I have an AF -- what should I know?

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I have an AF -- what should I know?

Postby Deleted User 5 » 14 Jun 2009, 15:16

I have started a stickied thread for all newcomers or lurkers who just want to read and get info on their anal fissure. Sticky means it will always be here at the top.
Hopefully this will help prevent the creation of threads that cover topics that are already scattered all over the board. Please, boardies, chime in and add info here, whatever you can think of that will help a newcomer tot he board. I'll start a sticky info post for the surgery board, also, so you LISer's and even Hemmorhid and Fistula folks can add info to that thread pertaining to surgery.
If you feel my advice is off, or incomplete or just want to add something, please speak up...the purpose here is just to provide as much information as possible in this one thread (plus the surgery sticky thread) and let AF sufferers sort through it for themselves!
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Re: I have an AF -- what should I know?

Postby Deleted User 5 » 14 Jun 2009, 15:33

Diet: It is important for otherwise healthy adults to remember that they need to keep their digestive system regular, with daily trip(s) to the toilet, and avoidance of constipation which can result in hard stools that will (re)-tear the fissure and cause the pain levels to skyrocket. So, fruits and vegetables are a must, although veggies should be cooked soft to avoid "scraping" as they pass the fissure. In the same vein, things like peanuts, potato chips or any hard food that may not digest fully can also do damage as they scrape past a fissure.
Try not to get *too* much fiber as you can then have larger than normal stools which will make your pain worse. But you definitely need adequate amounts and natural sources are best in my opinion...
Junk, processed foods can cause harder, lumpy, mis-shapen stools that can wreak havoc as they pass out. Large portions of meat probably do the same thing. The tougher the meat, the worse damage it may do. So fish would be preferable to steak (darn!).
In my own opinion, an AF sufferer needs adequate water intake, but personally, *I* wouldn't over-do the amount of water ingested, just get the RDA -- although I doubt anyone who drinks several liters a day is doing any harm -- just don't get dehydrated, that is very important as that can dry out the stool.
Stool softeners are de rigueur for any AF sufferer, but you may have to experiment to see what works best. Colace, mirilax, milk of magnesia, there are many types but try to avoid those which are classified as stimulant types unless you really need to use them.
Hot soaking baths are VERY important as they not only soothe (they really do!) but they also bring much-needed blood flow to the fissure site.
Which brings me to one point that is common to the majority of fissure folks...the reason that bad boy will not heal is most likely your rectal area is too tight, because the sphincter is exerting an abnormal amount of pressure. This restricts the blood flow to the fissure and prevents healing.
There is so much more to add...ok, boardies...if you think of something here's the place to post it!
Last edited by Savaici on 02 Oct 2015, 06:27, edited 2 times in total.
Reason: typos
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Re: I have an AF -- what should I know?

Postby cherylk » 14 Jun 2009, 15:43

These sticky threads are such a good idea, Kim. We continue to get new people, and then we all repeat to each new person basically the same thing (our views) over and over. I would add that I am learning to tell my muscle to relax and am measuring the muscle tension scientifically with a very sensitive sensor. This would probably not be possible nor practical for most others as I am in a special class for it. But we can all try to tell our muscles to relax although that can be very, very difficult when one is dreading the bm and worried how much it will hurt or in my case, breaking out in a cold sweat in the am in anticipation of what might happen.
Again, Kim, great idea to create these threads. Image
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Re: I have an AF -- what should I know?

Postby pinky » 03 Jul 2009, 16:48

Great idea Kim.I was just thinking this morning how we repeat everything to a new comer on board.didnt think of this idea.very impressed!
Am i supposed to advice only on diet now?sorry,dumb question.its 2345 and im finding it hard to be awake.
Youve covered most of it on the diet.Probiotics is good for digestion.Yoghurt digests easily and good for digestion and a good source of calcium as well.Ive never had problem with dairy foods esp yoghurt but everyone is different.try to avoid gas forming veggies during AF like cabbages,onions,potatoes etc as blowing wind can be very painful.Chew your food as much as u can no matter wat u eat esp hard foods(better to avoid them as kim as mentioned).

Try to shower the area after BMs to keep it clean instead of using a tissue.If BMs are very painful,can try lignocaine gel(for a short period of 2 weeks) or even vaseline to slide it down.Vaseline is a great coating when u have diarrohea as it forms a barrier from the acidic stools which burns and damages the area.dont linger on the toilet as it puts more pressure down there.

Exercise is also important for good digestion.walking is the best option for AF suffers in my opinion.it also increases the blood supply to aid in healing.No heavy weights or strenous exercises.

Lots more to add but too tired now.will add somemore tomorrow.
hope this helps
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Re: I have an AF -- what should I know?

Postby buttgirl » 12 Jul 2009, 14:07

I know I have been gone for a while, but I did want to add that my saving grace--the one thing that made and still makes the most difference for me--is fiber water. What I do is mix about three tablespoons into a quart of water and carry that around with me during the day. I also have a tablespoon or so of the fiber in my evening tea.
Drinking the water intermittently throughout the day both keeps me hydrated and and keeps the stool consistently soft.
Also, making sure i have adequate dietary magnesium is also a must. I guess mine tends to deplete rather quickly when I'm stressed (which is more often than I'd like), so I take 250mg/day still, more on high stress days. It makes a difference not just in my bm, but in my feeling of well-being.
Last edited by buttgirl on 12 Jul 2009, 14:21, edited 1 time in total.
Reason: added about mag
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Re: I have an AF -- what should I know?

Postby NeuropathicGuy » 21 Aug 2009, 15:09

Hello folks, I've been wrestling with my fissure for a few months now, and am far from healed, but feel that I've learned enough where I can contribute a bit now about what's helped me. It took me a lot of severe pain and a very urgent, unbearably painful trip to the emergency room to really get serious about tackling this thing using every means necessary.
DISCLAIMER:
I don't know if any of this has actually helped heal my fissure any, but it's certainly reduced some of the incredible pain associated with and following bowel movements.
DIET:
I eat a daily regimen consisting of high fiber bran cereal (the Fiber One brand is great for this), sushi (with brown rice if available), soy beans (edamame), and boiled vegetables (mostly broccoli, cauliflower, carrots, and cabbage). Note that the boiled part is critical; when I was eating raw vegetables in salads, they didn't digest nearly as well. For protein I've found that small portions of boiled fish and boiled chicken work well for me. Any fried foods are a major no-no, in my case anyway, as they come out rock solid at the other end.
STOOL SOFTENERS:
For me, Miralax (Movicol overseas), whose ingredient is polyethylene glycol, has worked the best for me. In my experience, it works better than docusate sodium, which is what my physicians typically suggest first. Miralax is strong, however, so adjust the doses as necessary for your own digestive tract (too much can sometimes cause diarrhea). I personally split a full day's dose in half and take one part after lunch and one part after dinner. It tastes weird at first (like plastic water) but you get used to it quickly.
TOPICAL HEALING OINTMENTS:
I have tried both 0.2% nitroglycerin in aloe vera, 0.2% nifedipine in petrolatum, and a combination of 0.2% nitroglycerin / 2.0% hydrocortisone / 5% lidocaine. For me, the nitroglycerin based ointments provide the most short term symptomatic relief (i.e., they reduce pain and calm down the sphincter spasms), but they also come with a throbbing headache as a very overt side effect. The nifedipine ointment does not seem to give me much short term relief from symptoms, but most literature I have consulted seems to suggest it offers better long term healing rates. I alternate between the two every other day (but never both at the same time as this can potentially lead to sudden hypotension!) as I figure a combined approach likely wouldn't hurt. When applying the ointment, I put a little inside the anal canal using a syringe, and also rub a little around the anal opening using a finger.
TOPICAL PAIN OINTMENTS:
If I have an inkling that a particularly painful bowel movement may be coming, I use an over the counter product called dibucaine (brand name is Nupercainal) around the anus a few minutes before the bowel movement. This can help numb the pain a little bit, although it will not completely eliminate it. I have also heard of an over the counter product called LMX5, which contains the numbing agent lidocaine, that can be used in the same manner, although I have no personal experience with it. Both of these topical analgesics are not always readily available in brick and mortar drug stores, but can be found easily at many online stores, so look on the Internet if you have trouble locating them locally.
OTHER MEDICATIONS:
One colorectal surgeon I consulted with prescribed me Valium (diazepam) due to my severe anal sphincter spasm (it was so tight that even gas could not pass through the sphincter). While not often used for this purpose, I have found the Valium to be of great benefit. Even at low doses, it helps relax my sphincter. I have found that it makes it easier for stools to come out during bowel movements, and more importantly, I credit it with reducing the painful and uncomfortable anal spasms that follow bowel movements. Do consult your physician if you're interested in more information on this, but I can tell you that Valium certainly seems to have helped me.
Finally, I did have one severe spasm and pain episode that prevented me from standing, walking, or even moving without extremely terrible pain. That sent me to the emergency room in a wheelchair. After confirming my fissure via a rectal exam, the emergency room doctor prescribed me an opiate painkiller. He indicates that opiates are typically contraindicated for bowel diseases due to the side effect of constipation. But, he says that in very bad cases like mine, sometimes it is necessary to use them in the short term to "break the cycle" (his words verbatim) of spasms. During those several days, my bowel movements and spasms were very, very, very painful and completely debilitating, and I took the opiates plus Valium and temporarily increased my dosage of Miralax (to counteract the opiate constipation). Eventually the pain levels got back to a controllable level. At that point, I quit the opiates and continued the Valium and Miralax as well as diet and topical ointments. Knock on wood, but since that time I have yet to have the same level of incapacitating pain that sent me to the emergency room.
SUMMARY:
After employing all of the above, my fissure is clearly still present, and does still cause pain and discomfort daily, but has been noticeably more manageable. It will take time to see what happens in the long term, but I feel strongly that what I've described above has at least helped me to some extent, and am hopeful that some of the information can help others as well.
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Re: I have an AF -- what should I know?

Postby cherylk » 22 Sep 2009, 07:14

In my opinion, an AF needs to be addressed "holistically":
Get your mindset to be positive. If necessary consult a psychiatrist or other professional therapist and possibly use anti-depressants. If you are anxious and/or depressed, try deep breathing, meditation, and/or prayer. AF's are a pain in the *ss literally, but try to remember in the grand scheme of things they are not the end of the world!
Work on healing the fissure with cremes/ointments and sitz baths. If that doesn't work (4-6 months max), consider Botox shots or LIS. Realize that all treatments have various side effects and risks.
Normalize bowel movements as quickly as possible. Try Miralax or other stool softeners and fiber supplements--get 20-30 grams of fiber daily. Drink plenty of water--maybe even 8-10 glasses a day.
Eat a healthy diet. Forego sweets (candy, cake, pie, etc) and pop as much as possible. Instead concentrate on "fissure friendly" nutritious foods--cooked carrots, soups, fish, chicken, applesauce, baked squash, cooked spinach, baked potatoes, baked apples, oatmeal, bananas, whole grain rice, whole wheat bread, and porridge.
Try to live as normal of a life as possible. E.g. participate in activities that are still tolerable that you can enjoy. Always tell yourself there is hope--even when your circumstances seem very dire! The mind is powerful, and the mind/body connection is real!!
Last edited by cherylk on 22 Sep 2009, 13:44, edited 2 times in total.
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Re: I have an AF -- what should I know?

Postby Deleted User 5 » 22 Sep 2009, 10:11

WONDERFUL ADVICE, Cheryl!!!
FIVE stars!! Image
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Re: I have an AF -- what should I know?

Postby nimitor » 05 May 2011, 12:50

Just a thought from the U.K, my CRS prescribed Instilligel for me,it's the local anaesthetic they use prior to rectal exams. when you have a fissure.I use it before a B.M (if possible) and it makes passing a stool more comfortable and reduces the spasms drastically.
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Re: I have an AF -- what should I know?

Postby maksmom06 » 24 Mar 2012, 11:03

TIPS!!!!
I have a good remedy for people suffering with Anal Fissures!!! Lots of sitz bath, especially after a BM. After your BM and washing good down there apply diaper rash cream with Zinc oxide...and if you cant bathe after BM then apply it right after. This will make it so the bacteria from your feces doesn't infect the fissure. Also, in the morning and at bedtime apply wound honey (or you can get regular maunka honey, which is what wound honey is!) This wound honey starting healing my fissure immediately!!! I only had my fissure for 2 weeks and I'm almost all healed! BM aren't nearly as painful as what they were. You can find Maunka honey or would honey online at ebay or amazon. I hope if you are having problems with this like I did this brings you some relief!!!
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