Hi,
Newbie here!
I've suffered with anal fissures on and off for about 3 years as I also suffer with IBS. Usually after about a week of extreme pain, they clear up.
Due to absorption issues, I am on iron tablets all the time and my BMs are VERY acidic. Last week I was admitted to hospital for a small bowel resection (about 6" was removed) as I had a bowel obstruction caused by a nasty twisted loop. While in they treated my anaemia with an iron transfusion and I was nil by mouth for about 3 days. While NBM, I was pain free downstairs and loved it! Then when I got out they prescribed yet more iron (Ferrorous sulphate) on top of my normal iron. When I totted it up, I was getting 661mg of iron per day PLUS what I was eating. It was like pooping (sorry if I'm not allowed to say that!) solid iron bars. The first time I went post op after I started eating, I screamed as I could literally feel the tearing, ripping sensation. The toilet bowel looked like someone had slashed their wrists into it. I am also on codeine, paracetamol (NOT co-codamol) and diclofenac for the post-op pain.
I went to my GP on Tuesday who took me off the extra iron and is going to do bloods in a few weeks to see if that's caused any probs or if I really need the extra. He also gave me lactolose but told me not to use it unless necessary because it could stop me absorbing nutrients as it speeds up digestive transit. Since cutting out the extra, my stools have been MUCH better and a lot easier to handle but still the pain and bleeding persist now that the fissure is there.
My question really is this;
WHAT CAN I DO ABOUT THE IMMEADIATE PAIN??!
I'm already on a lot of painkillers which don't touch it, over the counter haemorrhoid creams with Lidocaine in, at first seemed to help but have since stopped working and I can't sit, stand or lie down (lying down is painful coz of the op) for long periods of time.
Does ice help? From the small amount of research I've done, it seems that while it might initially soothe the pain, constricting the blood vessels with cold actually delays healing, so does that mean haemorhoid creams which contract the skin, also delay healing and I'm just making things worse?
I read all kinds of things about dietary changes etc, which are fab for long term healing (bear in mind I have IBS so my diet is high fibre and due to my absoprtion issues it's also low fat, low carb and high protein). But I'm after short term, effective, immeadiate pain relief. I also have a 1yr old son, a house to run, a wedding to plan and I'm mature uni student so sitting in a warm bath 3-4 times a day for 20 minutes is just not going to happen! Perhaps a hot face cloth applied to the area for a few minutes? I could manage that. Does this technique work if the fissure is internal though?
I'd also be interested to hear anyone's thoughts on what to do when you feel the need to go but you know it's going to hurt. I've tried quickly putting some vaseline on to reduce friction and make the area more flexible but it doesn't seem to reduce the extreme pain. I've also tried taking my painkillers as soon as I wake and then trying to leave it till they kick in to go but with IBS, when I have to go, I HAVE TO go! I have found aloe vera baby wipes are nice and soothing post BM so I use those instead of ordinary paper but the effect is short lived and I can be in pain for hours.
Any ideas would really be welcome!
Thanks for reading

Have you tried Miralax?

Hi,
No but I'm not constipated anymore. Just in pain because everytime I go no matter how small and soft it reopens the fissure and more blood comes out.
Thanks though!

Honestly, it sounds like your body needs some healing time and recuperation time and rest time. You've had a lot of major things happening in your body and it has been through a great deal, and with all that is going on in your life besides, it's going to be a pretty high level of difficulty to heal very well in that context.
That being said, diet plus some type of stool softener to get the stools soft and easy to pass is the fastest way to pain relief, but with your surgical recovery you will need to run anything by your doctor first to make sure its okay. A bowel resection usually requires special diet considerations and restrictions and being careful with medications you take.
Soaking in the tub or sitting on a heating pad are also very soothing for the pain. Ice can also be really helpful, and actually can help healing. With short applications of ice, followed by heat, you have a resulting surge in circulation to the area. I would, however, avoid hemorrhoid creams with vasoconstrictors in them. Your doctor can also prescribe a topical compounded ointment with nifedipine or diltiazem that may help relax your sphincter and promote blood flow to the area to assist with healing.
I'm so sorry you're suffering so much and have been through such an ordeal already. This site is a wonderful place to pick up tips and is full of really helpful, caring people. But again, in your case you will need to run things by your GI surgeon to make sure its safe for you. Read as much you can of the other postings and you should be able to find some things that feel like a fit for you.
Welcome!

hot bath is the only thing that would soothe my fissure pain. i would take up to 10 a day when it got bad (anywhere from 10 minutes - 45 minutes at a time).

Thanks everyone. Ice does seem to help, thanks for that suggestion JR2 and I'll try applying a hot cloth and a hot bath. As everyone seems to suggest. Does miralax actually work "fissurecankissmyass" (love the name!)?
I still can't stand for very long... I've noticed it's standing still which hurts most so I've taken to wiggling my bum from side to side (as if walking) while standing if necessary. I've also found total relief after a while by sitting on what was my breastfeeding sausage coiled into a circle. Still in a lot of pain though and unable to do much. GP has recommended hot curries, lots of coffee, lactulose, coming off the iron till it heals and has given me some pain relief cream.
Does anyone else get stabbing/shooting pains in their groin with it? The GP said they were a typical symptom of anal fissures but I've not heard of this before.
Thanks everyone :)
Me

um... are you serious that your doctor has recommended hot curries and caffeine? Yikes!

yeah. He said "what you need is to have the runs for a few days... go home and eat a hot curry and drink coffee"
He wasn't my regular GP, I went to the urgent care centre. I ignored his advice on that bit! I do drink coffee (not often) but I wouldn't eat very spicy food if you paid me. It would BURN on the exit with my dodgy digestive system!!!
He gave me proctosydil which is supposed to be a local anaesthetic but it's not working AT ALL!! :(

wow... I've heard wacky advice from doctors before but this ranks up there and out there... You deserve a refund for anything you may have paid for that stellar advice, and he deserves to be reported for it.
yeah, something like proctosedyl isn't the greatest for anal fissures. Why suddenly does this not surprise me that this fine doc in the box would choose to prescribe that for you. Do you have an appointment with a colorectal surgeon? You should get far better care from someone who actually knows what they're doing.

Hi Georgiamb. You are not alone with the stabbing groin pains. Shoots right from the tailbone practically, all the way up to the pubis. Insult to injury, I say! But a hot water bottle between the legs while lying down can ease the pain for a bit.
Good luck!