Hi Rosey- Welcome to the forum. Sorry your fissure has returned. It's so discouraging when you think it's healed and it returns.
Good luck with your appointment Thursday.Hope things are better than you think. It's hard to believe such a small cut can be so hard to heal Please keep us posted on how things go with your appointment.

Thank you so much Dawn. I so scared.

Hi again everyone especially hopetoheal,
Back again with the same problem :(. Got my fissures back around 2 weeks ago. i have tried several laxatives and changed my diet completely but it seems to be getting worse. Every BM is more painful and i have to suffer a long 8-10 hours of pain post BM.
This time i noticed that my first stool is what causes the pain to come back again. Irrespective of how much laxative i take, the first stool is always hard and painful. Once that has passed away, the rest is a piece of cake but the first one causes all the pain and spasms i guess.
Can anyone suggest me what to do or is a surgery only an option for me now?

Hi Jehanzeb - I'm so sorry you are struggling again. Have you tried Miralax/Movicol? I suggest this because many folks here have found that this is really helpful stuff. It's an osmotic laxative, so it draws water from the colon to help the stool soften (even the first part). Many regular, stimulant laxatives can cause watery, violent BMs, which are not good for fissures at all, and they don't really help with that first hard bit of poo.
I definitely think you should go back to your doc and get a referal to a good Colorectal Surgeon (CRS). Since you've had this problem (on and off) since July, it's very possible that your fissure is now chronic (sometimes 'chronic' is defined as recurring fissures - that is, a fissure may partially heal and not give much trouble, but then it re-tears again too easily). If this is a new fissure, then it's probably acute, in which case the doc may recommend ointments, and they very well may work. Only a surgeon can really tell what's going on and offer the best advice.
If your fissure counts as 'chronic', then it does seem that surgery may be in the cards for you. Your CRS may suggest botox first, which has mixed results, but it can work to heal a fissure. Otherwise, you might be looking at an LIS. If that's the case, try not to worry too much. I know that's easier said than done. Butt surgery is truly the scariest thing I ever had to face - but I'm healed now, there's no more pain and I have my life back, so I'm glad I did it. In fact, usually the biggest regret among many folks here is that they waited so long to have it done. I'm certainly not minimizing the surgery - it is surgery after all, so it's not fun. But it can be a good option for certain people. Having surgery is a very personal decision, and only you can say if it's right for you - and you'll know if it is or isn't and when. I think the best thing to do is get to a good CRS and have a thorough discussion about your symptoms and your options. Don't let any doctor dismiss your pain - be stubborn and insist on answers and options. It's your body and your life!
I'm so sorry you're in pain again. I really know how debilitating it is. Hang in there - there are options and things will get better!

jehanzeb
This time i noticed that my first stool is what causes the pain to come back again. Irrespective of how much laxative i take, the first stool is always hard and painful. Once that has passed away, the rest is a piece of cake but the first one causes all the pain and spasms i guess.
I had the hard first stool thing for awhile until i figured out that i had to take Miralax in the morning, after i had breakfast or lunch, whichever was bigger, then also right after dinner... i split the recommended dose, which seems to work fine. also I eat a very poo friendly diet with lots of fruit, whole wheat, yoghurt, etc.
When I go out with my GF to eat, I just take a little more Miralax just after... stools are a little loose, but they come out fine.
Watch the Miralax, tho... too much you'll have runny stools which they say in here can hurt the fissure also. You want soft, but not runny bms.
Feel better!!!
pat

jehanzeb wrote:Hi again everyone especially hopetoheal,
This time i noticed that my first stool is what causes the pain to come back again. Irrespective of how much laxative i take, the first stool is always hard and painful. Once that has passed away, the rest is a piece of cake but the first one causes all the pain and spasms i guess.
Can anyone suggest me what to do or is a surgery only an option for me now?

I have the same problem - that first stool is usually too hard - what I do for that is use a small anal bulb syringe. It only holds a couple of ounces of water, so I fill it twice, then lay down and wait for at least 20 min before you go poo. It works well for me to soften up that first hard stuff.

Hi
I've had 2 fissure nearly a year apart. Second one more severe. Ended up having a Botox injection. This was 5 weeks ago. Still in a lot of pain after passing BM.
Gtn I use is rectogesic. This cause me bad headaches so my gp changed me to diltiazam cream. This didn't give me this affect. Don't apply ur Gtn straight after a bath leave it half an hour. Try using a small amount. The only thing that I have found that will help with the pain is oramorph.
Your not on ur own. Plenty of support on here.
Good luck

Hi everyone,
Thanks pat123, Baba, lambertoz and of course hopetoheal for your advices and support, it really makes me feel good having all your support and motivation :). Been quite a busy week so i couldnt reply earlier.
Here are a few updates:
I'll hopefully be seeing a surgeon today, lets see what he advises (fingers crossed). Although i myself am scared to death about having a surgery, i have never been admitted to a hospital yet in my life, so you can imagine how much scared i am about getting a surgery :(.
To have smooth BM, what i am doing is, i apply some anesthesia (xylocaine 5) in the anal area and wait for 10 mins before BM, it was easy to pass out then, but once the effect of anesthesia was over, i had the pain. To avoid that, i just laid down in an angle that eases the pain alot. My fissure is on the left side i guess, so i lie down on my left, that gives me alot of relief.
One thing that i noticed and would highly recommend everyone else, i wasnt having smooth BMs for weeks now, no matter how much laxative i was taking. but during the weekend, i got some time to play soccer and believe me, the very next morning i had a really smooth BM with no pain at all. Just pooped in the morning and it was again very smooth with almost no pain at all, just a little discomfort but far better than the pain that i was having. So, physical activity is a must must during fissures i guess.
I will try the bulb syringe thing and lets hope my first stool is soft, it has been good over the weekend.
One thing that i noticed, last time when i had fissures, i could see really dark blood dripping down. This time, however, i dont have blood and even if there is a little blood, it is bright red. is it a good sign or am i having something else? :(
i went to a general physician who cured piles of a relative of mine and he highly recommended him. That doc gave me some antibiotics and an ointment to apply, they are something new for me and i have not read anything on the internet regarding antibiotics for fissures. should i continue taking them coz i am doubtful if they are helping me?
So, here is some advice from a newbie for people who are suffering from fissures:
- Be patient.
- Have warm baths daily especially after BMs.
- I havent used Miralax yet, but reading so much about it, i will advise using it as a stool softener.
- Poo whenever you have an urge to go, i am actually suffering because i hold it for a long time and that makes my stool (especially the first one) hard.
- Have some sort of physical exercise, i noticed it helped me in my BM.
- Visit http://anal-fissure.org regularly :).
Thanks,
Jehanzeb

Regarding smoking, I stopped smoking 3 months ago. How? I switched to an electronic cigarette. I have been trying for years to stop, I would do ok for some days but always started again. The electronic cig is the best thing I have ever done, I feel better, my skin does look fresher and best of all my hair, clothes and house doesnt smell anymore. I would say definately smoking interferes with blood circulation but have no idea if it hinders the healing process of fissures.

Hi everyone,
I just had a meeting with the surgeon a few hours ago. He checked my fissures and said that the wound has deepen a bit. I told him all about using GTN and laxatives, he said GTN usually heals the wound and it is so far the best solution for fissures. But i told him i wasnt improving and the fissure isnt healing so he suggested that in this case, i should have LIS ( He was suggesting me to get operated on Wednesday morning so that i would be able to go home by evening and would be able to come to work the very next day. i asked him about the risks of incontinence and any other side effects of surgery but he just said to relax and not worry about anything ( he is among the top surgeons in my city and was recommended by a very senior doctor).
One thing that he told me was that i was not applying GTN properly, my fissure is at the back while i used to feel pain on left and that is where i was applying GTN. I asked him for a week to try and apply the GTN at the right place. if that doesnt heal, then i guess i'll most probably be going for surgery.