wanted to cure this on my own. As I am concerned with my current condition, and even though the popping out and easing back in seems to be the worst of my pain at this time, the puss does concern me and should be looked it. I believe the popping out is from a Thrombosses Hemorrhoid, which is swollen internally and may have a fissure attached to it as well. As I have not seen much improvement in the size or swelling of this, I am not sure I can do anything to help it heal. I am planning to go for an EUA within the next couple of weeks. I will allow the Fistula and Absess fix do be done at this time if they present themselves and may hold off on the Fissure ops at this time. This way I will wake and not have to do the EUA a second time to review the options.
For your Fistula, do you know what procedure was done on it?
Have you had any internal hemorroids removed.
How long did it take you to heal following your procedure?
This has definetly been the worst year of my life. I have never been in so much pain, indecision, or under more emotional stress. I feel bummed that I have not been able to heal this without surgery. I have done everything I can, and know that before taking the next step which gives me some comfort. I am sorry to hear that it has also taken a toll on you. It sounds like the anti-depressants have been helpful getting you back on your feet. I too believe that it will get better, every day is a new day and there is so much to be thankful for and appreciate. Wishing you all the best for a good day today xo Image Image
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Re: Anal Fistula or not, & Unanswered Questions

Postby Ever the Optimist » 19 Oct 2012, 07:16

Hiya, Image
I so understand you wanting to get this all cured without surgical intervention. I'm a bit like that myself, bit stubborn, preferring natural healing and hate even taking painkillers! (which I've rarely done through the whole ordeal)...BUT a fistula does NOT go away by itself. An abscess must be drained properly and a fistula must be surgically removed and honestly, in my state of depression over it all, I just reached the point where I didn't care anymore. I just wanted it gone!! and I was so relieved to get it done!! and I am SO glad I did!....Also bear in mind, you've done nothing wrong to cause this, sometimes we are just unfortunate enough to be afflicted by these things and surgical treatment of it is your only option.
Tbh, I didn't even realise I had internal piles until the EUA revealed them, so no work needed there but if a prolapsed pile is giving you issues/ pain, just let a good CRS do what they need to do to remove that pain and stress for you. You really don't need that horrible experience of dealing with it every time you go to the loo and you shouldn't have to. Most CRS' won't touch piles unless they become really troublesome, inflammed, severly thrombosed so I'd really push for that to be sorted. You can't live with that Image

My surgery was a simple fistulomy for a very simple & superficial fistula. It was caught really quickly, so easily "deroofed" within 20 minutes and left open to heal naturally from the inside out. (Imagine just cutting the top half of a tunnel off, so it leaves the bit underneath to heal up) It didn't interfere with my internal sphincter muscle, so no need for a Seton, which some people do have placed.
It healed fully within 8 weeks although the internal healing and scar tissue take a few weeks longer. I'm 4 months post op and pretty much back to normal! I do have ocassional soreness/ discomfort after a BM but not always and I am feeling SO much better - almost back to my normal self!!!.......No more pus or anything nasty anymore. SOOO much better, bum-wise and mentally!
The first half of this year has to-date been my worst ever also with all this, having never suffered any anal issues before. Honestly, I just wanted to go to sleep and not even wake up some days as I knew what lay ahead but I promise, bite the bullet, get the surgery done that you need and yes, there is the recovery to get through but it is so worth it in the end. You need your life back and the realisation that it is worth living!!!
I'd completely agree with you in getting that fistula and pile sorted first and then focus on the fissure. My fissure disappeared when they performed my Fistulomy! so following that surgery, I didn't actually have to worry about that anymore. I did use Dilitiazem cream for 7 weeks prior to that though and am 100% convinced that that also contributed to the healing of it. I was advised to insert that internally also, about 1 cm in length (span of the top of my finger) and I was able to get in it quite deeply if I took a few deep breaths and relaxed in a comfortable position to do so. This could be an alternative for you to consider???
Pls keep us updated, get that pus checked out (you will probably just be prescribed anti-biotics for a week or two to help sort it out and in case of infection) but even anti-biotics will not "heal" the fistula, they will just keep a potential infection under control and ease some discomfort for you. As long as the fistula is there & formed, it will continue to pus on & off anyway. Hence, the need for surgical removal.
All the very best to you. You WILL get through this!!!!!! Image
Image
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Re: Anal Fistula or not, & Unanswered Questions

Postby mindfulnesshealing » 23 Oct 2012, 12:14

You give amazing feedback and insight and I appreciate all your insight with this experience. Emotionally, it does get me wondering how it occurred and why. Both not helpful in the healing process. Thank you for encouraging me to move forward and for letting me know that there is light at the end of the tunnel. I have scheduled an appointment with a Colo Rectal Surgeon on Nov 15th, and I look forward to knowing more and moving forward. Hot baths have really been helping me these past 2 weeks, so I am continuing with these daily. I will stay in touch. Thank you from the bottom of my heart for understanding how it feels.
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Re: Anal Fistula or not, & Unanswered Questions

Postby Ever the Optimist » 23 Oct 2012, 13:43

Hi,
Great news on getting your appointment sorted! Another step forward to getting yourself back to normal!..
I'm so happy that I can just provide you with the reassurance you desperately need right now. I am also so grateful to others on this site for all the support they have provided me with, at the times when I needed (need) it the most too.
Emotionally, I went through (and today, sometimes too) that mental process of "Why me?"......I'm healthy/ happy/ always very open, honest, giving, loving to others. I'm not a bad person - What did I do to deserve it all? Why am I being punished? "...but I think I just reached a point of acceptance in myself that it had happened to me and for no particular reason, just bad luck, probably not helped by childbirth and mild IBS and eating the wrong things back then. I just got to a stage where instead of dwelling on it, I just wanted to act to get rid of it all and move on. It's interesting because I really do believe in the mind-body connection and do partly believe that the symptoms of an anal issue could be linked to being "anal" in yourself in some respect and could be attributed to by unresolved spiritual/ emotional/ mental issues . I think it was in a Louise Hay book I read the following:
Anal fistula- Incomplete releasing of trash. Holding on to garbage of the past. (I am guilty of this!!!)
Anal pain- Guilt. Desire for punishment. Not feeling good enough. (Yes, sometimes)
Bowel problems- Fear of letting go of the old and no longer needed. (Yes, a little as I age!!)
Anal abscess- Anger in relation to what you don’t want to release.
Chronic disease- A refusal to change. Fear of the future. Not feeling safe.
Abscess- Fermenting thoughts over hurts, slights and revenge. (Also guilty of this although try my hardest not to be!)
I also looked at my sore bottom in terms of maybe needing to get off my backside more!! It's interesting how everything flared up just after we relocated to an area where I pretty much need to drive everywhere now but prior to that I walked for miles, spent far more time off my backside than on it!!!
Honestly, I've spent hours analysing the possible underlying causes of this whole thing but the bottom line is to definately get active, moving and to get it sorted and cured!!
Hot baths are fab! I always have two daily :)
Please let us know how you get on with your CRS & be in touch anytime you need to Image
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Posts: 1625
Topics: 24
Joined: 12 Apr 2012, 16:00
Location: UK
Has thanked: 62 times
Been thanked: 102 times
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