I'm new, my fissure isn't

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I'm new, my fissure isn't

Postby Mimime » 20 May 2017, 02:47

I'm so happy I found this forum! I'm about to ramble on a bit...

After suffering a bad anal fissure in my early 20's (over 2 decades ago), my GP at the time told me that I would likely have more of them, but he gave me nitroglycerin cream to use to accelerate the healing process. That was the stuff you rub on your chest, and I used only a rice-sized amount of cream. Wow! That stuff gave me an instant headache, but did it heal things up right quick.

Since then, I rarely have had a fissure. Maybe three in my thirties. They never hurt until recently. Now I'm 46.

For the last 6-10 months, I've had regular bright red bleeding. 4 months ago I freaked out the amount of blood was so great. Every time I go to see my doctor, she says she can't see fissure, no hemorrhoid, etc because it takes a few days to get an appointment.

I went to see her for a foot issue, and I mentioned that I had bleeding that day. So she took a look and said that yes, she found the fissure! She told me if she hadn't found it she was going to recommend a colonoscopy. She prescribed nifedipine 0.2% in petroleum ointment. I'm supposed to put it on 2-3 times a day and after each BM. I'm not sure if I smear it outside or have to insert it. I get it on once a day.

Very recently, I've had the spasmodic pain that some of you describe. It's usually at very odd times - nowhere near the bowel movement. Thankfully it's only happened a few times, because it's excruciating.

When I updated my GP about this, she said she was going to refer me to a specialist. This turned out to be the General Surgery department. After a bunch of back and forth, GI doctors at Kaiser don't care for anal fissures. Basically she's offering surgery since she said if I'm not responding to conservative treatment it's the only option. Oh, and apparently I have a very small/tight sphincter.

I'm gonna post a couple of other questions around here, as this is getting a little long. Thanks for reading, and thanks for writing all you have so far - it's been very helpful, depressing, and comforting all at the same time. It's not like you can talk to you coworkers about your anus issues.
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Re: I'm new, my fissure isn't

Postby Canadabum » 23 May 2017, 21:27

Mimime -- welcome
To the forum!!!

So you've got a right sphincter - join the club (lol). The pain and the blood can be horrible and we can all relate to the terrible feeling of passing that piece of glass only to be rewarded with a bowl of fresh red...you get the picture.

Tons of blood may be a hemmie...that happened to me once or twice even though I was told I don't have hemmies. As far as not being able to see the fissure - GPs are notorious for being fissure blind. You really need to consult an expert - CRS. Do yourself a favour and try and find a specialist who only deals with butt issues. You want someone looking and poking around who exclusively deals in that area - not a generalist.

As for the creams - no need to insert. Just run around the anus and the active ingredient will be well absorbed. Add to that heat, sitz baths, hydration, fiber, potty positioning and as much positive attitude as you can muster.

Keep the questions coming.

Alll best - Canadabum
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Re: I'm new, my fissure isn't

Postby Wits End » 27 May 2017, 15:11

I'm not quite sure how this forum works, but I thought I'd post my story in case someone can offer some helpful advice. I will apologize in advance for rambling, but it's so hard to find someone to talk to about this!! I had my first fissure in 2004-2005 and it lasted at least 8-10 months. It healed with conservative treatment, no medicine, and I was problem free for 11 years. I acquired another fissure last Feb 2016 after constipation.. I had it for 3.5 months, went to a colorectal doctor who prescribed hydrocortizone cream and suggested Miralax. Wtihin 3 weeks it healed. I went for my first colonoscopy in the fall due to my age, and he said everything checked out. I continued with the Miralax off and on and paid close attention to my diet in terms of fiber and water, etc.. always worried it would return. This past January I changed jobs and went through a stressful two weeks, at which point I committed the unforgivable sin of straining due to constipation. So here I am. I put myself back on the hydrocortizone cream (which seemed to help) and went back on Miralax, but after a couple of weeks I stopped using the cream as I've read you shouldn't use it for an extended time. The pain during BM was there but not excruciating for the majority of the time since January . I had some sharp twinges and itching during the day, but there seemed to be eventual improvement. I bled twice about 2 months into this during a non-painful BM, but I actually think that may have been due to a hemorrhoid but can't be sure. I actually had two periods of time -- one lasting 1.5 weeks, the other 2 weeks -- where I had zero pain during BM and felt as though the thing had healed. That was approximately 3 weeks ago. Then, for no apparent reason (no change in BM, no constipation, no straining, no hard stool) I started to feel mild sharpness during BM again. So several days later I went to a new colorectal doctor (my previous dr retired). She started to do the exam and told me she saw nothing on the outside. She started the internal but I felt pain, so she stopped. She prescribed Nifedipine/lidocaine ointment in a petroleum jelly base and told me to use it 2x per day for at least 4 weeks, even if it felt better. That was 2.5 weeks ago. I can't go up very far to apply because of the tighness, but in the beginning I was maybe trying too hard.. For some reason since that appointment and using the ointment, I feel more sharpness during BMs..more than before. Mostly just at the start. But I have not had any hard bowel movements, etc, so I'm very confused. I did have a few slightly larger movements, I believe, because I started taking Benefiber at the doctor's suggestion. I stopped doing that because I think maybe it was making my stool larger causing the area to stretch more (??) but I'm just guessing because I can't see what is going on down there. My sometimes optimistic mind is thinking since the ointment is supposed to increase blood flow, maybe there's more blood circulating there making it more swollen and sensitive, etc. Has anybody had this same experience? I am relatively problem free within a minute or so after the bm, and I'm very grateful for that. But I'm terrified every morning thinking one wrong move and I could make things much worse... and I don't know if this sharpness I'm feeling is the thing reopening or ?? I basically walk a tightrope with my diet and water intake.. I forgo foods that I think can worsen the condition, with the occasional indulgence. I'm very conservative in terms of medical treatment, and it took me a long time to get to the dr this time, mostly because I'd had those periods when I felt it was improving or possibly healing. I tend to obsess over problems, and I'm aware that's probably one of the worst things I can do.. but it's like relearning how to walk to tell myself not to worry. Most mornings I dread getting out of bed because I'm afraid of either being disappointed that there's no improvement, or that it's getting worse. In the grand scheme of things, I realize this is a minor issue compared to so many other things and I'm very grateful for the absence of more serious problems, but at the same time it's major to me because of the effect it's having on me in terms of anxiety/depression. I'm starting to feel this is going to be with me forever and I don't really know what else I can do to fix this.
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