Hi Folks

I’ve had a fissure since around the 19th Feb. To be honest it’s hit me quite hard and triggered some anxiety and depression.

Anyway, when it all started I had the usual symptoms - burning and really bad pain during and several hours after bowel movements. I googled it and started the usual techniques early on - baths, Fybogel, increased water, upped fibre consumption, limited amounts of alcohol and caffeine since. There was blood to begin with, but that seemed to go early on. The usual over the counter creams had some minor impact, but nothing that really lasted for an extended period.

I eventually plucked up the courage to go to the doctors on the 2nd March. She prescribed Rectogesic. Apart from the side effects, this cream has been excellent in treating the pain. So now 2 weeks into this treatment and I feel it is healing - but I’m not quite sure. The pain has gradually faded away. Over the last weekend bowel movements were pretty painless - some discomfort after, but a bath soon calmed it down before applying the Rectogesic cream.

In the last few days bowel money’s have triggered some mild pain/discomfort - certainly nothing like the beginning. It seems to be at the beginning of a movement that it hurts. But seems ok after.

After each bowel movement I have a bath - and it seems to calm it down to a point where I don’t feel I need to put the cream on (although I am continuing with it obviously until zero pain). If anything it’s the Rectogesic that seems to make it sting intermittently through the day - is that normal?

Anyway. I suppose I’m looking for some re-assurance that it is healing and any advice that might help me to get there.

Any advice you can give is much appreciated. I can’t actually go to the doctor again at the moment as they’re shut due to the Coronavirus.

Thanks
Dan

Sorry that you are suffering with this, especially at a time when the dang virus is spreading everywhere.

From what you've described it certainly sounds like you are healing. It's not unusual for the Rectogesic to sting. I experienced that too when I used it long ago. Even though the pain is reducing, keep up the regimen that is working for you. Fissures can be sneaky like that. One day it seems fine and you go back to normal routine, next thing you know it's back.

It's expected that you would have anxiety and depression from this. It's a very sensitive area of our bodies, and having trouble there can really mess with the brain. Take time out for self care and if it's possible to get therapy by video call it might help you. Just don't lose hope, you'll heal and get through this.

Thanks very much for your reply. So things seemed to flare up after I posted the original message. It became a little harder to pass stools and so I think it must have hurt it again. This put me in a really bad place, and was finding it difficult to cope...especially with all of the worry and anxiety around Coronavirus as well.

Anyway manager to speak to my doctor who recommended taking a stool softener laxative in addition to Fybogel. I started with Dulcoease 3 times a day plus the Fybogel twice a day. It does seem to have made a difference, and although It was still painful over the weekend it seems to have rapidly alleviated since Sunday evening.

Last couple of days though it’s been a little harder to pass stools again albeit not much pain still. Im worried that if I persist that it will knock me 3 steps back again.

I’m wondering whether Fybogel is actually making it too bulky now and perhaps making it harder to move along...if that makes sense. Have you had any experiences with Fybogel? Is it worth knocking down the dosage to once a day?

I would personally stay away from fiber supplements. I don't know why a lot of doctors recommend them, but I think they are best used after the healing is over. Right now the area needs to not be stretched too much. I prefer Miralax over any other stimulant laxative. I'm not sure if dulcoease has a stimulant or not.

Try reducing the fybogel dose and see if it helps reduce pain as well.

Fiber can help constipation and I notice a difference when I miss my benefiber.

I never had much luck with fybogel. One thing to remember, if you do not drink enough water when taking fiber, it will make your bm hard. Keep up the water intake and add in plenty of veggies.

Hi both

I stopped with Fybogel and continued with 4 Docusate sodium (dulcoease) tablets a day. Things got a little easier, but not quite soft enough to keep it healing. So I spoke to the doctor and she suggest taking Lactulose, and that I can take this with Docusate. the Docusate. Since starting the lactulose, things seems to be working well and right now I have very little pain when going to the toilet. I have been taking 2 x 15 ml (morning and before bed). I’ve been taking 3 Docusate, but to be honest I don’t know if it’s doing anything other than giving me pain and discomfort in my stomach. So I’m thinking of reducing the Docusate down to two then 1 then zero. But I’m hesitant because I really don’t want this to affect the healing process, or aggravate it again.

Has anyone else had experience of taking Docusate and Lactulose together? Is there any need to take both, they’re both stool softeners so so I don’t know if it’s a bit pointless taking both.

Thanks for your comments.

I had horrible gas pain from lactulose. I found movicol/miralax to be better.

Sorry to hear of your suffering. I also go with the movicol it is best for me. My doctor assured me it is safe long term. I am ok with half to one sachet a day way under the dose on packet.
I drink prune juice and eat dried fruit daily too. Fybogel also did not help me it bulls stools too much for my liking.

Almost 3 weeks since my last post and I have no pain at all. Im quietly confident that it’s healed, but quite uncertain and almost paranoid about it.

How do i really know without a doctor checking? (Can’t see the doctor due to current covid situation). When having a light “feel” around the area there is no pain at all. Also when using the Rectogesic there is no pain when pushing a digit in 1cm per the instructions. I’ve actually stopped using Rectogesic now.

I’ve remained on Lactulose to keep things soft and I plan to stay on that for as long as possible, I’m not sure if it’s safe to take it indefinitely?

Yeah it is, especially if you have constipation issues. At 6 weeks of no pain, I'd call it likely 100% healed. I'd keep up the lactulose at least for another 2 months just to be safe