Looking for some guidance

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Looking for some guidance

Postby laker12345 » 08 Sep 2014, 09:13

Ok so I'll start with some background of myself. I originally had my fissure late February... Now a full 6 months later I'm still dealing with the ups and downs and seriously considering the surgery route.

How it started, saw blood a few times but didn't think anything of it as that has happened before and gone away with no pain. This time was different - pain got worse and worse until I almost passed out on the toilet. It was the one of the most painful things I have ever felt.

Saw a doctor and he put me on MOM, 30 ML at night. I have been on this ever since. Fiber seems to bulk the stool up too much for me so I try to watch that.

Had a colonoscopy weeks later and she said my fissure had healed... I don't know how it could be healed since I cannot have a regular stool still without a laxative without the pain coming back.

I asked for Diltazem and have using that since June but I'm still not healed or at least completely pain free and off laxative.

The past 2 months were pretty good taking MOM and keeping it really soft/watery. But this past week I had another setback and it felt like another slight tear. So here I am not knowing what to do.

How long is it safe to take MOM / and the Diltazem cream? What are my options at this point? Surgery? Even though she said the fissure was healed? Shouldn't I be able to take a normal stool if the fissure is healed?

Thanks for any advice you can give, much appreciated.
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Re: Looking for some guidance

Postby laker12345 » 08 Sep 2014, 14:08

Also, does anyone know of a good CRS in the western NY area? Specifically Buffalo or Rochester. Thanks
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Re: Looking for some guidance

Postby Alyssa » 08 Sep 2014, 14:30

Laker,

I just wanted to chime in because I have been declared healed but continue to have different degrees of pain everyday.. I have been diagnosed with pelvic floor dysfunction. According to my doctor, my anal muscles aren't able to relax... perhaps the fissure was not active when you saw your doctor or he missed it?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Looking for some guidance

Postby msimon » 08 Sep 2014, 15:09

I agree with Alyssa. Sometimes the muscles need some help settling down after being in so much pain for a while. You may want to be assessed for pelvic floor dysfunction.

I take a little bit of MOM every night but I also take magnesium citrate throughout the day. You may want to look into this or even a stool softener like Miralax, which are okay for long term use. The issue with MOM is that it lowers the PH in the gut which is not good for the long term. Right ow though, I'm not too worried. Whatever works :)

You may also want to do some self-dilation. If you do a search on here you should find some good info on that.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Looking for some guidance

Postby Apes » 08 Sep 2014, 17:32

Is your BM the classic cutting pain, followed by spasms? If so the fissure hasn't healed and it's getting to the point of being chronic. If that is the case you may have to take the next step, Botox or surgery. Also, your BMS shouldn't be real watery that's not helpful for the fissure. Just try and keep them soft, everybody's different. Good luck.
Fissure 2/13/14 from Colonoscopy
Nitro no help
Nifedipine no help
Botox 5/5/2014 work in progress
HEALED 10/2014
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Re: Looking for some guidance

Postby laker12345 » 10 Sep 2014, 07:54

Thanks for the responses.

Msimon and Alyssa, what would be some signs of pelvic floor dysfunction? Just the fissure?

And regarding the MOM, would anything naturally help balance out the PH levels? Food or supplement?

And Apes yes that is the feeling followed by hours of dull pain / spasms.. but only when I re-tear. Since the first tear, I have had that awful first tear feeling maybe 5 times total. I was OK for near 2 months most recently but a week ago I had that cutting again due to 1 slightly harder BM..

Once the re-tear occurs it takes about a week or two to settle down back there and get relatively pain-free on the MOM. I'm wondering if I could have a high-resting pressure as that seems to be a common theme with chronic sufferers.
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Re: Looking for some guidance

Postby Alyssa » 10 Sep 2014, 15:01

Laker,

As for me my symptoms are similar to having a fissure although I no longer have one... I have burning pain all day long, sitting makes the burning stronger. When having bm, I have stinging, hot burning pain. Normally the pain is at a 3-4/ but during bm the pain increases to a 5/6.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Looking for some guidance

Postby Alyssa » 10 Sep 2014, 15:06

I had a fissure but it healed within 2-3 months but months later I am still having pain so I was referred to pelvic floor physical therapy which diagnosed me with pelvic floor dysfunction. The only way to determine if you have this problem is if you get evaluated by a doctor that is knowledgeable about chronic pelvic pain.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Looking for some guidance

Postby laker12345 » 10 Sep 2014, 15:31

Ok thanks for the info. I'm meeting with a CRS on the 23rd. I'll reply back on what his take is on this and let you guys know how it goes.

Thanks for sharing.
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Re: Looking for some guidance

Postby msimon » 10 Sep 2014, 15:49

Laker, do you have any other signs of pelvic floor dysfunction such as pain with intercourse (I assume you are female?)? I don't know where you are located but you could alternatively see a physiotherapist for evaluation, if you don't want to wait for the Doctor. To be honest, it is rare that Doctors know much about muscle problems and your CRS may not be able to diagnose you anyway. I have been to two here that are clueless. Even most gynecologists I have been to are clueless....
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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