Fissure No Pain Bleeds randomly?

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Fissure No Pain Bleeds randomly?

Postby septronius » 24 Oct 2021, 18:56

Hello!
I had an episode of constipation and developed a fissure many months ago, at the time of its occurrence it was very painful. I changed my diet and overtime the fissure's pain was gone however there was still blood in my stool. I saw a doctor and she confirmed that I had a fissure, I was developing a sentinel pile and the fissure had become chronic.

+I am using Nifedipine currently (twice a day)
+Eating high fiber diet (30g or more)
+Drinking 6-8 glasses of water
+Even though I have a sedentary work from home job I still get up every hour and move for 15 mins
+I had to learn to not strain when passing a stool, so far it's been rather good and the stools are generally good
+I do a sitz bath after each bowel movement to relax the muscle
+I'm doing some light relaxation exercises for the pelvic floor muscles too
+There have been few days that I passed a stool without blood
So now the pain is gone completely but I still have a fissure and a sentinel pile. There's blood when I pass a stool. There's also blood randomly throughout the day, I think it's triggered by specific movements that maybe some movements re-open the wound?
I'm going to do Nifedipine for 2 months and keep up my habits listed above and I'm looking to improve on them, I've been very diligent and tracking my habits and consumption.
I've had a fissure before but it managed to heal because I had a more active lifestyle, now the pandemic has made things a lot difficult. Also I should mention that on days I move a lot there's barely any bleeding (post-bowel movement) so I think staying active is a big part of the solution as it relaxes the muscle and promotes blood flow.
Some questions I have:

1. I just wanted to know has anyone experienced painless fissures bleeding randomly throughout the day for very short periods of time?
2. What are indications that I'm doing the right thing to promote healing?
3. Is every bowel movement supposed to have no blood for 2 months or something in order for it to heal?
4. Does it reset the healing completely each time the fissure bleeds?
Please let me know your thoughts
septronius
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Re: Fissure No Pain Bleeds randomly?

Postby patience_and_healing » 26 Oct 2021, 13:31

Hi there, I haven't experienced this problem but I would imagine that bleeding indicates a reversal in healing. Improvement indicators would involve no bleeding and minimal pain, although some folks (like me) end up with pelvic floor tension that causes pain during or after a bowel movement.

If you're having a lot of fiber it's possible that it's making your bowel movements too wide for healing. Maybe try reducing it while keeping up the laxatives and see if you notice any improvement in healing.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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