Hi there,

I have been dealing with anal fissures off and on from August 2015. My anal fissure heals than reoccurs in a few weeks. My anal fissures are superficial as described by doctors. I was told by two CRS doctors that I would not be able to get a sphincterotomy due to all the surgeries I had back in the 90s from anal warts. The doctors all told me that possibly what's going on with me is that I probably have thinning of the skin in the anal area due to past surgeries and due to the natural aging process. It's depressing at times having to deal with this problem. I've noticed the more I worry about it the worse it becomes. The doctors did say to me that I am not a good candidate for a sphincterotomy. Also they told me that I will have to learn to live with this condition for the rest of my life. I guess they are right. It could be worse. I have found out that emotional stress and not eating properly causes the anal fissures to flare up more often. And it also causes the anal fissures to take longer to heal. So the best thing to do is learn acceptance and prevention. I can no longer wipe normally with dry toilet paper anymore. I don't rub anymore. I wet the toilet paper and dab. I don't feel normal anymore. I get depressed at times having to deal this. Any suggestions?

Hi Kikaida,

Sorry to hear you are suffering. Yes is can be depressing at times - if not all the time :-(
If you are healing then that's good news at least. There are a few things you could try. Are you able to exercise? Might sound a bit condescending, but exercise it proven to help speed up the healing process and makes you less prone to injury. Even something like swimming, walking, etc will help. Other people have had success with Manuka honey to help heal (make sure it's medical grade though), and even some with Estrogen (Estrace Cream) - which may help if you can get it. Both have medical studies that show benefits with healing. Also vitamin C is good for keeping the skin healthy. Long hot baths can also help relax the area.

Has you Doc given you any creams or ointments to apply? If your fissures are superficial, then they may think this is not necessary and to stick to conservative methods such as stool softeners, plenty of sleep, veggies etc.

Hope things improve for you. Good luck!

Hi Kikaida, as LemonMan has said it's a horrible situation to be in - any chronic condition can be depressing but when it's something that keeps coming back after healing it feels awful.

Keep up with your fluid intake, plenty of vitamins, sit on a hot bottle after every BM if you can.

Keep us posted, happy new year

FF

I just had a talk with my CRS on the phone the other day. He said he could do the LIS surgery but he said he thought about it and in my circumstance he doesn't think I would benefit from it nor would it change my situation. I guess its again because of all the surgeries I had years ago for the three years of having anal warts. Thank God my anal fissures are superficial and they heal in a few days but reoccurs every month or so. I don't think I would want to take the risk of having the surgery knowing my situation with the thinning of my skin. But if the anal fissures got really bad beyond superficial and don't heal and causes constant bleeding I may consider it. But that is way down the line.

Hi Kikaida,

What did you decide?

I also have a similar problem of mine healing then retearing a few weeks or months later. I am also not a candidate for surgery. The CRS said nope, I would just have to manage. It was depressing but also a relief as I didnt have to decide whether to have surgery or not. However knowing that if I eat poorly or forget to take magnesium for just 1 day could send me back to fissure land is a downer.

Is there a way for you to thicken the skin down there? Like take MSM or something (I have heard people taking that here; I just started). I would recommend using a bidet after a BM -- I have a travel bidet and it is awesome. No wiping needed, except the water after.

I started seeing a naturopath and she gave me some balm and a supplement that was supposed to help my skin down there heal and strengthen. Well, I got a minor tear, so I'm back to the drawing board. However, I do credit the salve she recommended as speeding up my healing time. I am also making my own suppositories to always keep that area moist, since my tears generally happen at the rim of the anus.

Hope you are able to find relief through surgery or management.

Hi folks,

My working theory from my CRS is that I get chronic superficial fissures because my food moves through my system too quickly -- thus not allowing enough time for all the digestive acid to be reabsorbed, and then when you have a BM, your anus is bathed in acid, making the tissue friable and prone to tearing. I do have a very quick system and often have loose and not very well-digested stools... sorry if TMI!

She had me try digestive enzyme supplements bc this is part of the issue for some folks, but they really nauseated me.
What has helped is shifting my diet--I actually eat a bit LESS fruit and veg now, and more grains and a little more meat. This slows things down so my BMs are well-formed and look like my food is actually digested as it should be.

...And then I get a tear after trying magenesium for migraine prevention. It rushed my food, causing a little irritation that I could feel post-BM and a tear.

So, it has been tricky to figure out how to manage this--I want to be careful with laxatives bc I am trying to basically make that skin healthy again, but having a well-formed BM and a tear is MISERY. I've added miralax (about a 2/3 dose) back, an with my diet changes, this gives me a soft stool but mostly is still allowing me better digestion.

We always talk about fissures coming from hard BMs but these superficial ones are really common in folks with IBS or Crohn's who have a lot of loose stools, for exactly the reason I described. Something to consider!

Chia- that makes sense to me- I have been taking lots of supplements and probiotics and I think that has made things too fast- something I never thought I would say. The acidity makes sense. And I took magnesium for migraines once and OMG- I was in a panic to find a public restroom!

Thansk chiaseed. Thats interesting. I had watery BMs on magnesium when I was avoiding bulky BMs because those are the ones that cause the tears...but I know the watery BMs were also causing irritation and potentially weakening the tissues. Damned if you do, damned if you don't. However I got the magnesium to fiber ratio pretty good now to keep things soft and formed and not mush or watery. Occasionally I get it wrong though. Oops!

Hey Healthybutt, sorry for taking so long to answer your question. I've decided to do nothing as far as surgery that is because no CRS will touch me because of the thinning of my skin in the anal area. All have said that surgery could and would make matters worse for my situation. It's depressing having to live with this... but like they always say things could be worse.