Hi. I'm so glad that I was able to find this group. the pain and uncertainty caused a tremendous amount of anxiety since I acquired this fixture.

Here's my story. December 18th of last year I had a heart attack in which I had a stent put in. Along with that I was giving a slew of medications 4 blood thinning. One of these medications was called prasugrel, and Effient.

In March my family and I came down with this horrible cough. It got so bad, and the spasms were so horrible upon coughing that we bruised ribs. We went to the doctors and got codein cough syrup. During this time, I was waiting for a dental bridge to be finished at my dentists and I was taking Codeine number 3 for the oral pain. Needless to say I became horribly constipated.

I simply could not pass the stool. So I pushed very hard and when I could feel it approaching the opening of my anus I clenched to try to squeeze it out. I bled a little bit but nothing too alarming. It was pink and I knew it was because I damaged something. Up until this point I had no idea that there was such a thing as a fissure, and how painful it would be.

After a couple of weeks of bleeding pink I went to the emergency room because I was worried. The doctor put me on my hands and knees, shoved her gloved finger up to her second knuckle into my anus, hook your finger and it felt like she was trying to pull my anus out as she made a circle. I had never been in that sort of pain before, and that says something. She told me that I had a fissure. I went home and noticed that I was bleeding a heck of a lot more than I was before I went into the emergency room. Now the blood was bright red, and there was a hell of a lot more than there had been in the past. That was in March.

I went to my primary care provider and she prescribed rectiv nitroglycerin 4% cream which I have been using religiously as instructed. I'm about to start tube number 3, and I am still bleeding with my bowel movements although the pain has lessened.

Three days ago I went to a gastroenterologist who said that I did indeed have a fissure, but I was not using the rectiv cream properly. He said I had to shove it at least two knuckles into the anus.

Now, instead of bleeding every two or three bowel movements, I am bleeding with every single one. I am not a happy camper.

My question is, could the blood thinners be interfering with the healing process for my fissure? Is bleeding part of the healing process? Or am I ripping it open each time I apply the cream or have a bowel movement?

I'm really at my wit's end. I have become so anxious thinking that I may end up being this way forever. My only real constellation has been thus far finding this group. Thank you so much in advance firstly for having a group such as this and secondly for any advice you might have for me. Thank you

I suggest you find a goog proctologist. Mine told me only to put on the inside. Explain to him your experiences so far and he can provide further guidance. He can also examine you properly and check how long and how fee is the fissure. Since its been a few months already, you may need a surgery as severe fissure may not heal otherwise with ointments. For my surgery they told me not to use blood thinners for a while, but since you have a condition you better talk to the doc. Make sure though you find the best specialist to treat you properly. Also, don't eat acidic foods at all, because when your poop is acidic and it hits the wound, it prevents it from healing. You can Google PH level of foods and anything below 5 is a no. These are all vinegar and condiments with vinegar in tnem coffee, alcohol, most fruits except mango, papaya, figs and dates.

Thank you so much Hopeful123. I appreciate the insights. I will Google the pH of food and see if that helps me. My gastroenterologist is a proctologist, and he did examine me and said that I had the tags. The Sentinel and the other one which would indicate a chronic condition. He says he is still hopeful that it could be treated with medications and cream. I'm hoping that's the case as well.

you know it is weird I have Googled for months trying to find a connection with blood thinners and anal fissure healing and there's really nothing out there. This may just be new territory.

Anyway, do you mind if I ask you about your surgery? How long did it take to heal? Did it hurt very badly? Has it come back or are you still cured? Did you have any issues with incontinence?

Once again. Thank you for reaching back

there are differing opinions on wether it is necessary to put the cream inside. 2 doctors told me no, 1 doctor told me yes.

It's a maddening condition, patience is key.

Nitro ointment is essentially a type of heart medication. I would ask the doctors about it if you are taking blood thinners

Don't be afraid of surgery, the pain is bad just the first week but then it will slowly improve and over 3, 4 months everything will be healed. There is almost 0 chance of incontinence, no issue at all. Try ointments for 2 months, but if it doesn't help, don't delay the surgery, it's a quick procedure but so far it is the only reliable solution for chronic fissures. No need to suffer because of fears.

I'll tell you what. I can't live like this for the rest of my life, so the surgery is looking more and more attractive. It is truly maddening. I will be starting on my THIRD tube of Nitro tomorrow. :/

Just having some one to speak to about this is immensely helpful to my mental health. :) Thank you all.

OK. Unsolicited update.

So the doctor agreed with me and thought that the Prasugrel (Efient) may be causing the delayed healing in my fissure. Since it had been 6 months since my stent, he took me off it, but kept me on the baby aspiring and blood pressure meds. That was about a month ago. That was the last time I bled... until just now.

I have stuck with my 2 ducolax per night before bed, and a full dose of Miralax in the morning. Drinking a lot of water during the day.

I have been using Rective for months, and I do feel better in terms of pain, especially after bowel movements. I just don't get it.

Is it normal to bleed DURING healing, or should i just assume that I ripped it open again during my last bowel movement?

I am ok with occasional bleeding provided that it is healing, slow as the process might be, but I feel very depressed right now. Feels like i am starting over.

Yikes.