Fissure fully healed after 8 weeks on Nitro

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Fissure fully healed after 8 weeks on Nitro

Postby CrackinUp » 07 Apr 2013, 04:11

Hi all,
Well, here is my success story. I've written a very basic account of what happened week on week.
I'm 9 weeks in on Nitro now and fully healed. It's like I never had a fissure now, in fact I had been having trouble with pains down there for over 3 weeks before my tear so this is the best I have felt all year.
For anyone reading this who's got an acute / fresh fissure and have just started using Nitro, what I will say is don't lose faith. My first week on Nitro was absolute hell and it seemed to do nothing, but stick with it because after a couple of weeks you start to get control of the pain.
I didn't bother with any lubrication like vaseline or lidocaine gel, I stuck to a very simple routine and tried to leave the fissure alone as much as possible. I ate the exact same foods every day as it gave me confidence I would not have a large BM and be able to heal. In 9 weeks I have still not had a single large / hard BM.
This was my daily routine;
Drinking
200-400ml water every hour. Around 4litres per day in total (did this even pre-fissure!). Allowed myself one small, weak cup of tea every day but other than that only ever drunk water. Some days didn't even have the cup of tea.
7-8am
Get up, run a hot bath and try to get in quickly before BM urge to loosen things up, then back in afterwards.
9-10am
Apply Nitro. I found that Nitro (when it started working) could relieve my spasms for around 3 hours. These would be strongest around 11am>1pm so I tried to apply the Nitro as late as possible so I would have relief during those hours.
12pm
Soup time. I ate vegetable soup every day on the basis that it wasn't much volume and I'd get good nutrition / fibre from the vegetables. Spoon of olive oil before the meal.
1pm
Cry if the pain was bad... it reduced me to tears a few times let me tell you.
6pm
Dinner time. Fish and vegetables. Spoon of olive oil before the meal.
9-10pm
Second dosage of Nitro as instructed. Never had spasms this time of day really, but stuck to the routine on the basis that it's working round the clock then.
10-11pm
15ml Lactulose.
And this is my (rather basic - apologies) account of events;
29/01/2013
Fissure tear - unbearable pain wanted to go to hospital. Fissure pain has me in tears - the first time in my life I have ever cried from pain.
05/02/2013
1 week into Nitro. Doesn't seem to be working and went back to the doctor who wasn't much use. Fissure regularly reducing me to tears.
12/02/2013
Started applying Nitro to internal shpincter and got some relief. Doubting I would heal with Nitro so booked a CRS appointment. Fissure still managing to reducing me to tears on bad days.
19/02/2013
Noticed a senitel pile for the first time. CRS confirms fissure and senitel pile in the normal position. Still very painful some days but noticing an improvement now.
26/02/2013
Continued with diet and treatment. Some good days some bad. Eating or drinking anything outside my normal diet seems to upset things. Pain seems to be mainly under control now with the Nitro, but it's definitely still there and I need to be careful.
05/03/2013
My Pain 'changed' over the weekend. There was no more intense knife like pain with the spasms, instead I had a 'pressure' type pain. Booked a CRS appointment as I was concerned. CRS confirms fissure has healed over but is still tender so to be careful. Senitel tag is also a bit swollen and tender.
12/03/2013
Stopped using Nitro after 2 painless days following the CRS visit, only to find spasms return! So started up on Nitro again. I went away for the weekend and freaked out because I expected to be back to normal and wasn't. Spasms were very painful but felt like a horrible pressurised sensation. Starting to worry this is all in my head as I know I'm healed. Levator syndrome? Image
19/03/2013
Nitro has spasms under control once more and things are starting to get better. Sometimes a bit of burning and aching after a BM, but not really painful. Perfected squatting and no longer need to push when I have a BM - this seems to be really changing things fast for me.
26/03/2013
Things getting much better now, slight burning and itching after a BM. I am introducing different foods into my diet again; lamb, beef, curry and of course red wine!
02/04/2013
Feel almost back to normal so dropped the Nitro down to 50%. No pain or sensation during or after BM, other than sometimes it's a little bit itchy. Been drinking alcohol (lots!), eating curry, red meat, chicken... almost back to normal. Still continuing with sensible diet most days, lots of water, olive oil and Lactulose.
09/04/2013
Going to stop the Nitro completely… I do hope the spasms don't return!
So assuming all goes well on Tuesday I'll be off the Nitro but will continue with my diet of fish and vegetables most days, plus olive oil and lactulose. I'm going to continue the diet forever when possible, but come off the Lactulose after 3 months. I'll reduce it slowly and monitor the effects closely rather than just stop completely.
The biggest shock for me with this illness has been how long it's taken to return to normal even after the fissure has healed. I had some really quite bad spasms after healing which scared the crap out of me (no pun intended!). Getting your mind to the right place is what it's all about and I can sympathise with anyone who is struggling with this - it is not easy. I'm absolutely socked and amazed that your mind is so powerful it can induce something as painful as a sphincter spasm. Even without an open wound down there these things HURT!
If I had to pin my recovery down to any one thing I'd have to say it's toilet technique. I think I've pushed my entire life and the fissure is all my own fault... I did this to myself. Now I've learnt to go to the toilet without pushing which I didn't even know was possible! I notice that (even now) if I get at all worried it causes me to tighten up, then if I try to push it makes me tighter again... this is a vicious cycle and I am absolutely convinced was the cause of my tear. If I relax again or just give up until the urge comes later then I have no problem what so ever - even if I have to go twice. It's really difficult to do but my advice to anyone with a fissure is learn how to go without pushing and don't give up until you can do it.
Well that's it folks... you can all get better too, just stay positive.
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Re: Fissure fully healed after 8 weeks on Nitro

Postby Ever the Optimist » 07 Apr 2013, 04:50

Crackin up!
Fab! Thanks for posting this and the simpler, the better sometimes, become things tend to overcomplicate in your mind when you get a fissure because of the stress of it all and the way your mind works to figure out solutions and make sense of it all!.....
My heaing techniques are not at all different to yours and my conclusions the same....
My diet has never been that bad. I have been a pretty healthy eater all my life, although perhaps lacking in the fresh fruit & veg area and I know I needed to drink more water. I wouldn't drink for hours pre-fissure ( just didn't make the effort or forgot!).....
I too have pushed all my life without even realising the effect this was having on my poor bum. It's quite a realisation when you realise you shouldn't and don't actually have to push! Like you, on the BM's I force out, I reap the consequences. It can be additional twinges from the fissure area again or more painful sensations from my internal hems and this is 1 year, 3 months on since I developed the thing!!! and I am 99% healed.
You are so right when you say that even without an open wound, you can still get those sensations. The mind is incredible and I try and harness it's power these days into positive anal healing rather then letting it take over and fill me with doubt that it could all come back again!!
Thanks Crackin!! Stay positive and move on from it all x
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Fissure fully healed after 8 weeks on Nitro

Postby CrackinUp » 07 Apr 2013, 05:25

Thanks Ever the Optimist :)
The other thing I meant to say is with regards to what works and what doesn't work for people. This is a battle of the mind as well as pain... I strongly believe that the reason there are so many different things which 'work' for some people and not others is due to the confidence it gives you, which helps you not to worry, which in turn helps short and long term recovery.
I think anyone is capable of healing with the right amount of focus and reduced stress. I was very fortunate as I work from home, so I had no worries really other than healing my fissure. Admittedly I did get a little obsessed over it and it seemed like a big deal at the time, but my environment for healing was perfect.
Facing social situations where my fissure could flare up made me stressed, which actually then caused it to flare up... another vicious cycle. Try to keep as calm as possible and don't be afraid to say no if you think something is going to cause you an issue - likelihood is if you're in that frame of mind about it then it's not going to go well. I'm not saying stop doing things as that would be wrong, but just do what you feel is possible and don't let other people stress you out about returning to normal. It takes time and you need to go at your own pace... I found other people wanted me to be better more than I did! :)
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Re: Fissure fully healed after 8 weeks on Nitro

Postby JHH » 07 Apr 2013, 07:16

Crackin, mate, thanks for your story, and congrats Image
I agree in many of your theories, and especially about the mind-body connection.
Im happy you are out of this missery, and I hope I too will be able to join the success club in a few weeks :D
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Fissure fully healed after 8 weeks on Nitro

Postby Anonymon » 07 Apr 2013, 08:10

I'm truly happy to hear that you healed CrackinUp! I went into this thinking I'd heal in a week, but I'm now comfortable reading that anyone healed in any frame of time at all, let alone 9 weeks.
You credit most of your progress to proper pooping technique, and I'm going to assume soft stool. How much do you think the Nitro really helped you? That's pretty much the last frontier for me, which I'm hesitant of getting because it would take weeks to get, and I worry I will have made substantial enough progress by then not to need it. I also worry that anyone I go to is going to want to pry my butt open to confirm things, and retear it in the process :(.
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Re: Fissure fully healed after 8 weeks on Nitro

Postby CrackinUp » 07 Apr 2013, 08:58

Anonymon wrote:How much do you think the Nitro really helped you? That's pretty much the last frontier for me, which I'm hesitant of getting because it would take weeks to get, and I worry I will have made substantial enough progress by then not to need it.

I couldn't have healed without the Nitro, I'm convinced of that. Once the Nitro started working it REALLY helped, to the point where I could wait for spasms to come on then apply it and have 3 hours relief. I was close to pain free most days. I would seriously get on with the Nitro now as it slowly relaxes your internal sphincter and also opens up the veins in your ass which encourages more blood into the area and speeds up healing.
Don't get me wrong, soft poop and not pushing really accelerated the healing process - that I'm sure of - but people seem to respond to the various treatments so differently. I really got on well with Nitro as I had no headaches and really did get instant relief after application (once it started working!). I'm on my second tube now and STILL haven't stopped using it. I'm a big believer in this course of treatment now and it does heal 80% of cases.
Before I had my big tear I still had a fissure or fissures, but was convinced I could heal through diet alone. Then I ripped myself really bad and my doctor gave me Nitro... for that I will be eternally grateful!!
A fissure will struggle to heal if you're having lengthy spasms every day, so my advice is don't waste any more time and get the Nitro :)
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Re: Fissure fully healed after 8 weeks on Nitro

Postby Anonymon » 07 Apr 2013, 09:59

CrackinUp wrote:
Anonymon wrote:How much do you think the Nitro really helped you? That's pretty much the last frontier for me, which I'm hesitant of getting because it would take weeks to get, and I worry I will have made substantial enough progress by then not to need it.

I couldn't have healed without the Nitro, I'm convinced of that. Once the Nitro started working it REALLY helped, to the point where I could wait for spasms to come on then apply it and have 3 hours relief. I was close to pain free most days. I would seriously get on with the Nitro now as it slowly relaxes your internal sphincter and also opens up the veins in your ass which encourages more blood into the area and speeds up healing.
Don't get me wrong, soft poop and not pushing really accelerated the healing process - that I'm sure of - but people seem to respond to the various treatments so differently. I really got on well with Nitro as I had no headaches and really did get instant relief after application (once it started working!). I'm on my second tube now and STILL haven't stopped using it. I'm a big believer in this course of treatment now and it does heal 80% of cases.
Before I had my big tear I still had a fissure or fissures, but was convinced I could heal through diet alone. Then I ripped myself really bad and my doctor gave me Nitro... for that I will be eternally grateful!!
A fissure will struggle to heal if you're having lengthy spasms every day, so my advice is don't waste any more time and get the Nitro :)

I'll see if I can get my GP to prescribe it then. What specific mixture did you use? And about how much did it cost? I hear some people use Nitro, others use Nitro/other things all together. .2%, .4%, etc. If I give my GP something specific, she might save me a trip to a CRS or Proctologist.
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Re: Fissure fully healed after 8 weeks on Nitro

Postby CrackinUp » 07 Apr 2013, 11:35

Anonymon wrote:I'll see if I can get my GP to prescribe it then. What specific mixture did you use? And about how much did it cost? I hear some people use Nitro, others use Nitro/other things all together. .2%, .4%, etc. If I give my GP something specific, she might save me a trip to a CRS or Proctologist.

I'm in the UK so all it cost was the price of a prescription... currently around Ј7. I believe the cream is around about Ј30 per tube.
Mine was 0.4% and the recommended dose was 2.5cm of cream applied inside every 12 hours. I think applying it to the right spot inside (the angry, contracted internal sphincter) makes a big difference as I really started to feel the benefit after doing this.
Edit: In the UK its called Rectogestic if that helps at all.
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Re: Fissure fully healed after 8 weeks on Nitro

Postby Savaici » 07 Apr 2013, 11:51

Great work, CrackinUp. So glad things are working for you - in fact have worked! Image
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Re: Fissure fully healed after 8 weeks on Nitro

Postby owmybum » 07 Apr 2013, 14:45

Thanks for that Crackin,
I agree, stressful situations are certainly a way to aggravate fissures. I try to avoid most things I know will leave me worse off.
I love a good success story!!!
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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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