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New and glad to have found this forum

Postby Fizzymoto » 30 Nov 2014, 22:38

Hi everyone,

I just stumbled upon this forum through an internet search for remedies for my 3+ week old anal fissure. I have so many questions going through my head and it kills me to not have answers when I'm in so much pain and seemingly no end in sight. I just feel very helpless and sad. I've never had an anal fissure, am 30 years old, am a mom to a 3 month old baby boy that I absolutely adore and wish I can spend every waking moment with instead of tending to this stupid fissure.

I've had hemorrhoids all my life but never an anal fissure. Hemorrhoids I can deal with but I didn't realize how utterly painful fissures are until I got them. At first I didn't think much of it, thinking it'd go away the next time I have a BM but after about 4x with the same intense razor-like sharp pain, I then realized it was something a lot more serious that needed my attention so I went to see a gastroenterologist (he just confirmed my suspicions, 1 "medium-sized" fissure and suggested some home treatments I already had read up about and have been practicing already), read everything I could read on the subject matter and am now doing everything I possibly can to heal this thing!! My question for you veterans are... (and I am very appreciative if you can shed some light on this)

1) How long does it take (once you start the home treatments) until you feel a lot less pain during BMs? Right now the pain has not subsided and it is an intense, sharp pain right before a BM since I think it comes from slowly opening the sphincter. Once the stool is on its way out, the pain subsides dramatically. But then I get spasms for hours which the sitz baths have helped a lot but still will last a couple of hours sometimes.

2) How the heck will it ever heal if you have to have a BM daily and each time I feel like it's just re-opening the wound? ): That is what I am most curious about... am I opening the wound back up when I go each time? How would I know??

3) How do you know once it is completely healed??

Thanks so much for your responses. I appreciate any answers I can get at this point. Childbirth is nothing compared to a fissure!! This has got to be the worst thing I've ever had and so I'm just praying it'll heal soon and I can get on with my life!
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Re: New and glad to have found this forum

Postby Scientist2516 » 30 Nov 2014, 23:19

Hi Fizzymoto,
I'm so sorry you are having this pain, but welcome to the club nobody wants to belong to, and I hope you get some good answers here.
So - how long does it take to heal? Obviously it can vary, because fissures can be bigger or smaller, and people respond to drugs differently and heal at different rates.
Did your doctor prescribe a topical muscle relaxant? Specifically nifedipine, diltiazem or nitroglycerine? If you are using one of those, and if it works for you, you could start to get relief almost immediately. In my case, I started with nifedipine and it did not work at all. Dilt. and NG were both effective for me. So one thing I'd say is, pay attention. If you don't get results in two weeks, go back, ask for a re-evaluation, tell them you want to try a different drug.

For the most rapid healing, you have to get several things right.
1) find the right painkiller for you. Ibuprofen took the edge off my pain. Some people use topical lidocaine. Pain causes spasms, which cause pain - a nasty feedback loop - so it's a good idea to knock that pain on the head as much as possible.
2) get your stools soft (but not diarrhoea). Drink lots of water, take a stool softener, do not overdo the fibre. Your doc may have recommended fibre, but you don't want bulky stools. Again, pay attention, maybe keep a diary of what you eat and how bulky your stools are. Note the hardness/softness and note how much pain.
3) find the right drug to relax the internal anal sphincter. You cannot relax it consciously, but the drugs I mentioned do that. Also warmth is a great muscle relaxer. Relaxing the muscles also relaxes the blood vessels, allowing more healing blood to the area. Sitz baths are great, but with a 3 month old you can't spend long soaking. I use a warm hot water bottle. It's soothing and it helps healing.
4) If you are breastfeeding, search this forum for threads on breast feeding with a fissure. It can be very difficult to stay hydrated when you are feeding a baby.

Yes, you are right, you feel as though you are re-opening the wound with every BM, and it can be a real downer. The key is soft stools. It takes time, and it could take a few months (hopefully not, though) so don't get depressed if your progress is slow. Come here, vent, ask questions, read the success stories - this is a very supportive community.

How will you know if it's healed? My experience was that although my bum is still sore sometimes, the spasms stopped. I think the last spasms happened about 5 months after the fissure first came. I had some pain (if I tried to do too much) for a few months after that, and I still sometimes have soreness more than a year later, but I "got my life back" about 4-5 months after it all started.

You can also get examined to see if it's healed.

Congratulations on your baby!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: New and glad to have found this forum

Postby Fizzymoto » 03 Dec 2014, 16:38

Thanks very much, Scientist! I meant to reply earlier but have been busy trying both in taking care of my son and fixated on how to heal my butt faster!! After my initial post, I switched from Colace to Miralax and am applying coconut oil instead of the hydrocortisone cream the doctor prescribed which I find of no real use. The Miralax is more effective to soften the stool than Colace is for me so that has helped relieve some pain when going. The coconut oil I think does promote healing although I'm not 100% sure but it feels that way anyhow. Along with 2 sitz baths (10 min each) a day and a good diet and not TOO much fiber, the last 2 days have been considerably nicer than previously. At least the spasms are at a minimum even though BM is still painful (but softer stool is definitely helping to lessen the pain). Anyway, I hope I can recover a little more before going back to work next week but don't want to jinx myself. ): This experience is quite ... something.
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Re: New and glad to have found this forum

Postby Scientist2516 » 03 Dec 2014, 18:07

So glad you were able to get softer stools - that is great.
Hydrocortisone is not recommended for long term use, as it can thin and weaken the skin (the last thing you want to do). I don't know why some docs prescribe it for anal fissure. The recommended fissure medications are muscle relaxants. They are topical nitroglycerol, topical nifedipine and topical diltiazem. If you see your doctor again, make sure to ask about those drugs.
A lot of people here swear by coconut oil. If it feels good, keep using it!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Scientist2516
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Posts: 1120
Topics: 16
Joined: 21 Jul 2013, 16:00
Has thanked: 157 times
Been thanked: 209 times
Gender: Female


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