Incredibly Frustrated

Fissure problems for over ten years

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Incredibly Frustrated

Postby Me82 » 12 Mar 2014, 09:08

Hi all,

I've spent some time reading without posting. I had my first fissure around 2000 and it healed on it's own without too much trouble. I kept having fissures with minor bleeding on and off (they always healed on their own) until fall 2010 when I had a very bad episode. I was in lots of pain with what I considered lots of bleeding for a few weeks. I finally went to my GP who had a quick look and said it was a nasty looking fissure. He prescribed Movicol and Ultraproct (I think) cream. It took a couple of weeks and the pain and bleeding stopped.

I kept buying Movicol (OTC) and kept the fissure under control with only minor pain and bleeding episodes which happened maybe once or twice a year until early this year when I seemed to get diarrhea from the Movicol. I lowered the dosage (I used to take one sachet a day) and things improved a little but I still got episodes of diarrhea. In the end I stopped taking Movicol and was okay for about a week without taking any softener (I maintain a 'fissure' friendly diet and drink plenty of water). However, my stool started to get firmer and I bought both Fybogel and Lactulose. I tried the former first and that was a mistake as I re-tore two days ago and I've been on Lactulose since (approximately 15ml twice a day). The pain is minor but I'm bleeding which bothers me quite a bit. My stool is soft with the Lactulose and I had a bit of bleeding on my first BM today and on the wipe off, there was bleeding in the water after my second BM and on the wipe off. I have not had another BM but I did fart when I had a pee and that made the fissure bleed. I do use the leftover cream from fall 2010.

I don't know about you but what really bothers me is when I bleed when I go for a pee (I assume this is because it does put a little pressure on the area). I live in the UK and I don't think it's worth going to the GP again as all they seem to recommend here is wait and see. I do have private, BUPA, insurance but I don't really want either botox or LIS as the pain isn't bad at the moment but it's the bleeding that bothers me.

I guess it's a matter or keeping the stool soft and things will clear up.
I do apologize for the rant but I needed to get this off my chest and my partner has had more than a fair share of 'butt talk' the last couple of days.
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Re: Incredibly Frustrated

Postby Phil McCrackin » 12 Mar 2014, 13:47

Hi Me82,

Welcome to the forum and sorry to hear about your fissure problem. It sounds very similar to what I've been experiencing for the last 3 years; and as of late a lot of bleeding which I definitely think was caused by a reaction to diltiazem cream. For the past 3 days the blood has been dripping into the bowl from my butt and the paper is bright red, but I've never had problems with the fissure when peeing. It sounds like your fissure is very irritated though. Have you ever tried Rectogesic? That usually helps my fissure stop bleeding within a few days.

I find a level teaspoon of Movicol before bed really helps keep the BM soft without causing diarrhoea. Too much of the stuff really works against you. And even though it says 1-3 sachets per day I eventually realised that a level teaspoon was perfect.

I understand about not wanting an LIS or Botox. I don't want that either. Do they do " Standardised Anal Dilations" in the UK? I've heard they are a very good alternative to LIS and Botox, with a good healing success rate. I'm living in Germany at the moment and will probably go through with this procedure soon, as no cream has helped at all so far. And the Germans avoid the LIS at all costs! They almost seem to refuse to do it; or at least do their best to talk you out of it.

Anyway, maybe head back to your Dr and try your luck with some Rectogesic.
And I know what you mean about putting your partner through the "butt talk". I think I'll be kicked out the house if I keep going on about this fissure much longer.

All the best!
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Re: Incredibly Frustrated

Postby Ouchies » 12 Mar 2014, 15:19

Hello,

I have also bored my partner to tears talking about my horrible bottom which for some reason has decided to turn against me.

I have similar problems to what you both describe, two plus years now. I have been prescribed rectogesic a few times, I find it does help but the problem always returns within a few days.

I have in the past few days started eating a handful of prunes (just a small handful mind you) after each meal, which already, has made a huge difference to my poop, much softer and easier to pass with medium/low pain. You could give that a try? Also- buy some moist toilet paper as that also works wonders and is so soothing to your bum.

Hope you feel better soon both of you. X
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Re: Incredibly Frustrated

Postby owmybum » 12 Mar 2014, 15:49

Hi me82,

I would ask your gp to refer you to a colorectal surgeon for a proper diagnosis. You may have internal hemorrhoids that are causing the bleeding. You may be prescribed something stronger like diltiazem to use, which is pretty good stuff.
Keep using the movicol to keep things nice and soft in the mean time.

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Incredibly Frustrated

Postby Me82 » 13 Mar 2014, 04:42

I did compose a reply on my iPad last night but it logged me out and I lost the entire message. New day, new attempt.

@Phil I've called my GP practice this morning and a GP will call me after 2pm today and the receptionist said they will be able to fit me in today if the GP who calls me thinks it's necessary. I've had two reasonably soft BMs so far today and there's been blood on the toilet paper but no dripping so far. I only have very minor pain as the BM passes (it's been like passing glass but it's only a little painful at the moment so I can't complain). Baby steps!
I've only tried Ultraproct (as prescribed by the GP who officially diagnosed the fissure after I'd self diagnosed it several years earlier) so far but I'll ask the GP today for Rectogesic.
I have no idea whether they do Standardised Anal Dilations in the UK. I thought I'd read somewhere here that they tend to go for Botox first in the UK and only as a very last resort LIS. I have the impression that dialations are considered 'dated' for treatment of fissures. Although I have read success stories from the US with dialations performed by Dr. Sohn in NYC, although I think he has retired since.
I will pester my GP today and hopefully be on the road to minor symptoms again soon.

@ouchies I've not tried prunes. I've tried many other things over the years and have found what seems to work for me. I usually have oatmeal porridge for breakfast, baked potato for lunch and a healthy meat with veggies and potatoes/rice for dinner. I've found that bread (white, brown, all sorts) make things worse for me as does too much fiber. I was able to feel normal when the Movicol was working but it's back to being scared of BMs, almost panicking when on the toilet etc.

@OWM I did use Movicol for three years and it worked beautifully until I started to get diarrhea from it. I did halve the dose but still got diarrhea. I'm on Lactulose at the moment (approximately 30ml per day which doesn't seem to be enough) but I'll speak to my GP about Movicol options today.
I've been wondering whether I have internal hemorrhoids as well as the fissure. I'll have a chat with the GP today and see what he says.

Thank you for your support!
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Re: Incredibly Frustrated

Postby Me82 » 13 Mar 2014, 11:59

The NHS works in mysterious ways. I called the GP practice this morning and the receptionist asked why I needed to see a GP. I told her and she asked it it was possible to deal with over the phone. To make a long story shorter, the GP called about an hour ago and he said he didn't need to see me. He prescribed Laxido (it just like Movicol contains Macrogol 3550 but I assume it's a generic product) and Proctosedyl Ointment. I've filled the prescription and we shall see what happens when I try the Laxido. The instructions he gave states that I should take four sachets on the first day and then increase in steps of two satchels daily until a maximum of eight sachets a day. I certainly won't start with four but with one and see what happens.
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