multiple fissures with soft BMs? why? :(

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multiple fissures with soft BMs? why? :(

Postby beansbeans » 31 Dec 2013, 12:01

Hi all,

I'm happy to say that the manuka honey had helped a rather large external fissure I had about two months back. That was excruciating! I think it has healed :)

However, I've had fissures off and on pretty much constantly over the last three years, most are about a 6 on the pain scale, so not too horrible. I am always on either Miralax or Natural Calm (every single day) to maintain soft (bristol scale 4) bowel movements. But this is where I get really discouraged and depressed... I *still* get fissures over and over again. Always. About 4 times a month I feel one in a new location. They are always in different locations, although since I've had dozens by now, I'm sure they are overlapping in location since my bum is only so big. I maintain at "worst" a bristol scale 4 poo, which is not very thick in diameter, and very soft - like a toothpaste consistency. Sometimes I don't measure too accurately (for the Calm) and I overdo it, and get some Bristol Scale 5 or 6 poos, which is basically diarrhea but it still has solid bits to it. But I have nowhere near "large" or hard poos at all - the "worst" I get is still very soft and small.

I currently have one that is half inside, half outside - only visible if I bear down (with a mirror), so it is not too painful as there aren't as many nerves inside I think? But it does sting a bit, and there is some bright red blood. I do see the fissure on a mirror though, it is at the 3 o clock location. I can almost always visualize them when I get a new one, so I *know* theres a new one in a new location - previously, I had one at the 12 o clock, and previous, 5 o clock, etc.

So... what do I do? I'm having textbook perfect poops, maybe sometimes a little TOO soft/liquidy, but still getting new fissures repeatedly!? Old ones DO heal, but it is frustrating to always get new ones as well. This is making me very stressed and depressed, as I know every time an old one heals, the integrity and elasticity of the skin gets worse. And I'm young - 24. I don't know if my bum skin can hold out til I'm old!

A side note - I have gotten a sigmoidoscopy a year ago, with clean results. I have a GI doctor appointment in 3 weeks, but I am having a low day and its a new doctor (I just moved) so I am anxious. I hadn't seen any other cases like mine on here... which makes me feel even worse.
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Re: multiple fissures with soft BMs? why? :(

Postby pinpin » 02 Jan 2014, 09:31

Hello,

Multiple fissures might occur due to Crohn disease. Probably you should repeat at least blood tests to check on very first symptoms.

Another question, do you have spasms after BMs? Or there is only pain during BM.
07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story
11.12.2013 - LIS surgery
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Re: multiple fissures with soft BMs? why? :(

Postby beansbeans » 02 Jan 2014, 09:59

Hi there,

I didn't know crohns could cause fissures, but I have done the blood test in the past with no signs of it (although I know the test isn't 100% conclusive).

Typically there is only mild to moderate pain during the BM and slight pain and burning for 30 min after. I always take a sitz after every BM, so that may be helping to reduce the pain. I only get the all day pain on large external fissures which happens maybe 2-3 times a year (vs my smaller ones 2-4 times a month).
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Re: multiple fissures with soft BMs? why? :(

Postby Lauren12 » 03 Jan 2014, 14:43

I don't know if this helps. I got a major fissure in mid 2009. It healed after about 5 months using Diltiazem. However I was still getting pain and couldn't lead a normal life. It transpired that what was happening was my anal muscle tone had increased with the muscle spasms from the major fissure and despite the major fissure having healed, I was now getting minor fissures with most bowel movements. Like you, the stools were soft, but they were large due to fibre in my diet and Movicol (Miralax in the US I think). However, even attempting to get the stools to a smaller volume didn't seem to help. As I'd been in great pain with the major fissure, I'd also developed something of a pain cycle between bottom and brain, in that the kind of minor fissures that wouldn't bother most people, registered as painful to me.

It took me seeing three surgeons to find this out! In the UK, if a fissure has healed, it's not medical orthodoxy to perform the LIS operation, even if the patient is still in pain. However the third CRS I saw (the best of the lot!) said that some people still need it, even so. So I had the LIS operation and it sorted me out. It took a few months for the pain cycle to downgrade to normal sensation - but everything's normal now. I can even pass large, wide stools, which might cause the kind of minor scrapes which everyone would suffer from in such circumstances, and the sensations are absolutely normal.

I'm not saying that this may be the same for you; I'm just offering information in case it's helpful. My recommendation would be to see a really good CRS and explain what's going on for you, have an examination, and ask for treatment options. The CRS I saw explained that the anus is quite a delicate apparatus and if disrupted (by a fissure for example) it can take a while for it to settle down again. I think having a fissure may also alter, in minor ways, the process of passing a stool (you tense muscles without realising it for example) which again, may take a while to relax back to a normal bowel habit.
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Re: multiple fissures with soft BMs? why? :(

Postby Alyssa » 08 May 2014, 12:50

beansbeans wrote:Hi there,

I didn't know crohns could cause fissures, but I have done the blood test in the past with no signs of it (although I know the test isn't 100% conclusive).

Typically there is only mild to moderate pain during the BM and slight pain and burning for 30 min after. I always take a sitz after every BM, so that may be helping to reduce the pain. I only get the all day pain on large external fissures which happens maybe 2-3 times a year (vs my smaller ones 2-4 times a month).



Are your multiple fissures visible on examination?
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: multiple fissures with soft BMs? why? :(

Postby Justbehealthy » 06 Mar 2018, 21:51

I know these are older posts but, I’m going through similar symptoms (multiple recurring fissures appearing anywhere around anus even though I have soft bm’s) as beansbeans was and I’m curious as to how everything is now? Did you get answers? Lauren12’s explanation for these types of fissures makes perfect sense which is so reassuring to me.
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Re: multiple fissures with soft BMs? why? :(

Postby Chambers21 » 08 Mar 2018, 09:53

:thanx: very useful thread.
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