First time fissure- worst pain ever

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First time fissure- worst pain ever

Postby Casper » 18 Mar 2022, 17:03

Hi everyone,
I recently got my first fissure a few weeks ago. I don’t know how I got it as I had soft bms and there’s nothing I can’t think of that I did to cause it. I did have my appendix removed about a month ago and was on antibiotics when my fissure started.

Nothing seems to be helping. Originally the dr I saw wouldn’t do an exam so I didn’t know if it was a hemorrhoid or fissure. The dr wrote for a hemorrhoid cream which seemed to make my rectum very irritated and my symptoms worse.

I stopped using that and saw another dr who wrote for the diltiazem ointment, I just started it Wednesday night and so far no improvement.

How long did it take people to notice a difference with diltiazem?

The pain I’m experiencing when having bm’s is absolutely excruciating, and I feel pain afterwards throughout the day, but bms seem to be the worst part for me in this whole situation. I’ve also made myself constipated a few times due to the anxiety of the pain, constipation has NEVER been an issue for me until now.
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Re: First time fissure- worst pain ever

Postby owmybum » 23 Mar 2022, 14:33

Sorry you’re in such pain.
the diltiazem will take a few weeks to heal. To really help it on its way, try a stool softener and drink plenty of water to keep your stools soft and easy to pass.
antibiotics can cause lots of problems, but I’m sure it will heal up in a few weeks as you’ve started treatment early.
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: First time fissure- worst pain ever

Postby Casper » 23 Mar 2022, 18:35

owmybum wrote:Sorry you’re in such pain.
the diltiazem will take a few weeks to heal. To really help it on its way, try a stool softener and drink plenty of water to keep your stools soft and easy to pass.
antibiotics can cause lots of problems, but I’m sure it will heal up in a few weeks as you’ve started treatment early.


Thank you for the positive words and advice, I appreciate it!
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Re: First time fissure- worst pain ever

Postby Yishai » 23 Mar 2022, 23:10

Hello and welcome to the club, unfortunately. First, validation: I've heard this awful thing described as worse than 1) cancer leading to chemo, radiation, a mastectomy, and hospitalization, as well as 2) being shot in the leg, adult circumcision, and penile surgery. So whatever kind of hardware you've got, there are some frames of reference for you.

Second, yes, give the cream time. One surgeon told me if possible, it's good to get it up in there ~20 minutes before a BM so things can already be relaxed, and to reapply after. Softeners were key to healing my most recent flare; I used 2/3 a dose of miralax before breakfast as well as after dinner (tip from another surgeon).

I also significantly reduced my fibre intake this round; I was having these awful, giant, destructo turds which the fibre was creating. Many of us seem to eat less during these periods and no one ever talks about the recommended fibre intake being relative to caloric intake - 14g PER 1,000 kcal! So don't just eat a shit ton of fibre and nothing else! I found insoluble especially to be the main aggravator for me. Last trick

Last trick from a third internet doc: try relieving yourself in a tub of warm bordering on hot water. It can really help things relax; if this is too weird, try jumping in right after using the toilet as it may help the last little bit sneak out (which tends to be come the horrible little ball of dark matter that starts off the next session). Good luck and happy healing.
Fissure 1: Jan. - Mar. 2018 (spontaneous/stomach flu heal)
Fissure 2: Jan. - Apr. 2021 (diet/medical therapy?)
Fissure 3: Nov. - Dec. 2021 (low fibre/PEG)

Ongoing hemorrhoidal/pelvic floor/anal sensitivity issues...
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Re: First time fissure- worst pain ever

Postby Rich44 » 25 Mar 2022, 23:33

Hi Casper, welcome to the club! Just kidding - definitely not a club anyone wants to be in! I am so sorry you are in pain. You can get past it, but it depends on how you handle things.

Here's my personal experience with over 6 years of suffering and eventually having a LIS surgery to finish off the fissure once and for all.

Buy a sitz bath, the kind that sits on top of your toilet seat. WAY easier to do than the tub and more comfortable. I only wish I had found the one I have now way back in 2014. Drink plenty of water and have more fiber (but not tons). You also might be mindful of your salt intake and electrolytes. Too much water can throw that off and actually dry out your stools!

You want large bulky stools whether you have a fissure or not - do not try to hold it in you will regret it. I do not believe that stool softeners help but actually PROLONG fissures. If your stool is too loose I feel your rectum will tighten more and more and guess what happens? Fissure cannot heal. Your sphincter needs to relax, not tighten up.

In short, I would recommend doing a warm sitz bath (toilet or tub) not only after each BM, but do at least a few each day even if you have no BMs. It's all about RELAXING the sphincter to allow the fissure to heal. I have heard some mention of coconut oil to help with pain (inserted into the rectum) so maybe check that treatment out. It also sounds like a nice lubricant.

Fissures are a vicious cycle. You win a battle, then lose a battle. It starts daily. Then weeks go by. Then years. But if you get things under control now and remember to relax, reduce your stress and anxiety and not strain when going to the bathroom (very important!) - it should heal before it becomes chronic. And if you feel like things are getting out of control go see a colorectal surgeon for guidance. Don't worry, it doesn't mean you'll have surgery, it's just what proctologists are called now. The procedure I and many other had is called a lateral internal sphincterectomy or LIS. It is a small incision in your sphincter which helps it relax - just like I have been saying. I had an anal manometry (strength) test to see if I could tolerate the incision. I was so tight the doctor said I could crack a walnut in there! Thanks a lot stool softeners!

Anyway, let us know how things are going for you and let's hear the good news that you are doing great soon.
Chronic Fissure June 2014 - October 2020
Botox, skin tag removed - February 2015
Levator Ani September 2014 - February 2016 (caused by stress - left my job, cured!)
Lateral Internal Sphincterectomy, skin tags removed - October 2020
Fissure 100% healed!
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Re: First time fissure- worst pain ever

Postby missy moo » 26 Mar 2022, 17:03

Hey Rich44 you make me want to get lis like no one on here ever has :p
I'm going to see a crs outside of my town first time for a second opinion on lis and my next step to heal this fkr once an for all. 8 years too many I've got to that point were I'm sure you got to when you just think man do what ever you need to do just make it stop. My appointment is on the 4th of April bring it on. Also I'm completely anti softeners too. It completely make sence to NOT use softeners having 1 hard bm does not mean you should forever create super soft stools. That muscle needs to stretch like all other muscles in order to WORK properly
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Re: First time fissure- worst pain ever

Postby Rich44 » 28 Mar 2022, 10:51

missy moo wrote:Hey Rich44 you make me want to get lis like no one on here ever has :p
I'm going to see a crs outside of my town first time for a second opinion on lis and my next step to heal this fkr once an for all. 8 years too many I've got to that point were I'm sure you got to when you just think man do what ever you need to do just make it stop. My appointment is on the 4th of April bring it on. Also I'm completely anti softeners too. It completely make sence to NOT use softeners having 1 hard bm does not mean you should forever create super soft stools. That muscle needs to stretch like all other muscles in order to WORK properly
Thanks! 8 years is WAY too long and my CRS laughed when I said, "I wish I had done this sooner." He said everyone says that. But of course this pertains to the long term sufferers. Our new friend Casper doesn't need to go down that road. If you think about how a loose stool can aggravate a fissure or even cause one, then you start to realize stool softeners are all they are cracked up to be.
Chronic Fissure June 2014 - October 2020
Botox, skin tag removed - February 2015
Levator Ani September 2014 - February 2016 (caused by stress - left my job, cured!)
Lateral Internal Sphincterectomy, skin tags removed - October 2020
Fissure 100% healed!
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Re: First time fissure- worst pain ever

Postby missy moo » 28 Mar 2022, 15:28

Also i would add while trying to heal avoid eating dry hard stuff like nuts popcorn chips etc gor me its processed junk that blocks me up and fibre insoluble fiber is a killer man don't over do the fiber all it does is create larger then normal bms and creates more bms which when your in pain 1 bm is more then enough per day
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