How can a small fissure last for 10 years?

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How can a small fissure last for 10 years?

Postby SorePeach » 08 Jul 2023, 07:03

Hi, I'm new to the forum! It's comforting to see people with similar issues, I feel less alone!

I started suffering in 2014, and was in pain for five years, then healed for 4 (and I thought that was finally the end of that!), but relapsed seven months ago.

Here is what is strange about my case: In all that time, I've only had light bleeding five times or so. I've consulted with over ten doctors, and they said I don't have anything or just irritation. Only one said that I had a very small tear, which was difficult to see because of my tight sphincter. But that it was too small to consider surgery/injections.

They basically treat me like I'm hysterical, but they don't understand the mental toll this takes after YEARS of daily discomfort.

There seems to be an irritated papilla down there. Walking is particularly painful, as it rubs together. Sitting is also very uncomfortable, at home I use a donut cushion...but I dread having to sit anywhere else. I avoid travelling (even staying over for one night) and sex as these often worsen symptoms. I only work part time in the afternoons, as I'm worried that it will interfere with BMs in the morning. I feel so limited.

Funny thing is, the last time it healed, it was due to me developing IBS from all the stress this caused me. IBS gave loose stools...that helped me heal. Now my IBS doesn't cause daily loose stools, so I'm taking Miralax. I'm terrified that it will make me dependant. It's also not solving the problem: like others on this site, I'm dealing with the hard tip problem, despite taking olive oil as well.

Been using NTG for five days....hope this helps finally...
Nov 2013: fissure misdiagnosed as piles:hem cream
May 2014: healed
Sep 2014: relapse
June 2015: dilitiazem+Miralax
Mar 2018: diagnosed with IBS, new round of dilitiazem, fissure healed
Jan 2023: relapse
May 2023: on daily Miralax again
July 2023: GTN
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Re: How can a small fissure last for 10 years?

Postby dmcff » 09 Jul 2023, 04:03

Welcome to the forum.

Sorry to hear of walking problems. I've personally found that swimming helps, also relaxation/deep breathing exercises, and meditation. But everyone is different, of course.

Maybe it's best to try to get over the anxiety - either alone or with a therapist. Also to realise that no medication is going to be 100 percent effective, but although some medications are more effective than others, all of them can be regarded as tools, to be used selectively, without fear, and with guidance from a trained professional.

Is NTG the same as GTN (glyceryl trinitrate)? Many members of the forum have reported good results from it.
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Living with it
2021 Still AF
2022 Therapy, meditation
2023 Onward, up
2024 Looking for closure
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Re: How can a small fissure last for 10 years?

Postby SorePeach » 11 Jul 2023, 04:01

Hi dmcff!

Thank you! Yes, sorry, GTN is what I meant!
Nov 2013: fissure misdiagnosed as piles:hem cream
May 2014: healed
Sep 2014: relapse
June 2015: dilitiazem+Miralax
Mar 2018: diagnosed with IBS, new round of dilitiazem, fissure healed
Jan 2023: relapse
May 2023: on daily Miralax again
July 2023: GTN
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Re: How can a small fissure last for 10 years?

Postby SorePeach » 27 Jul 2023, 12:18

Hi I've decided to post an update!

I had a rectoscopy where they found 3 hypertophied papillae, some inflammation and small sentinel pile, but no active fissure and no haemorrhoids. My sphincter was also normal so they diagnosed levator ani syndrome, prescribed prebiotics and oral aloe vera.

I was NOT happy with this diagnosis. The report said things like "family problems" (I really don't recall saying that), talked about previous mental health issues, about how my mom didn't breast feed me as a baby.....it really came off as "this girl has a history of being crazy and she is imagining things".

So I went to a proctologist and she was GREAT, she said this is quite common. Told me not to take aloe vera, as it's a stimulant laxative and not even regulated. Already knew this from my research! She really reassured me about Miralax, said that I can take it everyday for as long as I like, anything between 1 and 8 satchets, it's completely safe and does not cause dependence. I can stop weaning off once I am 100% pain free and having a bm is like brushing my teeth. She noticed that my pelvic floor was hypertonic, so I will be doing physical therapy.

I've been feeling much better the last two weeks and hope I can post a success story soon with everything that has helped me.
Nov 2013: fissure misdiagnosed as piles:hem cream
May 2014: healed
Sep 2014: relapse
June 2015: dilitiazem+Miralax
Mar 2018: diagnosed with IBS, new round of dilitiazem, fissure healed
Jan 2023: relapse
May 2023: on daily Miralax again
July 2023: GTN
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Re: How can a small fissure last for 10 years?

Postby AF3 » 28 Jul 2023, 05:03

Hi SorePeach,

Wishing you the best of luck! That’s great news that there’s no fissure present. Have you thought of applying anti-inflammatory oils to that region? I tried coconut oil but it wasn’t enough. I’m going for calendula next but that’s not been easy to come by. I’m tired of medical creams and trying the oil route now!

Hope all goes well.
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Re: How can a small fissure last for 10 years?

Postby Hazey123 » 28 Jul 2023, 17:34

Hi Sorepeach
Thanks for posting the reassurance about miralax that’s good to hear! I take this each day and it helps a lot but I always worry about becoming dependant on it. I’m glad you have found someone helpful to advise you and also that you have had a better few weeks. Someone listening to you and taking you seriously really helps. This pain is so mysterious sometimes as these fissures are often the original source of pain but even after they heal the discomfort can continue. I hope you continue to improve x
AF following skin tag surgery Feb 2022
GTN ointment
sigmoidoscopy & EUA Sept 2022 no fissure found
2nd opinion Jan 2023 fissure diagnosed, diltiazem - allergic
recommended Botox Fissurectomy
3rd opinion - dilation 2x per day plus GTN ….
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Re: How can a small fissure last for 10 years?

Postby SorePeach » 29 Jul 2023, 04:46

Hi Hazey and AF3!!

I agree about the Miralax, some general doctors made me scared of dependency, but when I've consulted with proctologists they've told me that it's totally fine...and they are the experts.

AF3, I also used coconut oil and didn't like it that much...I now have like a whole pantry of ointments, so I guess I will use those for a bit before buying more stuff lol. I'm using a lot of vitamin E. I'd love to know how the oils work out for you! I'm curious to try calendula and witch hazel.
Nov 2013: fissure misdiagnosed as piles:hem cream
May 2014: healed
Sep 2014: relapse
June 2015: dilitiazem+Miralax
Mar 2018: diagnosed with IBS, new round of dilitiazem, fissure healed
Jan 2023: relapse
May 2023: on daily Miralax again
July 2023: GTN
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Re: How can a small fissure last for 10 years?

Postby Vg7190 » 14 Sep 2023, 11:33

Hi there how do you use vitamin e oil?
I m thinking to try vitamin e 30000IU oil but not sure if it’s too much vitamin E
Can you please suggest which one you are using
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Re: How can a small fissure last for 10 years?

Postby Vg7190 » 14 Sep 2023, 11:33

SorePeach wrote:Hi Hazey and AF3!!

I agree about the Miralax, some general doctors made me scared of dependency, but when I've consulted with proctologists they've told me that it's totally fine...and they are the experts.

AF3, I also used coconut oil and didn't like it that much...I now have like a whole pantry of ointments, so I guess I will use those for a bit before buying more stuff lol. I'm using a lot of vitamin E. I'd love to know how the oils work out for you! I'm curious to try calendula and witch hazel.



Hi there how do you use vitamin e oil?
I m thinking to try vitamin e 30000IU oil but not sure if it’s too much vitamin E
Can you please suggest which one you are using
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Re: How can a small fissure last for 10 years?

Postby AF3 » 28 Sep 2023, 12:17

Hi Vg,

I haven't tried Vitamin E oil. I think I've seen other posts on this forum which have mentioned Vitamin E oil. Not sure if you've done it already, but perhaps post your question on the General AF thread?

I've tried a few oils such as Calendula, coconut - I didn't have much success with Coconut despite its properties - I prefer Calendula because it's more viscous and seems to moisturize better. I am also trying raw CBD oil as it is anti-inflammatory. Both these are alongside a small amount of vaseline as a barrier cream. My previous CRS recommedned Metanium (cream to prevent nappy rash). Not sure if the latter is a UK only brand name.

Good luck with the Vitamin E if you've already started to use it, and please let us know how it goes!
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