Hi All,

I've been dealing with an anal fissure since January 2020.

I kept getting misdiagnosed and finally figured out what it was this summer. I started treatment with NifeDipine (2%) the first week of August 2020. After starting treatment, I hadn't had any bleeding since August 6, 2020 - it just would feel very uncomfortable going to the bathroom.

After 6 weeks, my doctor said the fissure was starting to scab over (I can't see it at all - it's mostly internal). Since I was still having multiple anal spasms and pain, I went ahead with Botox to help with the healing and had Botox injections on September 17.

Since the Botox injections, the pain and burning after defecating pretty much went away. I have worked out my diet so that I only defecate once in the morning. I have continued to use NifeDipine (2%), sitz baths and stool softener and I lubricate my anal canal with vaseline and KY jelly before I defecate each morning.

Question:
As of this morning (10/19/2020), I had gone just over 10 weeks without any bleeding and was fairly pain free. After defecating this morning, I noticed a very faint hint of blood on the toilet paper - still no pain though. After taking a sitz bath, I applied my NifeDipine and found small little bloody scab pieces that came off on my finger. Clearly, the blood on the toilet paper came from these bloody scab pieces that my stool must have loosened.

Should I worry that my fissure is opening back up again or would it be expected that my fissure scab would eventually fall off and hopefully I have new skin underneath?


Thanks so much,
M