Anal Fissure sufferer 6 years ago, now it's back!

Severe pain affecting my life

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Anal Fissure sufferer 6 years ago, now it's back!

Postby Whatapaininthearse! » 26 Jan 2015, 19:24

Hi Everyone, this is my first post. I've only just found this forum this evening after doing lots of research about Anal Fissures. I am a 35 year year old female. This a long post, sorry but I hope some of you will read it.

It is some what of a comfort to know this forum is going and fellow sufferers can share their stories/advice/opinions. It's also good to know that someone else understands what this horrible condition is like to deal with!

I first visited my GP 6 years ago, when I started to have problems with pain when going to the toilet and long lasting pain after every BM. I was told i was suffering with Piles at first and started to use Anusol cream, the cream was of no help and so I went back to my GP a few more times before he decided the Piles may need banding. I arranged an appointment for this to happen. On the day, i got to the medical centre to have this procedure done, the doctor made a start (this was the first time anyone had actually examined me) and said ' you haven't got piles, you have a Anal Fissure', so I went back to my GP.

I was given various different creams, Rectogesic, GTN, Lidocaine. None of these worked. My GP eventually referred me to a CRS after I went to him in tears and practically begged for a referral. I was in so much pain.

At my first appointment at the hospital, I was prescribed Diltiazem Hydrochloride cream, I started to use this and to great relief the Diltiazem worked :-)

It is now 6 years later and the problem is back, worse than ever! I'm pretty sure this was triggered by passing a one off hard stool around 9 months ago, I never get constipated. So, off I go back to my GP, again I am put through the process of trying every cream, or possible medication the GP can prescribe me, again none of them helped, this process in it's self took a long time, as they wanted me to give each cream time to work....all this time I am still in horrible pain!

I eventually decided to go Private and have a consultation with a CRS as I was in so much pain and fed up with waiting for my GP to arrange a referral. The CRS prescribed the diltiazem i'd been longing for and explained 3 different procedures to me that may be a option for me if the Diltiazem didn't work. First was Botox Injections, 2nd was a Lateral Sphincterotomy and 3rd was a Anal Advancement Flap. I left the consultation feeling positive this would now be sorted, one way or another.

On this occassion the Diltiazem has not worked, it is now 8 months of being in horrendous/clawing the wall pain after every BM. I cannot compare this pain to any other, I regularly experience 6-8 hours of severe pain after every BM, which i describe as it feels like someone is shoving a poker up your backside and twisting it over and over again. It is unbearable/Dibilitating pain at times.

After realising the Diltiazem was not working, I contacted my CRS's secretary and explained I was desperate for something to be done. They thankfully contacted me soon after the call and got me in to have the Botox injections.

I had the Botox injected into my Sphincter on 2nd Jan 2015 under general anesthetic, the operation took a hour, i had no pain when i woke up and I was in and out of hospital the same day. The CRS also did a EUA and found no signs of inflammatory bowel disease or such like, which was a relief to me!

During the first week after the OP, I suffered from more wind than usual and struggled to control it, which was slightly embarrasing, i also noticed some leakage after wiping myself clean after having a BM. I guessed this was the Botox relaxing the muscle. It is now about 3 weeks later and that seems to have stopped. The first couple of BM's after the Op were particularly sore and to be honest I have not really felt any improvement 3 weeks on. The pain feels as if it is higher up inside now and slightly better around my anus. I was sceptical about the Botox after reading other people stories on different websites but felt I had to try it. I am again in Pain and have again been referred back to the CRS through my GP, this is desperate now! I did however, remember one thing I was prescribed 6 years ago, that I had not tried this time, I rang my GP and got a prescription for INSTILLAGEL (a local anesthetic gel) I have been using this for just over a week and along with warm baths it seems to be taking the edge off the pain considerably! I have had the first fairly pain free BM in months!

I do know that this Instillagel isn't a permenant solution but it will help until i can get another appointment with the CRS. I think I will end up having a LIS and from what I have read they seem to be quite successful. My CRS said they are more reluctant to do the LIS on women incase they are going to have children but it's highly likely I wont be having kids so that doesn't effect me personally.

I just want all this sorted out now. It has dictated my social life for months and I can't make plans incase I will be in pain, as all I want to do is lie down when i'm in the awful pain! It has been no fun for my partner either, although i have a lot of support. It has affected my life at work, I am currently on reduced hours and although my employer has been sympathetic, I am starting to get pressure from my employer as to when i think this problem will be dealt with! It really is a nightmare but I am hoping there is light at the end of the tunnel!!!!!!

One thing i have realised is that you have to keep on to your GP and CRS and make them constantly aware of how you are! Good luck to anyone else going through this, I really do feel for you.
Whatapaininthearse!
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby jlm1 » 26 Jan 2015, 20:46

I'm so sorry you are going through this. I hear you and relate to the pain as will everyone on this site. It is just horrible. The worst pain I have ever experienced. Far worse than labor, in my opinion. I had botox in July but I then developed a fistula which I had surgery for in October. If you are interested, you can read my posts that are all over this site! Unfortunately, I am still in pain.Not fissure pain, thank god! It seems the botox healed it. But now I have nerve pain and have been doing physical therapy.
I have no advice really. Just wanted to say that I hear you and you are not alone. I am actually taking time off of work to try and let this heal. Thank goodness my partner is supportive and I can do this. I'm a teacher and I just couldn't do my job fully.
Anyway hang in there. Sounds like LIS might be your best bet. Do not give up. It will heal. The body is always working to heal itself. I'm sure you are watching your diet, taking sitz baths, stool softeners and all that good stuff. Keep it up and take the next step with your CRS. Let us know what you decide and share here! Everyone understands and wants to offer support :)
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
jlm1
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby jlm1 » 26 Jan 2015, 21:09

Another though: If I remember correctly, It took a while for the botox to start working for me. A good month I think. Is it possible that you need to give it more time? Or are you still in horrible pain with the spasms as bad as before?
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
jlm1
Proctosphincteranalogist
 
Posts: 188
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby Whatapaininthearse! » 27 Jan 2015, 05:10

Hi Jlm1, thanks for taking the time to read my post and reply!

Yes, I have been wondering if I should give the Botox more time to work? I would say the pain is worse now than before I had the botox but it's slightly different...the pain feels higher up inside. As I have been using the Instillagel for pain relief, I really should stop using it for a few days and assess the level of pain again. That is my plan now anyway.

The only thing that concerns me slightly with Botox is that it only lasts 3 months...it would be great if the fissure can heal in that time but what if it doesn't? I just really want a long term solution to this problem but it seems quite a lot of people have the fissure reoccur. Fingers crossed I will get away from this problem one day!
Whatapaininthearse!
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby jlm1 » 27 Jan 2015, 08:25

My doctor said the botox lasts about a year but I have heard most people say a few months so I don't know if it depends on amount or what. The fissure should heal in that time. As I'm sure you know, botox just relaxes the area so that the area can heal. Keep your stools soft, walk to get blood flowing to the area, take stool softener. I also take magnesium, prune juice or prunes and aloe vera juice. (and a bunch of other supplements)
I am also afraid of the fissure coming back but I think that, unfortunately, that can happen even with LIS. I think that I am going to watch my stools for the rest of my life.
I had botox in July and my CRS said the fissure is healed. I know that many people retear and hope that doesn't happen.....
If I did get another fissure, I think I would do LIS even though I do want another baby. But theres no way I can even think about that right now until this is fully healed.
I didn't know what pain was before this fissure hell! But it will get better and so will you. Hang in there :)
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
jlm1
Proctosphincteranalogist
 
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby jlm1 » 27 Jan 2015, 08:30

Oh and my partner just reminded me that when I had the botox, it got worse before it got better. So maybe that's the case for you? I would call the doctor just to ease your mind.
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
jlm1
Proctosphincteranalogist
 
Posts: 188
Topics: 22
Joined: 22 Jun 2014, 15:20
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby Whatapaininthearse! » 28 Jan 2015, 09:49

Thanks for your reply! I have had a BM this morning and am again in great pain to
the extent where I can hardly walk. Surely
this amount of pain can't be right??

I am considering phoning the hospital to see if I'm ever going to get a reply to the letter my doctor sent them 2 weeks ago, do u think that is reasonable? I don't like making a fuss but I can't go on like this!
Whatapaininthearse!
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Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby jlm1 » 28 Jan 2015, 10:49

In my experience the pain can be that bad. I do not know if the botox is just not working or if you need to give it more time. I suggest going back to the doctor. Demand that she/he see you or at least talk to you. Being in that kind of pain is terrible.
In the meantime, soak in a hot tub, then use hot water bottle. You are not making a fuss. You are in pain and that is valid.
Hang in there
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
jlm1
Proctosphincteranalogist
 
Posts: 188
Topics: 22
Joined: 22 Jun 2014, 15:20
Has thanked: 48 times
Been thanked: 23 times
Gender: Female

Re: Anal Fissure sufferer 6 years ago, now it's back!

Postby msimon » 28 Jan 2015, 12:30

I'm so sorry to hear you are in so much pain. I am wondering if you have tried the diltiazem since the botox? I found that the ointment became supercharged for me after botox, and LIS for that matter. Maybe there is another ointment you could try, Nitro or Nifedepine?

I have had botox many times and have to say it does not reach its full effect for 1 month. Hang in there. I hope it gets better really soon.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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