Are multiple fissures often something sinister?

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Are multiple fissures often something sinister?

Postby mercexe » 21 Feb 2018, 12:18

I went to my GP today complaining of the following symptoms for 4+ weeks:

- extremely sharp pain when passing stools
- general aching/burning pains in rectum afterwards
- "raw" feeling when touching anal area
- extremely itchy anus, especially at night

He examined me and said I had THREE fissures; two "fresh" and one which looked like it was healing "at the back".

I'd already done some research and suspected fissures and had read that it is extremely rare to have more than one fissure. I mentioned this to him but he disagreed and said it was not that unusual.

Should I be pushing for further diagnostic testing (e.g. for Chron's/IBD)? For what it's worth, I have no other symptoms (digestive or otherwise).

He prescribed me "Uniroid-HC" and told me to try it for a week; it looks like it is 5mg Hydrocortisone and 5mg Cinchochaine Hydrochloride. I've read that Hydrocortisone is BAD for fissures, so why did he prescribe me this?!
SO stressed right now. I just want to get rid of this horrible discomfort!
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Re: Are multiple fissures often something sinister?

Postby Mypoorbutt » 21 Feb 2018, 13:42

Hi, if your dr is not concerned then I wouldn’t worry too much. Some people have sking that just tears easier or have a high resting pressure so minuscule tears become an issue. If you wipe a lot or have hems then that will also weaken the area.
Most fissures that are caused by peri anal crohns are quite obvious even to gps and don’t heal even with treatment. Is also unlikely that you would have crohns or UC without some form of intestinal distress.
Try not to worry as that releases cortisol which in turn tightens the internal sphincter and makes healing harder.
About the cream, I personally haven’t heard of that being prescribed for fissures it’s usually diliatazem GTN or nifedipine. You could ask a pharmacist if this is the right prescription for you or phone up your nearest CRS and tell them you have been diagnosed with fissure and is your prescription correct. Unfortunately a lot of gps don’t know what to prescribe for a fissure. I was told to buy anusol and given lidocaine suppositories I checked with the pharmacist and she was like “no that’s for hems not fissures”
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Re: Are multiple fissures often something sinister?

Postby mercexe » 21 Feb 2018, 13:50

Thanks so much, Mypoorbutt. My prescription is definitely right; but it's clearly a cream intended for hemorrhoids rather than fissures so I think I'll give it a pass, although I wonder if he prescribed it because I was complaining about the itching and it seems to be effective at stopping that.

The other thing that is REALLY stressing me is that I don't think mine are at the "12 o'clock" or "6 o'clock" positions I keep reading about - I think mine are on the side of the passage? :cry:

I have health anxiety at the best of times and all the websites saying that multiple fissures and/or fissures not in the 12 or 6 positions should be cause for concern is really not helping me relax about this ordeal. I'm 29 and fit and healthy with a normal body weight, I eat well and exercise regularly - just wish these nasty fissures would disappear.
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Re: Are multiple fissures often something sinister?

Postby Mypoorbutt » 21 Feb 2018, 14:41

One of my fissures was at the 9 position and I have crohns but my CRS reassured me that just because a fissure is off centre line doesn’t mean it’s sinister it’s just more unusual. I had mine checked after Botox and sure enough it was just a plain old fissure in an unusual position.
Perhaps your fissures are a symptom of your anxiety and some mindfulness or meditation may help. Your fissures are new and should heal very quick but I would go back and ask for a different cream to help the healing.
Also lots of hot baths as this relaxes the internal sphincter and promotes healing. Also if possible do not wipe with toilet paper after a BM use a shower head or portable bidet to clean the area, any wiping will irritate the area
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Re: Are multiple fissures often something sinister?

Postby Canttakethis » 21 Feb 2018, 16:19

I wouldn’t worry. I have had two fissures for the past 14 months. I don’t actually even know where they are. I’ve seen several CRS (due to the 1st one quitting, seething another in that practice, then moving to a different state) and nobody has mentioned it being unusual or checking for chron’s or IBS. I don’t have any other symptoms. My stool is normal. Try to stop researching, you can scare yourself to death. Stick with support and ideas on here. And see a CRS not a GP. I agree that the standard fissure creams are those listed above - ditlitzam, nitro and nef. I have tried all three with not much success. I just had Botox which I don’t think was successful either but I am still trying to hold out hope. Hang in there!
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Re: Are multiple fissures often something sinister?

Postby chachacha » 21 Feb 2018, 16:53

Also, if your doctor is not concerned, after the examination, and says that it's not that uncommon, you should believe him/her. I liken it to medications that have warnings on the box to "not take for more than 7 days", but some are fine long term as long as your doctor has ruled out something more serious. When my husband had heart surgery, and was put on stool softeners for several months, we asked about just such a warning. We were told that it was fine, but if someone needs the medication for a long while, and doesn't consult a doctor, they could be missing something important that needs to be addressed quickly. That's why those labels are there.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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