Anal fissure and nitro ointment

Anal fissure and nitro ointment

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Anal fissure and nitro ointment

Postby svet » 25 Apr 2015, 16:26

Hi everyone,
I am new to this forum. I am so happy to have found it though. For weeks I thought I was alone and that no one has these AF problems. Ever since I had my 5 year old, I have had issues with the BM’s at times. Sometimes they hurt, sometimes I was so constipated I felt like I tore things down there from straining. But it always healed.
As of January this year I have been having some troubles. I asked my doc and without examining me she gave me proctocedyl suppositories. I never ended up using them because for 2 months things were good. Then mid March, I started having excruciating pain, and bleeding. I ended up using the proctocedyl suppositories for 2 weeks and no help. I had hydrocortisone cream, which hazel, sit baths couple of times a day and no relief. I did have a few times where I didn’t have to have ibuprofen after a BM, but that is not often.
My family doctor looked at it and said I have an external thrombosed hemorrhoid and that I should continue with the sitz baths and it will fall off on its own. I thought great! Yeah right…
One week later after crying with BM’s and almost hyperventilating trying to convince myself to go to the bathroom, I went to another doc who said its most likely a fissure and gave me diltiezam. I used that for almost 2 weeks and no relief. Then was referred to a general surgeon. I saw him two days ago and he gace me nitro. I have been using it twice a day, and today I will try three times, it gives me a headache. The dose says one inch of the cream but I can only handle half an inch. And the cream makes that area unbearably itchy for a bit.
I am waiting to get an appointment to a well rated CRS here in Alberta. That will most likely happen first week of June. I am ok to wait because he has very good ratings.
I have changed my diet, and drink 2-3 L of water a day, I take Benefibre in the am, stool softener Colace in the evening. Almost gluten free and dairy free. The only dairy is with coffee sometimes. I still have to strain at times. The general surgeon has suggested to get it so soft that it literally comes out on tis own but I cant ever remember going to the bathroom like this. I’ve always had to push it out a tiny bit.
I am most likely going to be a candidate for LIS but I am so scared that it wont help me or that I will have incontinence after. I have had two vag births, episiotomies with both that healed well.
I am very regular, I have a BM every morning as soon as I get up. And then I pray that I don’t have one till the next day. I have a skin tag on the anterior portion, and a sentinel pile on the posterior side. That’s what my doc thought was a hemorrhoid. The pain has been better during the day for the last 24 hours, but when I go to do my Kegel’s I feel like I am pulling on something inside my rectum.
I am away for the last 2 weeks in May, I am staying on a campus for school. I was able to secure a suite versus a dorm room so I can have my own bathroom since my bum has to have a facial three times a day. J
For any of you that have used nitro, how long did you use it before you started to have a normal BM and pain free? I hope that I don’t have to have LIS but if I do then I do….
Thank you to everyone that has any thoughts. I am sorry for the long post, I just wanted to explain my story.

:thankyou:
Cheers!
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Re: Anal fissure and nitro ointment

Postby Canadabum » 25 Apr 2015, 17:04

Hi Svet -- glad you found this board. It has been a comfort to many who have found it -- hopefully it will provide you with some decent info...so welcome.

You can read some of my discussion on my intro called "6 months...now what". I too used Nitro -- but did the opposite of you. I used it for about 8 weeks and had stalled in my healing. I was then told to use Diltiazem and have been using for about 12 weeks now.

The Nitro helped me calm the pain down from an 8-10 to a 4-7 but it did not alleviate the burning and discomfort i felt during the day. It took me probably another 4-6 weeks on the diltiazem to really begin feeling ok....and the real progress i have begun to feel was after using the dilt for 10 weeks. I know that my time frame seems like an eternity...it felt that way to me...but i stuck to it and it seems to be helping.

As for keeping stool soft -- i wish i had known about that right from the start. My doctors kept telling me to take fibre fibre fibre...did little to help and in fact did a lot to hurt me i think. It bulked up my stools and made them more irritating. Now I still make sure to eat a decent amount of fibre and little processed food -- but i dont overdose on it anymore. Also -- of me the big help with softening my stool has been to take 450mg of magnesium citrate a day and make sure i drink a kombucha a day and perhaps have some other fermented foods (kombucha and fermented foods are full of probiotics which are great for digestion). Some people do well on more mag citrate...so if you go this route you will need to experiment a bit. I take one capsule of 150mg with each meal.

Sorry to hear that you are having headaches with Nitro...i was lucky in that it just made me a bit lightheaded. If Nitro does not agree with you -- you might consider going back on the Dilt....or trying Nifedipine (another calcium channel blocker like Dilt)...speak to your doc about your options....no need to suffer if the Nitro is not bearable.

i hope some of this is helpful...

best,
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Re: Anal fissure and nitro ointment

Postby hurtinend » 25 Apr 2015, 18:26

Hello and glad you found the board. I agree with Canadabum so I don't have much to add but I will say that I too take magnesium citrate about 450 to 600 mg per day. Works nicely as a softener and gentle mover.

I just started nitro a week ago. I have to say my spasms have decreased so I'm going to stay with it. I don't get headaches from it but if you need to, take the odd ibuprofen to offset your headaches.

All the best
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Re: Anal fissure and nitro ointment

Postby svet » 25 Apr 2015, 18:39

Thanks to both of you I appreciate your help. I will look into Magnesium Citrate. I also noticed that my spasms aren't as bad in the last 24 hours...headaches are manageable. I will trade those for fissure pain during and after a BM anytime.

Also as far as a diet, do you restrict yourself from certain things for sure?
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Re: Anal fissure and nitro ointment

Postby hurtinend » 25 Apr 2015, 18:44

I am eating mainly fruits, vegetables, and some lean protein. I have moments where I eat or drink anything I want but I would say I am eating 75% clean, the rest not.

Honestly, I'm not sure if the diet makes a huge difference, for me anyway. The key is to take things be it supplements or through food, that keep you soft and regular. Straining is bad and I try to avoid those times.
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Re: Anal fissure and nitro ointment

Postby Scientist2516 » 25 Apr 2015, 21:33

Hi Svet,
you've had some great advice here already. I'm just going to chime in and say that different things seem to work for different people - I had to try first nifedipine, then diltiazem and finally nitro, before I found relief. So don't be afraid to switch if nitro doesn't help.
Stool softeners like miralax and magnesium citrate may help you a lot more than fibre. They soften without bulking, so your stools are easier to pass. It's great you are drinking so much water.
If you get tired of sitz baths, try a hot water bottle - not too hot, but just hot enough to soothe. It also dilated the blood vessels of the anus and relaxes the anal muscles in much the same way as the creams, so it's healing as well as soothing. I would sit on one literally all day at work (heating it up in the microwave) and it gave me great relief.

It's good to hear your spasms are more manageable today. I hope that continues!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Anal fissure and nitro ointment

Postby Canadabum » 25 Apr 2015, 21:37

Svet- as far as diet is concerned, the magnesium citrate has been great but so too is the probiotic food I have been eating. I would highly recommend drinking kombucha every day...other probiotic foods include natural sauerkraut, miso soup, tempeh, kefir. I have found kombucha the best and quite a bum-saver if not a life saver!!

A friend of mine gave me advice that I generally stuck to in my initial recovery phase - "soft in, soft out". Generally image easy digestible foods that included a lot of steamed veggies, soups, fruit , smoothies.

A couple things I do religiously other than the mag citrate and kombucha is to have 1 tbs of either flax oil or olive oil with each meal (including breakfast). Also, I have cut out the following: dairy and processed/refined foods. Dairy is simply hard on everyone's gut so give yourself a bit of a break and lay off. If you are a dairy addict try using lactose free milk etc and kefir where the lactose has been broken down by the bacteria. As for processed foods - stay away from pre-made stuff, fast food and stuff with lots of white flower and white sugar....basically if you are making it for
Yourself from natural ingredients then you are doing yourself good. I have found that regimen very helpful.

Last but not least - for protein I have stick to beans, lentils, fish (the fattier the better!! More oil, yum ). And have stayed away for the most part from red meats and have the occasional chicken/Turkey.

The very last piece that has helped me - cutting down on volume of food. Personally I only want to go to the loo once a day (if that, lol) so I have cut down on volume so that I only need to visit with the porcelain Master once a day.

I hope this helps - keep the questions coming and know that in time you will be feeling better.

Best,
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Re: Anal fissure and nitro ointment

Postby svet » 26 Apr 2015, 03:00

I teared up reading your advice. I can't beleive how supportive you all are. Truly thank you.
I love kefir so I will be starting with a cup of that at bedtime. I have managed to be regular every morning. I hope for one BM a day as I can't imagine going through this pain more than once.
Now the magnesium citrate, I've read that it shouldn't be used long term. How long have you guys been using it? I will go buy some tomorrow.
I have no idea yet what kombucha is so I will research that. And try it. I will do ANYTHING for this to heal. I mean ANYTHING AND EVERYTHNG.
thank you again for welcoming my questions. If you were here I'd give you the biggest hug now.
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Re: Anal fissure and nitro ointment

Postby Canadabum » 26 Apr 2015, 09:55

Kombucha is a naturally carbonated soda made from a base of tea (can be green, black or white) and cane sugar. You add that to something called a SCOBY and it ferments in a week or so...then flavour is added. Some people dont care for it...i love it thankfully and find it really helpful. If you google it you will find tons of info on line.

I went to a Naturopath and was told that Mag Citrate -- so long as you are taking under 500mg/day is quite safe to take for the long term...as in years. Most of us are somewhat deficient in magnesium in general and my understanding is that it is water soluble so that we eliminate it quite easily and quickly...it does not really build up in our systems. All that said, it would be a good idea for you to confirm this info with a naturopath, doctor or the like. I have been using Magnesium Citrate for the past 8-10 weeks and plan on using it until i am fully healed which could take another 8-10 weeks...or longer...who knows.

You are doing all the right things -- the hardest part for me was the time that it takes for stuff to simply get better....this is a very slow moving experience. My kids were asking me why it has taken so long the other day and this is how i explained it to them...imagine getting a cut on your lip (the skin there is similar to the skin in and around the anus...very delicate) and then imagine that while you are trying to heal your cut lip, each and every day you rub something across it that is both irritating, abrasive and quite frankly...not that clean....now you know why it takes so darn long for this to heal. What we can do is cut out the abrasive quality by making it soft and thereby cut down on the irritation and the subsequent inflammation.

Hang in there....anyone dealing with this issue should be given a medal....it is not easy by any stretch....but you will get through this.

Good luck and keep us posted.

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Re: Anal fissure and nitro ointment

Postby svet » 26 Apr 2015, 10:40

I feel like I've had a set back this morning. When I went to the bathroom, the toilet looked like a murder scene due to so much blood. I can't even imagine how big the AF is. Has this happened to any of you? Yesterday was much less blood than today. This morning was awful!!!. I feel like spasms are gonna be brutal as a result.
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