Fissure healed with nifedipine but still have pain

Pain despite being declared "healed"

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Fissure healed with nifedipine but still have pain

Postby Alyssa » 30 Jun 2014, 21:31

Hi,

I have written on different forums regarding being "healed" but still having ongoing pain during and after bm so wanted to hear from others who have healed naturally, with botox or surgically to see if this is normal.

I had a fissure for two months and it healed with nifedipine after 6 weeks. I went back to the doctor because I was still having pain after bowel movements; dull rectal pain throughout the day but I was surprised to know that my fissure had healed. I've been to several doctors and they all have said that they don't see an active fissure (last CRS suggested that I might have a little tear so he suggested botox (despite having a normal sphincter; no tests performed to determine this just digital exam); I am seeing a pelvic floor physical therapist (was told that I have a pelvic floor dysfunction) for the last two months but no effect to my pain.

My symptoms: rectal burning/ stinging, paper cut feeling around my anus; sitting for long periods of time makes the burning pain increase, sometimes too much walking does it too. When I have a bowel movement it stings/ burns and when I wipe it stings and is tender to the touch. I feel dull ache (soreness)/ pain all day; there is no visible irritation or redness. In the month of June, I've had 9-10 days of little to no pain... others have mentioned that they get discomfort once in a while but mine is more constant than others.

I had the fissure for two months, and its been two and a half months since its been healed, how long does it take for your bum to get back to normal sensation/ no pain? (longer than the fissure itself)...crazy!

For those of you who are healed, do you still have tenderness when you touch or have stinging pain when you wipe?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Fissure healed with nifedipine but still have pain

Postby mmklinemm » 30 Jun 2014, 22:18

Since dealing with this, I've read a lot about nifedipine. Most of the studies indicate that treatments between 8-12 weeks have the best healing rates. I plan to use it for 12 weeks, even if I feel perfect earlier. I can't find a web link to post, only .pdf files. Google "Aggressive treatment of acute anal fissure with 0.5% nifedipine ointment prevents its evolution to chronicity." That's the title of a paper authored by Katsinelos P1, Kountouras J, Paroutoglou G, Beltsis A, Chatzimavroudis G, Zavos C, Katsinelos T, Papaziogas B.

Maybe you need to use it longer than 6 weeks?
Status: LIS 20 Oct 2014, 2nd LIS 05 March 2018.
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Re: Fissure healed with nifedipine but still have pain

Postby Alyssa » 30 Jun 2014, 23:47

I used it for two months straight but I was getting an allergic reaction to it so I stopped using it; I continued to apply it off and on until two weeks ago; I finally decided to stop all ointments (my bum was getting sensitive to anything).
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Fissure healed with nifedipine but still have pain

Postby FahmidFCR » 02 Jul 2014, 08:03

Hello,
I am suffering from Anal Fissure. Always having when passing stools and after passing stools.
Doctor prescribed me Glyceril Tinytrate. But had bad headache after using that. Although it completely vanished my pain.
So doctor changed it to Anoheal. Unfortunately Anoheal is not helping me that much. It causes some uneasiness in my anus, like cramps, as if some gas is stuck inside. But Anoheal is not giving me headache.
Do you think I should go back to Gylceril Tinytrate?
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Re: Fissure healed with nifedipine but still have pain

Postby Roidsfizzman » 02 Jul 2014, 11:43

Alyssa,

I would recommend that you keep a daily diary as it may help you know what is different on the 8 to 9 days with little or no pain. You should keep track of the stool texture on the Bristol scale and note size of stool and the number of time you go each day. You should also keep track of the types of pain when, where and severity. It appears that you are going to need to figure this out and provide the direction to your doctors. Your diary would also be a good tool to give to your doctor to help solve your problem.

Can you identify the spot of the pain source or is it a more of an all around pain issue? Can you touch the area of the pain source if so is there a lump?

My fissure has also healed and I am 9 weeks post LIS. I have a mixture of normal days and some days with minor issues. On issue days, I still get some stinging pain from the fissure area and the skin is still sensitive during a BM as I can feel the stool texture and size difference with it passes the fissure area and sometime after a BM I will get a little discomfort. My issue days usually start with a firm stool.
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Re: Fissure healed with nifedipine but still have pain

Postby Alyssa » 02 Jul 2014, 15:39

FahmidFCR,

My doctor prescribed me Nifedipine but there are others that also work to help; check out the forum for other meds that you can ask your doctor to prescribe.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Fissure healed with nifedipine but still have pain

Postby Alyssa » 02 Jul 2014, 15:46

Roidsfizzman,

Thank you that is a great suggestion, I started to do that last month but I think I need to write more details regarding the stool size; my BM are usually dimed size snakes...usually my second BM of the morning aggravates (more stinging)much more than the 1st. I cannot pinpoint an area of pain but it is more of a all around pain (paper cut sensation around my rectum) and it remains sore the rest of the day. When pressure is applied, I feel as though it burns (like I have bengay up my bum).
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Fissure healed with nifedipine but still have pain

Postby PianoMan » 08 Jul 2014, 15:31

I'm on my 4th week of nifedipine and my pain is down about 60% from my worst pain. Unfortunately I was treating it as hemmoroids for four months before I went to a CRS, so I'm afraid it'll take just as long to get back to normal. Colace didn't do anything for me beyond the first week, and I'm now taking a cocktail of Benefiber and Miralax. I'm having a bad episode right now which caused me to do some internet searching which led me to this website. Wow, who knew there was an entire forum dedicated to anal fissures?!
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Re: Fissure healed with nifedipine but still have pain

Postby Alyssa » 29 Jul 2014, 14:38

Update: My fissure has been healed but I continue to have CHRONIC pain! It's very frustrating because they see nothing wrong but I continue to have pain throughout the day and burning/ stinging pain while going to the bathroom and it is tender to the touch. I have been seeing a pelvic floor physical therapist for 3 months with no improvement on pain. She did say that I have tight muscles so they have referred me to Dr. Jennifer Schmitt at Kaiser in San Francisco (Chronic Pain Department) for a follow up; she has suggested that I get Botox but I'm scared that I won't be able to hold it in...my appointment with her is next Monday! I want out of this misery, almost 6 months with chronic anal pain!!!! I also have a 5 year old and an almost 6 month infant to take care of along with my anal misery.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Fissure healed with nifedipine but still have pain

Postby sweetpea » 30 Jul 2014, 12:02

Is it possible you have a second occult fissure somewhere? the symptoms you have sound like a fissure. Sometimes they need to look under anesthesia to find them, i believe.
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