Hello everyone – I’m new here and I’ve never posted on a forum before, so please forgive my blunders. I’ll do my best to learn the ropes. I’ve been ‘lurking’ on this site for a while now and I’ve been so impressed by how compassionate and helpful you are here. This site has already helped me so much!
I’m posting now to introduce myself, since I’m pretty confident that I am facing a difficult fissure mess and I expect I will be needing some advice and emotional support fairly soon. Well … actually, I could use some now!
Last April, after a very bad flu, I developed *huge* hemmies (or rather, ‘perianal hematomas’, as my CRS insists I call them). It took all summer, but they eventually resolved. I live in Canada, so, of course, the hematomas had resolved by the time I got to see the CRS! He told me that I have anusitis (inflamed anal tissue), and put me on a strict diet. That was last November. Since then I’ve been struggling with digestive issues that I developed when I went on an ultra-high fibre diet over the summer (my doc thinks I might now have mild IBS-D). The digestive problems were just starting to settle down when I developed a fissure! That happened on Feb 27. I believe I now also have a second one, which developed two days ago. This new one is bleeding like crazy (although I suppose it’s possible that both are bleeding and that accounts for the copious amount of blood after the morning BMs).
I don’t know if I should be worried about a lot of blood or not – does a lot of blood mean anything serious? I haven’t been having the extreme spasms and tightness that many of you describe; but the BMs are very painful (the familiar passing razor blades feeling), with raw, burning and sometimes throbbing sensations for a while afterwards – is this what spasms feel like?
I am scheduled to see my CRS again on Tuesday and I’ll say I’m very anxious. Oddly, I’m more anxious that I am NOT a candidate for surgery. After reading so many success stories here, I feel pretty comfortable with that option. The problem is that I don’t know what to do. The warm baths and soft stools are not solving the problem and I really can’t continue like this.
It’s difficult to know what to do here. It is possible that I’ve actually had a fissure most of the summer, but it just wasn’t diagnosed (I was bleeding occasionally then too). If this fissure is one that keeps healing and re-tearing, perhaps the nitro and/or botox won’t work? I don’t think I’m spasming, but I don’t know. If my sphincter isn’t spasming very badly, does that mean that surgery won’t work?
I don’t mean to put anybody on the spot and I understand that my questions are probably better answered by a doctor; but I’ve come to value the insights and wisdom of the people who actually live with this problem and would definitely appreciate any input/advice you can offer.
Sorry for the long post … Thanks so much :)
Hope

In my case the spasms start first, keeping me from going until finally there's so much pressure that there's no choice. This leads to the tearing (spasm+pooping, I mean) which leads to pain, which leads to spams until there's so much pressure...etc. There's also a real lingering pain after the toilet that's a bit like feeling punched in the bum...
Emerg gave me a follow up in two weeks. I'll try to remember to ask if low spasms = not a good candidate for surgery.

I also don't think that I have that many spasms, though did not consider the surgery question about that. Will be very interested to hear. I have almost come to the conclusion that Sitz baths do not do good things for me. I find that when I soak that the pain is more intense afterwards, though as everything with these fissures, I wonder if it is just something that happens on a particular day. Today, no Sitz bath, and felt like I had less pain. Also very seldom have blood, but that may be the enzyme I take which is an anti inflammatory, so that might be why. So many questions!!

hi savaici - i have the same experience. Some days a warm bath is wonderful. Other days, it just hurts more. I've been having a lot of blood for the past few days. Not only does it feel like someone took a chainsaw to my butt, it also kinda looks like it too! Are you considering surgery? Are you taking any meds?
I see from your profile that you are from South Africa - what a beautiful country! I've been there a few time ... to Joburg and Cape Town and spent some time in the Northern Cape too. I can understand why your heart is still there!

Hope and Sav,
When I started sitting in the tub, rather than using a Sitz bath, my fissure started to improve. I think the position of sitting on the toilet for a prolonged period of time with the Sitz bath puts more pressure on the rectum than using the tub. Another person who was on the board in the past suggested using the tub, and that is why I switched. Warm water does promote blood flow to the area, so it is a good thing to soak!!

Hi Cheryl - Thanks so much for your reply! I think you're right about soaking in the tub instead of using a sitz bath. I couldn't sit in/on one for more than half a minute. I do sometimes feel a bit raw after having a bath, though; but that may just be because I'm having a particularly bad butt day anyway. I really, really, really would love for this pain to go away!!!!

Hi Hope! Have u tried restoralax? It's canada's miralax and it eliminated my bleeding completely. One dose a day split up at dinner and bedtime make morning BMs painless for me now. I still have the burning after which is caused by the spasms I think, I don't feel actual spasms but know this causes the burning pain. Sitting on a heating pad or magic bag also makes a big difference and ibuprofen and extra strength robaxacet, pharmacy brand, for bad days. For really bad days, I was recently prescribed oxazepam, a less addictive, slow release, Valium derivative, which also really helps stop the spasms, at least the burning stops so u can get on with your day. It does become somewhat manageable with time but I am 18 days til my LIS so hopefully I'll be done managing soon! I am also in Canada and was told I HAD to try diet, ointments, Botox before surgery. Had it all and I'm still here so hang in there but if u can get the surgery, my advice would b JUMP ON IT! Good luck hope this helps

Hi Elphie - thanks for your reply and helpful advice about pain-killers. I'm reluctant to try Restoralax because my BMs are alread soft/loose (sorry if that's TMI). This is one of the reasons why I'm concerned that the LIS may not be for me. I think you are right that the spasms can cause burning - I'll ask my CRS about that.
I'm seeing my CRS tomorrow and I expect him to suggest ointments and/or botox *sigh*
How long did you have to try the ointments and botox before anyone suggested surgery? What was the botox like? Did it hurt? For how long?
I would like to take the surgical option if it's viable for me - I am so sick of this now!
Thanks again for your reply. I hope your LIS is a wonderful success ... I'll count down the days myself!

I was diagnosed late march 2010 by my gp, had been slightly bothered for a few months before, thought it was my recurring hemmerhoids, so she referred me back to CRS in Ottawa who had helped me before. Saw him in April he started me on nifedipine right away, had me start taking metamucil 3x a day, docusate sodium stool softener. From there it got worse, I finally got Botox in November after no change from ointment and diet. I had about 36 hrs max relief from Botox then, for me, everything got much worse, CRS said he couldn't do anything to give it time. Three months of pain, as the Botox wore off the pain went back to what it was previously which, suddenly, seems bearable in comparison. CRS was still reluctant to do surgery but I INSISTED. I have three kids and I need to get back to it! Maybe it will work for u, some have healed without surgery, but I've waited long enough! It takes so long here to see the CRS, for me the drive is he'll and the wait in the waiting room then the EXAM... He is supposed to b very good so I just hope it works. Like everyone else, I'll post my results and recovery, I can't wait to get started!
Oh, I forgot to mention that the two Botox shots I got, one on either side of fissure, hurt alot but it was pretty quick and I had relief from the spasms by the time we got back to the car. I wish it had worked...

Hi hope, just you talking about SA makes me feel a bit better. I used to live in CT at Mouille Point, and i miss the view of the sea. Had such pain today. Sadly I can't soak in my bath because I have lost so much weight from not eAting so much that my bum cheeks have gone flat, so it hurts to park myself on the bottom of the bath! Today my coccyx hurts like hell. Don't think I get more than a few hours without pain. So frustrating. I am hoping that the OB/GYN might have some suggestions when I see her in a couple of weeks. Getting quite desperate, especially as the Nifedipine does not seem to be doing anything.