How do I know I'm getting better?

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How do I know I'm getting better?

Postby SpiderMan120988 » 11 May 2022, 17:33

At the beginning of April, I started experiencing a severe burning/itching sensation after a bowel movement. It would subside in 90 minutes to 2 hours but during that time, it was a struggle to concentrate. The only thing that made it feel better was spraying warm water on my anus using the showerhead. I had experienced something similar last year but it went away as suddenly as it appeared (don't remember how long it lasted) so I just suffered through it. After 2 weeks, I was getting worried so I made an appointment to see a gastroenterologist. There were no external hemorrhoids but she did notice a "superficial wound" which led her to diagnose it as an anal fissure and she suspected the majority of the cut was internal. She gave me a nifedipine/lidocaine ointment to use for 6 weeks. I've been using it for a three weeks now. Meanwhile, I made some adjustments to my diet. I eat a couple of prunes a day, eat half a bowl of All-Bran Buds, and have been drinking more water. I'm pretty regular as far as bowel movements go. I'm still experiencing burning/itching after going to the bathroom but it seems like it's less? I can't be sure. I reapply the nifedipine/lidocaine ointment after a bowel movement (no more than 3 times a day), try to wait half an hour, and then apply some calmoseptine which seems to help it subside faster. I only use the calmoseptine after a bowel movement. Other than the burning/itching after a bowel movement, I'm usually okay. Sometimes I get some slight discomfort or itching but I can ignore it. I'm not doubled over in pain or anything and I wouldn't say a bowel movement is painful for me either, it's just the feeling that comes after that has me worried. I've also been using wet wipes with aloe vera and cleaning my anus with the showerhead after a bowel movement before reapplying everything. Oh, and no burning/itching at night when I sleep. Does anyone have any thoughts about this? Am I on the mend? How long does it take for nifedipine to make significant progress?

Some additional info: I might have had a slight retear a few days ago due to some slight constipation because I missed eating a bowl of All-Bran Buds. I felt something sharp and then the next day saw some blood on the tissue paper, like dime-sized. Also, I don't think the lidocaine does anything for me except give me a slight stinging sensation.

Is there anyone here who managed to heal in 6 weeks? It seems like a lot of people here resort to surgery and I'd rather not have to do that.
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Re: How do I know I'm getting better?

Postby patience_and_healing » 12 May 2022, 17:49

I think in general you can consider yourself healed when the doctor can see no evidence of a fissure. That doesn't mean you will be completely pain free because such a sensitive area takes time to calm down.
Burning after a BM is due to the tightened muscle usually, and should improve as things heal. It's common for fissures to be reinjured but as long as the graph of pain continues to generally trend downward, that's a good sign.
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.
On and off in pelvic physical therapy
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Re: How do I know I'm getting better?

Postby SpiderMan120988 » 12 May 2022, 19:39

I will say that the burning/itching I'm getting now is not as bad as it was three weeks ago, though it still worries me because I'm wondering if this is forever. I ended up having to cancel a whole vacation over this because I wanted to focus on healing. I have a trip coming up in July so hopefully, I'll be feeling better by then. The worst place to get a cut, and you can't even see it to see whether it's getting better or not. After this, I'll never take my butt for granted again.
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Re: How do I know I'm getting better?

Postby Rich44 » 17 May 2022, 13:11

One of the trickiest things with fissures is that people start stressing out about it and the more you stress the more your sphincter tightens up which slows down healing. And then come the stool softeners because you get scared to have a larger BM, thinking softer is better. Softer is better, but bulky is what you need. If you have too soft, the sphincter tightens up even more.

A hallmark treatment for fissures is a simple one - a sitz bath. You can do it in the tub or buy a bowl to put on your toilet (love mine). The idea is to relax the sphincter which promoted blood flood and healing to the fissure. No medications are needed. Lidocane is simply to help with pain and won't heal you. Niphedipine can work but again - if you are stressed, I don't expect it to work too well.

My recommendation is you should try to do sitz baths a few times a day. It will soothe and relax you. Have a normal amount of fiber - don't go overboard (psyllium husk, bran, fruits, veggies or Citrucel) and plenty of water. You want a bulky normal stool. Have a follow up visit to a doctor or even a colorectal surgeon (don't worry, they don't push surgery on you) to make sure it's healing. I think you will be on the right track. Itching, burning, pain are all part of the fun. Just try to relax when you have a BM. Let it come nice and easy.
Fissure June 2014 - Oct 2020
Botox, skin tag removed - Feb 2015
Levator Ani Sep 2014 - Feb 2016 (left job, cured!)
LIS, skin tags removed - Oct 2020
Fissure 100% healed - Nov 2020
Still healed as of March 2024
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