5 months of pain "superficial fissure"

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5 months of pain "superficial fissure"

Postby Bathbomber » 06 Feb 2018, 22:25

Hello, I am a 24 y/o male and I've been dealing with a very painful fissure for the past five months. I also have some urinary issues related to hypertonic pelvic floor muscles. For the past three years my main symptom has always been urinary frequency with some intermittent rectal pain from anal fissures. In the past, the fissures I've had would cause bleeding and pain but they would usually clear up within a month or two. About 5 months ago I started having more persistent rectal pain that would get worse after bowel movements. I went to see my CRN and he confirmed that I have a "superficial fissure." I have not had any bleeding this whole time but I am experiencing a lot of pain. I had a botox injection about a month ago and have not seen any improvement. I'm not sure how a superficial fissure with no bleeding could take this long to heal and produce this much pain. Has anyone else experienced anything similar?
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Re: 5 months of pain "superficial fissure"

Postby hurtinend » 07 Feb 2018, 19:57

Hi, yes very similar situation. "small fissure", along with urinary issues possibly related to tight or dysfunctional pelvic floor muscles.

Not much in the way of treatments have been helpful. I have not had Botox or LIS. I am seeing a CRS (a new crs for me, seeking second opinion) on Feb 27.

Have you tried pelvic floor physiotherapist?
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Re: 5 months of pain "superficial fissure"

Postby Bathbomber » 08 Feb 2018, 19:19

I’ve have tried pelvic floor PT. I think it’s helpful but it did not provide any lasting relief for me.

I’m seeing my CRN again tomorrow and I’ll see what he suggests.
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Re: 5 months of pain "superficial fissure"

Postby dmcff » 14 Feb 2018, 04:56

I have similar symptoms, but have been told by an experienced and well-regarded CRS that in my case the problem is not a fissure but is related to the effects of medication (lactulose, macrogol) that I've been taking for a long time (3-4 years, have now more or less discontinued them). Tomorrow I'm due to attend a pelvic floor clinic at a London hospital here in the U.K., and am curious as to what kind of therapy they may offer me. I'll report back when I have some clear information. I have not had Botox or LIS either, by the way.
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays - severe to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Physiotherapy and pain management
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Re: 5 months of pain "superficial fissure"

Postby Ash1988 » 14 Feb 2018, 07:07

Did they say that taking the lactulose has contributed to pelvic floor problems?

I’m currently on month 8 of taking it and trying to stop, but worried about reopening my fissure!

I am also in the UK but have not been offered any sort of help with the pelvic floor even though I think it is a huge contributor to my problems as I have horrible tailbone pain as well’!
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Re: 5 months of pain "superficial fissure"

Postby dmcff » 14 Feb 2018, 07:23

Hi, the advice I got was to stop taking both the lactulose and the macrogol I'd been using, so presumably it was thought that these were contributing to my pelvic floor problems. In the letter it says: "However, if he is unable to stop both of these medications he should just stop the lactulose."

At present I still have pain and minor incontinence, even after stopping the lactulose, but am hoping for an improvement with time. At the clinic I'm due to get biofeedback treatment, and maybe that will give me some results.

But everyone is different, and you need to get a proper diagnosis. The route I took was to get a referral from my GP to a local colorectal surgeon who then passed me on to the pelvic floor unit at St Thomas's. It might be worth insisting to your doctor that you get such a referral.
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays - severe to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Physiotherapy and pain management
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Re: 5 months of pain "superficial fissure"

Postby Ash1988 » 14 Feb 2018, 07:36

Yeah I had a referral to a CRS and they saw what they described as a tiny fissure and gave me diltiazem!

But maybe at my review I will ask about pelvic floor referral!

Thanks!
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Re: 5 months of pain "superficial fissure"

Postby dmcff » 15 Feb 2018, 11:08

I wrote about my first visit to the physiotherapy department at the St Thomas' Pelvic Floor Clinic here.
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays - severe to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Physiotherapy and pain management
dmcff
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Posts: 219
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