I think I have a fissure

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I think I have a fissure

Postby BUTTHURTT » 21 Apr 2014, 15:22

Hi All,

About a month ago I had a very solid, painful BM where, as I described it, I didn't necessarily feel like I "tore the o-ring" but maybe "over-stretched it a bit". At first the residual pain wasn't that bad - just sore it seemed. Then after my next few BMs it became clear that there was more than just soreness involved. At first I thought it was hemorrhoids (never had them either - age 34 btw), then, after visiting WebMD, I came to the conclusion that it was actually a fissure because of the one specific, traumatic BM.

I have good days and bad days. Usually the good days are the ones that I don't have a BM, but not necessarily. Sometimes I can have a BM in the morning and, while the act itself is definitely painful, there may not be the follow-up twinges of severe pain that usually follow - sometimes those pains will last for days even without a BM. There is generally some blood on the TP and some on the "front-end" of the BM, but never drips. And the blood doesn't really seem to indicate any other symptoms.

I have tried several things to help ease the pain and self-medicate. Lots of water; high-fiber diet; stool softeners; long, hot, baths (these seem to be the most effective way of relieving the pain, but not always practical); hemorrhoid cream; tucks pads; hydrocortisone cream; etc. Other than the bath, I can't really point to any of these things as having any real effect.

My diet and stool softener efforts have been pretty successful in that my BMs have all been pretty soft (yet still extremely painful). I've never had much problem with being constipated. The problem is that while the softer stools are definitely less painful, it's still not seeming to heal or have any effect on the extreme twinges that I experience during the day.

Some times I feel like I'm getting better, then BAM! three bad days in a row.

I made a doctor's appointment for this coming Friday because I just feel like I can't take it anymore.

Any advice other than "Go to the doctor."?
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Re: I think I have a fissure

Postby havefaith » 21 Apr 2014, 17:25

My first question, does it feel like glass is coming out in ur stool? So much pain that ur anus almost closes back up due to it? The blood could be an indicator of a fissure or internal hems. And you mentioned never having troubles with constipation but you mention "sometimes these pains will last for days even without a bm" if you are going days without defocating then in my books (not the docs) you have troubles with constipation. I would hold off on any hem cream as stuff with hydrocortisone is shown to thin the skin after ten days of use. The twinges you speak of sound like spasms, which can be caused by fissures.

What is ur diet currently like?
What stool softener do you use and how many times per day?
What fiber supplement do u currently use and how many grams of fibre do you get per day?
How many bms do you have per day?
How much water do you currently drink?
Do you have a history of straining while defocating?
Have you ever laid in side lieing position with a small mirror propped up to see if you can spot a cut or abnormal bump?

These questions will help myself and others to answer more questions. I am glad you are going to be assessed, early diagnosis is the best treatment.... Ps did these twinges only start after that rough bm or were they there prior?
I have faith in you always, i love you like my own son or daughter, when you hurt, i hurt. Let us all be each others guiding light, and heal without anxiety :) Much love to all.
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Re: I think I have a fissure

Postby Only22 » 21 Apr 2014, 17:27

Hi there! I'm new to the site myself, so I don't have much advice, but I just wanted to welcome you. I don't know if you've tried this for your pain, but Lidocaine works wonders for me, even the over-the-counter kind. I was using Prep-H for lubrication, and though it helped, it's nothing like Lidocaine which actually numbs up the fissure and surrounding area. It's like novacain for your butt. :) I do enjoy me a long, hot bath, too.. They really help the muscles relax. I've heard Epson Salts added to the water can help, but that's a big no-no if you're diabetic because too much magnesium in the body, absorbed from the salt, can cause uncontrolled fluctuations in blood sugar. Have you tried squatting with both your feet up on the seat? That alleviates some tension.
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Re: I think I have a fissure

Postby Scientist2516 » 21 Apr 2014, 17:29

Hi Butthurt,
welcome to the forum. Sorry you've been having fissure pain and misery, but you've come to the right place for support and advice.

You really have been doing all the right things. Everything you are doing is helping you, and will go on helping, but it sounds as though you need more.

Go to the doctor is always the first and best advice, but you are already going to do that, so - good for you.
Hopefully the doc. will prescribe nitroglycerine or nifedipine or diltiazem. These are all ointments that relax the anal sphincter, help the pain, increase blood supply to the anus and help you heal. You may have to try more than one to find one that works.

Just know that healing a fissure can take a long time, and be quite discouraging, with set-backs. I'm not saying this to depress you, but to let you know that even if it seems like it's taking forever, you CAN heal. You may have to keep up your diet, water, heat and ointments for weeks, but eventually you'll notice things getting better.

If things don't progress, don't be afraid to go back to your doctor, ask for a different ointment, or see if surgery is the way to go.

Good luck, and let us know what the doctor said.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: I think I have a fissure

Postby sugarspice » 22 Apr 2014, 13:24

Hi butthurt

I think havefaith has covered most of the questions needed here. I have hems and a fissure so I know the difference in the pain. An internal thrombosed hem is frigging painful like a dull ache but painful too. A fissure however is like poo-ing broken glass and you get a BURNING pain whilst going and one that lasts for ages afterwards too. Which pain is it more like?

REgardless of which it is ask your doctor for a prescription of movicol/laxido (can't remember the american name, but not sure where you are based) it will help for either condition and it makes your BM's like silk :-D
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Re: I think I have a fissure

Postby sugarspice » 22 Apr 2014, 13:26

PS - I forgot to say get one of these. Save you running a bath every 5 minutes! I use mine about 4 times a day! Use warm water, not hot, as if you have hems hot water will make them a lot worse :-(

http://www.amazon.co.uk/NRS-Healthcare- ... =SITZ+BATH
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Re: I think I have a fissure

Postby BUTTHURTT » 23 Apr 2014, 10:04

havefaith wrote:My first question, does it feel like glass is coming out in ur stool? So much pain that ur anus almost closes back up due to it? The blood could be an indicator of a fissure or internal hems. And you mentioned never having troubles with constipation but you mention "sometimes these pains will last for days even without a bm" if you are going days without defocating then in my books (not the docs) you have troubles with constipation. I would hold off on any hem cream as stuff with hydrocortisone is shown to thin the skin after ten days of use. The twinges you speak of sound like spasms, which can be caused by fissures.

What is ur diet currently like?
What stool softener do you use and how many times per day?
What fiber supplement do u currently use and how many grams of fibre do you get per day?
How many bms do you have per day?
How much water do you currently drink?
Do you have a history of straining while defocating?
Have you ever laid in side lieing position with a small mirror propped up to see if you can spot a cut or abnormal bump?

These questions will help myself and others to answer more questions. I am glad you are going to be assessed, early diagnosis is the best treatment.... Ps did these twinges only start after that rough bm or were they there prior?


It is definitely NOT a dull pain. Very sharp stinging and burning, both during and long after BMs. Sometimes the twinges won't start for hours after the BM.

I have stopped using the creams because I don't feel like they've done anything to ease the pain or promote any healing. Just tucks occasionally, though they don't really work - only slight relief during the application.

I started dieting a couple week before all this started. I try to eat lots of vegetables, fiber, low sodium, low fat, low sugar, and NO fast food. I definitely stray occasionally (ok, frequently) but I am definitely eating better than I ever have.

I'm not sure which stool softener I use but I take two pills at night.

I don't use any fiber supplement but I plan to start this weekend. I say this weekend because I want to see how it's going to affect me while I'm at home - not at work. I'm not sure how many grams I take in per day but I generally try to eat as much as I can.

I usually have 1-2 BMs per day. It could be none, or it could be up to 4. I know, really irregular, but very rarely constipated.

I would say I generally drink between 64 and 128 oz. of water per day. I'm not very consistent, but I've been making conscious efforts to drink more than I used to.

I would say that I DO NOT have a history of straining while defecating. I've never had any sort of anal trauma before - no hemorrhoids, etc.

I have never tried to look at it, though that makes me think I should and I will. This brings me to another question: I don't know about anyone else, but I have quite a lot of hair in that region. Is it customary/appropriate to shave or something before my dr visit? The potential embarrassment is the main reason I have not already been to the dr.

All this started after that one, fateful morning. I had absolutely no problem until that one, specific BM.
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Re: I think I have a fissure

Postby BUTTHURTT » 23 Apr 2014, 10:07

Only22 wrote:Hi there! I'm new to the site myself, so I don't have much advice, but I just wanted to welcome you. I don't know if you've tried this for your pain, but Lidocaine works wonders for me, even the over-the-counter kind. I was using Prep-H for lubrication, and though it helped, it's nothing like Lidocaine which actually numbs up the fissure and surrounding area. It's like novacain for your butt. :) I do enjoy me a long, hot bath, too.. They really help the muscles relax. I've heard Epson Salts added to the water can help, but that's a big no-no if you're diabetic because too much magnesium in the body, absorbed from the salt, can cause uncontrolled fluctuations in blood sugar. Have you tried squatting with both your feet up on the seat? That alleviates some tension.


I've been wanting to try something like Lidocaine. I didn't know it was available over-the-counter. I really feel like a local anesthetic would help A LOT. Is that something that could be used "internally" as well?
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Re: I think I have a fissure

Postby BUTTHURTT » 23 Apr 2014, 10:09

sugarspice wrote:PS - I forgot to say get one of these. Save you running a bath every 5 minutes! I use mine about 4 times a day! Use warm water, not hot, as if you have hems hot water will make them a lot worse :-(

http://www.amazon.co.uk/NRS-Healthcare- ... =SITZ+BATH


I heard about these. I plan to get one. Thanks!
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Re: I think I have a fissure

Postby sugarspice » 23 Apr 2014, 12:26

Burning pain sounds def like a fissure, poor you :-(

Please don't be embarrassed about going to the Drs they have seen everything and they really don't give a sh*t....pardon the pun lol. But they really don't, the main thing is that you get help. The longer you leave a fissure the worse it gets....trust me!

Def get some laxido/movicol if you can, it's dreamy for silky soft BM's. Don't worry about the regularity of your BM's either as we are all different, so all go at different times.

I have had botox twice now as when they put me under GA I had a very long, deep and chronic anal fissure :-( First lot didn't work, mainly because my diet and medication was wrong, but I have changed all that now, so fingers crossed!

About a week after the botox had kicked in I had no pain, it's dreamy!!! Well itchy and sore but not that horrendous burning pain from hell.

Rot in hell fissures!!! LOL

All the best tomm
SS
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