Help, I have an IPAA and two fissures

need advice on how to deal with it

Do you suffer from Crohn's/Colitis or IBS. If you are looking for info on how to deal with an anal fissure with these ailments, or just wanting to share your experiences, then this is the place.

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Help, I have an IPAA and two fissures

Postby faithy09 » 31 May 2014, 00:58

Hi, I have an ileo-pouch anal anastomosis due to ulcerative colitis that I've been using for 5 months. I had a dilation for an anal stricture in April and ever since that procedure I noticed a skin tag. I didn't think anything of it until it got larger and started to hurt. This week my surgeon removed the large skin tag and found a one inch long and deep fissure and a smaller fissure, both mid-line. He also told me I have a lot of anal inflammation.

I am using an ointment, but how do you get it to stay on the inner anal ring? Why is my anus inflamed with a diagnosis of UC, it worries me that it might be Crohn's related instead? How long should it take the fissures to heal with an ointment treatment? Could the dilation be the reason why I'm having this anal fissure trouble or is it from the anal inflammation?

I'm so upset and would appreciate any advice or answers to my questions.
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Re: Help, I have an IPAA and two fissures

Postby Savaici » 31 May 2014, 20:29

So sorry you are in pain. I wish I could give you some solid answers, but can only welcome you and give you an idea of how it has been for others after surgery for skin tags, and other bits and pieces. Hopefully someone might come along with a few more words. 

Tags usually form with fissures; I have a few but have not had them removed. Do a search for tsgs (and anything else) using the Search function at centre top of the page.  It's a good search engine and there is lots of info on here. 

I have done dilation (self), which I found caused me too much pain so I stopped. However, if done by your surgeon this might help given some time. I found eating the correct amount of fibre helps me - mostly, but not always - to keep my BMs a 'decent' size. 

Not knowing (but taking a guess), you are using one of three ointments. Diltiazem, Nifedipine or a nitro mix. I never tried to get what I used inside as my CRS said it was not necessary to do that, and nigh impossible for some.  Usually with the ointments, it can take six weeks or so to see some improvement, but whether it will heal the fissures depends on whether you have had them for a short period of time or not. Chronic fissures are more difficult to heal with ointment. Use it regularly though and keep at it.  

You are just over surgery in a very tender part of your anatomy, and I am not surprised that there is swelling. I can't take a guess at whether it is something other than your UC and you really should discuss this with your surgeon/specialist. 

Do (can you) use a Sitz Bath? I find that really helps me a lot. 

Hope I have been of some help!
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Re: Help, I have an IPAA and two fissures

Postby faithy09 » 02 Jun 2014, 20:41

Thank you for your help! I talked to my CRS today and the plan is to use the nitro mix ointment (diltiazem wouldn't stay where it needed to be), to do sitz baths a lot and eat a high fiber diet. I've been doing these things pretty religiously, so I hope I start to feel improvements in the next week or two! If no healing takes place, I am going to be referred to a GI that can do a full-body check to see if it is due to Crohn's. I really hope it heals!!! because a diagnosis change would suck. And I was told today that it does take 4-6 weeks to heal completely. No one told me that until you and them today. So thank you! PS my skin tag came back with a diagnosis of ulcerated mucosa and inflammation, still not sure why I'm in this position and neither are the docs. Take care!
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