Hi. I'm a new member though I've been looking at the board for about 7 months (just didn't sign up don't really know why.....) Been getting lots of great tips and advice, thank you all!!!!
I am female aged 48 (though I don't look it lol )
Quick history - I had hemmeroid surgery Nov '15 (private not free on NHS as I didn't want to wait on long waiting list and thought maybe better results... Hmmm how wrong that was!...) My consultant had not quite done the job (in his own words) and left a lot of excess skin.. He offered to fix for free (I thought wow, lucky me, (sarcasm ) He did this Jan '16. After that didn't feel healing was going well, hurt like hell with every BM. Thought this was normal healing but after back and forth to 2 consultants (my surgeon and a second private specialist at my own cost) told me I have a small fissure. This was about last July. Since then I've tried it all....
In no particular order......
Sitz bath with Epsom salts (still do every day after BM)
GTN ointment (headaches and constant twitch in right eye!) Stopped at 6-8 weeks - not healed
Coconut oil
Castor oil
Acupuncture
Sudocreme (nappy rash cream, zinc oxide)
Diltiazem (just finished 8 weeks seems a bit better but wondering if it's irritated my delicate skin as it's so sore! So having a break)
Homeopathy (doesn't seem to work)
Now trying Reflexology and just started Ozonated Olive Oil (has anyone had any success with this? If so how much did you use, how often and did you use internally and externally?) I seem to be having twitch in right eye again but not sure if this is coincidence as it's purely Olive oil?!
Sitting on heat pad (is this good? sometimes wonder if this actually
heats too much and causes internal 'swelling' ouch)
My BM's are not as painful as they used to be (near tears as I'd go to toilet!) and GP says the fissure is very small and looks like healing (yay!) but can't seem to get rid of this horrific internal bruise/ache/pain! And want to know why does it hurt so much when my fissure/cut (back of my backside) is on the outside of my body?... I find it difficult to 'sit' up straight on my poor bottom! walking, standing, laying down all pretty good! Sitting is painful, an hour in the car and I'm near tears
Has anyone got any new advice for me and any answers to my queries?
By the way in between all this I have had a 3rd surgery, Nov '16 to have left ovary/tube removed due to large cyst...luckily turned out benign (all within 12 months!)
As you can imagine I'm desperate to avoid any more surgery, including Botox suggested by my consultant!.....
Thanx to all for reading my long post x

Hi there - sorry to hear that this has been so tough!

The pelvic floor can be a little tricky. It sounds like you've had a lot of trauma down there, and that can cause tightness and spasms in the wrong places at the wrong times. I would ask your CRS about it first, of course, but i would also consider seeing a pelvic floor physiotherapist.

I had fulllll on pelvic spasms when my fissure was bad - I couldn't have a bowel movement, I couldn't even urinate they were so bad. And I did feel that internal pain - as if a goofball was up inside. As the pain subsides, the tension reduced, but I still had the golfball feeling, painful up inside. This feeling can be from overactive muscles in the pelvic floor - a pelvic floor physiotherapist can really help with this.

I would also ask your CRS if your anal sphincter tone is very high - I'm almost healed up from my fissure, have no pain during bms, but I still have a tight sphincter and spasms that cause pain all on their own. It's been six months - they're not gone, so I'm going straight to LIS! If your sphincter tone is high, then maybe Botox or LIS would help you out!!

-GG

Hi sorry to hear your still suffering
But on the plus side if your fissure is starting to heal then hopefully the pain will go.
The full on spasms are horrendous but being left with a constant ache isn't good either.
I agree with GG about getting your resting tone tested. Although it could just be from the hem op in which case your tone could be normal.
We have so many nerve endings down there which are all interconnected that even a relatively small cut can cause unbelievable amounts of pain and it can take a while after it has healed for the muscles and nerves to calm down and relax.
If you don't want Botox and you are healing then don't let them push you. If your pain doesn't improve...consider it, it could give your muscles the rest they need to go back to normal and stop aching.
Good luck as a fissure is the worst pain I have had.
I tried the ozonated olive oil and it didn't do much for me but at the time my fissure was long and deep and the spasms were full on. You could try adding some comfrey cream to it as comfrey is a great wound healer. I think this has helped mine to get to 95% healed after my LIS
Also try some gabapentin for the pain as I really believe this stopped my pain/spasms cycle and enabled me to heal. No other painkiller even came close to touching the pain.

Hello. Thank you for your replies!
I've been reading a bit about physio and wonder if that would help this terrible 'tight' feeling I get internally... It feels like I have something stuck just up inside my bottom..... Thing is, when I've been examined (Consultant/GP) I've been told all feels "normal". So confused, if it feels normal why does it hurt so much and give me so much trouble?! I've had 2 babies, both easier than this!!!!

What is the Resting tone test you mentioned?
Thank you x

Hi,
Thankfully I do not get that full feeling my pain is just related to my fissure so only comes after multiple BMs or when sat for long periods
The pressure test is to see how high a tone or tight your sphincter is....a high tone will stop a fissure healing and make the risk of more fissures higher, it can also cause spasms. Most people have a resting tone of 60/80 mine was 120/130 hence why I got temporary relief from the Botox and why LIS has helped me.
If your resting tone is normal your fissure could just be an unlucky result of your op and the pain you are having could be related to pelvic floor levator ani pain, which LIS is not often used to treat here in the UK...it's only given on the NHS if you have an active fissure. But there are quite a few places that specialise in pelvic pain so don't let them tell you to deal with it just because your fissure is healing

Hi again - to me that sounds like the levator muscle is tight, just from my own knowledge and experience with physio. It happened to me as a side effect of sphincter spasms and pain. A physio would most definitely be able to help you out, especially if you can tolerate a rectal exam! If you have a pelvic floor physio near you I encourage you to check it out.

They use a manometer to test the resting tone of the sphincter. It's generally done in colorectal centres or units at hospitals. Where I am (Canada) there is a long wait to have it done. If you have a colorectal surgeon, they should be experienced enough to tell if your tone is high just by doing a rectal exam.

-GG

Sounds like something I should look into. I have been examined by my GP and my CRS surgeon (with finger) and they said it feels "normal", but is the test you're suggesting to test the tone further up inside?
My BM's are quite regular and normal, but it hurts after I've been to toilet (a horrible aching bruised feeling internally) and burning feeling externally (though that does subside quite quickly especially if I all some coconut oil etc) and I find massaging gently with a finger eases the pain/aching a bit.
My worst thing is trying to sit : (
I have been told by my nurse at last vaginal exam (smear test) that (in her words) I'm very small and tight in my pelvic region (possibly why both my children were both born premature, unable to get any bigger?) I am only 5'2" and petite sized.....
I've always wondered if my hem surgery then the skin tag removal surgery was done too close together (only about 10 weeks between) not allowing my poor behind to recover and heal... Its not been good since then...
(By the way at the top of each post is a thumb up emoji, when I press it goes thumb down... is this to thank you for the post?)
Thanx x

I'm not sure if the manometry can be used for other pelvic muscles. To be honest, I would start with the physio. I had that feeling you describe and my physio was able to help with that. Actually, the physio was recommended by my CRS to try before LIS - sometimes they even work out of hospitals.

I mentioned physio to my GP, she said she hadn't heard of doing that for this issue/problem.....
Sometimes I get a bit frustrated with doctors, and feel I know more about my health problems than they do! (probably because I'm always reading about it on here, lol!)
She said it wouldn't be offered on the NHS so I'll look into private....

Ugh that's a pain. I'm surprised it wouldn't be offered. I'm in Canada, and it's covered under my insurance luckily.

My gp didn't know much of it either - sometimes I think this is just a bit over their heads, if it's not just a simple hemorrhoid issue. My surgeon was the one who prescribed.

I hope you can find someone - even a consultation might be worth it so you can relay whatever information you get to your doctor.