Diagnosed with a fissure, but unsure

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Diagnosed with a fissure, but unsure

Postby Fizzbang » 08 Dec 2015, 15:48

Hi everyone,

Relieved to have found a forum dedicated to this issue, I have been diagnosed with an anal fissure.

A little history - I have been having bleeding for around 5 years on and off. Always bright red blood, and usually after hard stools. I can feel when it is going to bleed generally. I've been to several doctors over the years who always said fissure. Now I have developed a groove in my stool, and when I bleed - the blood is typically along that groove. I just had a colonoscopy a month or so ago, and the doctor confirmed there was a fissure - "but could see nothing that would be causing the groove".

I believe the groove is caused by the fissure.

Anyway, from reading on this forum, the thing that gets me is: it doesn't really hurt. I would call it a mild discomfort while pushing out a big/compacted stool, but afterwards it's fine, there is no pain to speak of (perhaps a little "awareness" that the area is a little tender, but certainly nothing that impacts my ability to sit, stand, walk etc). The blood is sometimes not even there after a big stool, it can be a little random.

Very occasionally there will be pain, and when there is then I understand the pain people on the forum talk about. I usually have to stand in the bathroom for 5 minutes just breathing until it settles down. But this happens say once every 3-6 months.

I'm trying to drink more water, eat better, and take fiber supplements. It's helping to a degree, but I'm still bleeding.

Looking forward to delving into all the discussion here to try and find out how to fix this, I would really prefer not to be see blood on the toilet paper anymore.
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Re: Diagnosed with a fissure, but unsure

Postby Canadabum » 08 Dec 2015, 22:53

Fizzbang

:wel:

You have found the right venue to discuss all things fissure!! Sorry to hear you have been dealing with this for the past number of years...but glad to hear that it has not been a debilitating experience for you.

I have no real insight in to the groove you speak of other than speculating that it could be some scar tissue or other tissue around the fissure that has built up and now creates the groove when the stool passes by.

Were you given a prescription for the typical fissure ointments after you were diagnosed...diltiazem or nifedipine? If not I would first recommend that you get a prescription and begin using this cream for at least 8 weeks (consult your doctor of course...cause i am not a dr...just a fellow fissure sufferer). Aside from the creams I have found applying heat as much as possible helpful for pain and it is also helpful to stimulate blood flow to the area which helps in healing. Good that you have changed your diet...perhaps make a more radical change for a couple weeks and see if that helps...so eat less processed foods, more fibre, veggies, soups, salads, fruit and the like and see if that helps. as for water...make sure you drink a couple liters a day if you can.

Finally...when were you diagnosed with a fissure...recently...and who diagnosed, and after what sort of procedure?

Hope some of that is helpful...feel free to keep the questions coming.

All best,
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Re: Diagnosed with a fissure, but unsure

Postby Fizzbang » 09 Dec 2015, 10:45

Hi Canadabum, thanks for the reply!

I wasn't given any cream or anything. When I first started bleeding years ago, the doctor took a look and a poke around and diagnosed a fissure, but didn't give any cream. When I have been back the couple of times since to kind of "re-inquire", they have done the same - or just said "sounds like a fissure, eat more fiber, try a laxative".

Finally I was diagnosed 2 months ago after a colonoscopy, the GI doc says in the report "An anal fissure was found in the anal canal". His recommendation was: "increase fluid/fiber, fiber supplementation (Citrucel, Konsyl), stool softener (Colace 100mg twice a day)".

I think my fissure might be a little deeper in, I had a GP poke around pretty extensively before the colonoscopy, and she said she "thought" she might have felt something. So I'm not sure how easily/accurately I could apply an ointment myself?

As for the pain - thats the thing, I don't really have any...
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Re: Diagnosed with a fissure, but unsure

Postby Canadabum » 09 Dec 2015, 11:24

I am surprised that you have never been given one of the ointments. Application does NOT require that you apply on the fissure but rather around the anus...the active ingredient is well absorbed by the skin and will be able to do its work without getting it up there.

The ointment is a smooth muscle relaxant...your internal anal sphincter is a muscle that you do not control (sort of like your heart muscle) and the idea is that the ointment is absorbed and causes the internal sphincter to relax which thereby allows for increased blood flow to the area...it is that increased blood flow that you are working towards because that is what will help in the healing process. In fact, all of the ointments us fissure fighters use are the same drugs that heart patients use to help them control certain pressure issues with their hearts.

The advice you were given is good in terms of making sure the stool is easy to pass...you want to also help increase blood flow to the area to stimulate and help the healing of the fissure.
So I would go back and explore this with your doc.
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Re: Diagnosed with a fissure, but unsure

Postby Fizzbang » 11 Dec 2015, 22:44

Thanks Canadabum, that clears things up a lot! I will ask my doctor about the ointments!
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Re: Diagnosed with a fissure, but unsure

Postby Manitourose » 13 Dec 2015, 10:02

Hi Fizzbang,

Welcome to the group!

I also do not get much pain with my fissure. My 1st diagnosable fissure was considered a deep internal fissure and I had very little pain or bleeding. The 2nd more recent is considered superficial or rather less deep. I bled more with this one and the area ached but I never had the classic pain of ripping or even typical spasms.

I also have the groove you describe. I am not sure what causes it but have 2 theories in my case. I also have had a fistulotomy and had the grooves previous to that. I bring that up because for that surgery I had a examination under anesthesia. I have seen 4 colorectal specialists due to moves and a gastro doc that also examined me.

I do have a small anal (sentinel or sometimes called a hemorrhoid tag -- more likely caused by a fissure). My thoughts are that as stool passes that area the tag causes the groove.
Second thought is I was told I have "small internal hemorrhoids" and consider the possibility that these may also cause the groove.

In answer to your description about when blood is there and not, I too have noticed this pattern. Never seems to make much sense but it's fairly common.

Canadabum has given you great advice! Let us know what comes up with the ointments. Depending on where you live they have different names. Are you seeing a colorectal specialist, gastro doc or general doctor? They may or may not have familiarity regarding these items. My general doctor did not, just not their area I suppose.

Welcome again and keep us updated!!
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Re: Diagnosed with a fissure, but unsure

Postby Fizzbang » 20 Jan 2016, 21:11

Hi Manitourouse, my apologies for the very late reply. I really appreciate you replying to my topic and I just wanted to let you know that!

I thought my fissure was on the mend, but it seems to have come back, so now I am enquiring with my doctor about the ointments.

To answer your question, I'm seeing a general doctor, she is quite experienced though obviously not an expert. I saw a gastro doc only for the colonoscopy. The fissure causes me practically no discomfort, so I'm hesitant to really chase up a GI doc. If the ointment doesn't work I will though.
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