Hi,
I have a really good CRS who is one of the top in the UK, he is private consultant from Harley Street and is a trainer of surgeons. He has given me some great advice and has answered many of my questions via email after consultations. I also have a very good doctor who diagnosed my fissure from day one – she has seen many people with fissures and knows a considerable amount about them. Therefore I thought I would share some of the tips they have given me as well as answers to a few of my questions.
I hope this is of some use to people who are also suffering from a fissure at the moment.
SOMETIMES THE FISSURE PAIN SEEMS TO IMPROVE THEN OCCASSIONALLY I WILL HAVE A BAD DAY EVEN THOUGH MY FOOD DIET DOES NOT REALLY CHANGE – WHY WOULD THIS BE?
CRS: The variability of a fissure is extremely common, the explanation for that is really uncertain. Some people beat themselves up trying to blame a piece of food they ate the day before but on most occasions that’s not the case providing you have maintained a high fibre/water intake. The healing progress of a fissure should be measured over a week (and never daily) therefore if you have two bad days with a bit more blood and soreness than usual you should not be concerned as two bad days out of seven would indicate that you are overall improving.
IF THE GTN DOES CLEAR THE FISSURE, IS THERE A GOOD CHANCE THAT THE FISSURE WILL RE-OCCUR AS I HAD READ THAT I WOULD BE AT A GREATER RISK?
CRS: Yes it is true that following repair of a fissure there is a period of time where you are susceptible to further fissures; the feeling is that ultimately that will not be the case when the fissure is healed sufficiently. What is very important is that you stick to the full 8 week course of GTN regardless of whether you achieve complete pain relief and it looks like it has healed. Too many people return to their old ways before full healing has taken place.
Doctor: What people must remember is that something in their diet caused this fissure in the first place therefore if you go straight back to your original diet upon healing then naturally you are going to be at risk (otherwise you would not have got the fissure in the first place). If you were to incorporate additional fruit, fibre and water intake into your original diet then the risk of re-occurrence would be greatly reduced.
I HAVE READ THAT APPLYING WHEATGRASS CREAM CAN HELP WITH THE HEALING, IS THIS CORRECT OR JUST A SALES PITCH BY A SUPPLIER?
CRS: I have not heard of the use of wheatgrass on healing fissures, I imagine it will probably do no harm, it may do some good but there is always a risk of sensitivity to the skin and at the moment if you are winning with the GTN I would probably stick with that.
WHAT ARE THE CHANCES OF SUCCESS WITH GTN AS I HAVE READ MIXED REVIEWS?
CRS: The success rate we see with GTN is around 70% success – As a rule of thumb you should notice a considerable improvement in pain relief within two weeks, if this is not the case then the chances are it probably won’t work for you.
OTHER TIPS FROM MY CRS
Keep taking the GTN (0.4%) twice per day for eight weeks and DO NOT stop even if the pain clears up altogether.
Take Ducoease stool softeners three times per day
Take Magnesium tablets once per day
Take one sachet of movical (Miralax) before bed each night
Drink at least 6-8 glasses of water per day
EXERCISE! Treadmill and X-trainers are fine - Exercise bikes are not.
Keep eating fibre and do everything possible to avoid constipation
Do not strain during bowel movements
OTHER TIPS FROM MY DOCTOR
Do not feel anxious about the fissure. Although it is horribly painful, it is not a dangerous condition
Never avoid going to the bathroom – The more you put it off the larger the eventual BM meaning more pain and a longer healing time
Use cotton wool with warm water rather than toilet paper after each BM
Drink at least 8-10 glasses of water each day