Hello, iv been suffering from an anal fissure for 8 months, it developed an abscess in the first 2 months which I had an abscess drainage operation for and it went really well, and for a while after the op I was fine and pain free from the fissure thinking that it'd healed.

Up until 3 months ago that I started having very painful bowel movements followed by intense pain for couple hours after. Things became worse very quick after and the pain was unbearable to the extent that I couldn't sit, walk, stand or even lay on my back on bed, I had to always lay on one of my sides until I became very sore from this position.

I went to the hospital's emergency department many times to finally be seen by a CRS, who diagnosed it as an anal fissure and advised me to have a fissuractomy, which I instantly agreed to because I was desperate for any cure from this agony. He then set a surgery date 2 months away and prescribed me lots of painkillers and laxatives to survive on, I was on panadine forte, tramadol and endone. They might sound a lot but trust me on a bad day NONE of these pk's all together had an effect or even touched the pain. So I went back to the hospital's emergency and told the CRS that the pain has reached its climate and that none of the pk's would work anymore, he then prescribed me morphine tablets which helped quiet a lot and made me able to hang in there until the op.

I then finally had the op last Friday to find out that they actually operated a fistualotomy on me instead of fissuractomy, the dr explained it as my fissure went chronic and my previous abscess eventually formed a fistula!! Ok sudden change of plans then, I now have to deal with a fistula. I was then prescribed only endone and paracatemol to take after the op. It was painful after the anaesthesia worn off, and the bandage they stuck inside my "area" wasn't helping with the pain at all. So I waited for 2 days before I took the pad/bandage off, only had 2 bowls of soups during these 2 days. I then had my first bowel movement on the night of second day post op, and oh my goodness how insanely painful it was!!!!!! It was horrible that I had to retract after the passage of the very first stool and I almost fainted from the pain that my mum had to drag me on the floor all the way to the bathroom to sit in a warm/hot bath, which really didn't do much I ended up taking 2pills of paracatemol, 2 panadine forte and 1 pill of morphine just to ease the pain after 4 hours of agony.

I was so put off after what happened that I wanted to go back to the hospital suspecting that something went wrong in the surgery, but my mum advised me to wait for another BM and see if it gets better or worse, I then had my second BM 2 days later and I will just say that I was smashing my head against the wall from the pain screaming like a baby that my parents were crying and panicking from the sight. I ended up going back to the hospital again as none of the pk's worked this time not even the morphine. They then discovered that I grew another abscess possibly at the same place where I had the first one. I had an abscess drainage op yesterday under GA and it was very painful afterwards, then I had a BM last night only to have the same excruciating pain again that they had to inject morphine to my stomach to ease with the pain, although still I was in so much pain that I couldn't sleep the whole night, it was a real life nightmare..

Now after speaking to the CSR this morning she told me that the pain was to be expected even at these extremely high levels, and that I should wait for couple more weeks to see an improvement with the fistula!!!
Now iv been following alot of cases in this forum and i never saw anyone stating that he had more pain (10x worse) than before the op, so I'm getting alittle suspecious here having difficulties believing what the CSR said about the horrible pain being normal after an op...

what do you guys think i should do? I've really hit rock bottom here and sometimes I wish I don't wake up for the next morning as i can't handle this anymore..... any help would be appreciated..please..

Hi Fito,
It's normal to feel the way you are feeling right now after going through all this - Hell! Who wouldn't??.....Not a simple fistula to deal with but abscess, fissure, fistula & then abscess again all in one......Don't forget the most of us here tend to deal with one or the other and generally not all at once with the complications thrown in on top - I'm so sorry to read this and all the pain you are going through. Right now it must be tough without doubt.
Your CRS is probably right in advising you that your pain levels will be high, certainly maybe higher than the average post-op recoverer because you have been through a lot, BUT, and it might not feel like it right now, as healing begins in that area, it will get better for you with time and hopefully a couple of weeks from now, you should be starting to feel some relief....As hard as it sounds, you really do need to "rest it out" now and have faith in time helping you to heal.
Are your stools so soft when you go to the toilet that they can literally "fall" out by themselves at the moment??? If not, you must try to get them to this stage to help you with your healing - It's vital you eliminate as much excessive stress on that tender area as much as you can & rest in the most comfortable position that you can, off it - Are you working? Are you able to take lots of rest right now at home??.......
Are you taking a stool softener?? If not, see a Pharmacist or GP & ask them to help you - Make sure you are eating all the right things to produce a 5 or 6 stool right now:

http://en.wikipedia.org/wiki/Bristol_Stool_Scale

Eliminate white flour (breads/ pies/ biscuits/ pasta/ rice) - Make sure everything is brown....Fruits, veggies, salads galore & more water than ever...Limit cheese & eggs. Apple purees, soft cooked carrots & veggies, porridge oats, beans, olive oils are all nice & soft & help produce very soft stools. There is so much information on this site as to what you need to be eating right now. Please look for it.....
Also clean up with a shower head rather than any form of harsh rubbing with paper and I'm guessing as you have a Fistulomy wound, you really need to just keep it as clean & dry as possible to heal properly.
Gently applying a big dollop of Vaseline to your anal opening prior to a BM might be very helpful for you too to help lubricate the area more....
Do you use a heating pad or hot water to aid your pain relief?? Sitting on them can be wonderfully helpful & relieving & it also helps the healing process too........
The way you are thinking will change as you get better and the pain starts to reduce - Again, it really is normal to feel this way when your bottom is causing you so much pain....Try to distract yourself as much as you can through books, music, films, meditation, computer games - whatever helps you take your mind off everything for a while. Try to tell yourself all the time, right now, that this is temporary and it WILL get better and turn a negative thought into a positive one....instead of "can't handle this", try "I am handling this........and it won't always be like this"........It's amazing how the mind & body can work together to heal. (and they will)
If you're finding it difficult, talk to a regular GP about the way you feel & they might offer something new or a different approach. Hang in there & stay strong........It's hard to see now, but it will get better & don't feel alone because there will always be someone going through the same thing as you somewhere.
Take Care, look after yourself & all the very best in feeling better very soon.

Following up.. After having a fistula laid open 2 months ago and being sent home on the same day as the surgery, the first two bowel movements were relentless with excruciating unstoppable pain that none of the mentioned pain killers worked with. So i went back to the hospital to find them telling me the my abscess filled up again and i needed to have another operation on the spot.. so i had the operation the next day then spent 5 more nights admitted in the hospital having a big white pipe inserted in my abscess to let it drain.

After i went home my bowel movements were less painful than they were, and they were getting better over the time, of course they were still painful to the limit that i MUST have a sitz bath after each trip to the toilet otherwise nothing will soothe my pain. Gradually i started reducing the amount of pain killers that i took until i stopped most of the them and i was basically only on paracatemol. I also want to mention that my abscess filled up again during this 2 months period and i was scheduled to go back to the hospital by my GP but, luckily, i woke up that day on a pond of puss on my bed, and apparently it popped out on it's own while i was asleep, which my GP told me i was lucky it did it when i was asleep so i didn't feel any pain. And i've always been discharging puss since i've gotten out of the hospital anyway.

But there was a huge turn in events 2 weeks ago, my bowel movements started to be alot painful again, with the pain persisting the whole day as before i had the fistula laid open, and it was getting worse day after another, so i thought i'd go back to the hospital before it gets even worse to the point that im squealing and grieving the whole day. So i went, and after the CRS saw me he said that my fistula got "worse" and it became a deep one rather than superficial, and that i need to have another surgery with him leaving a seton in after, and also, i need a LIS because my fissure didn't heal properly, all in one surgery..

So i had the surgery 2 days ago and was discharged last night and i haven't't had any bowel movements since then... and the whole area is extremely sore and bruised since the operation and im so dreading the next trip to the toilet.... can anyone please tell me what will happen from now on.. or, what "usually" happens in a situation like this? would my next bowel movement be horrendous as before? do i need to keep on having sitz bath? any tips for healing will be much appreciated as i'm so mentally down at the moment and feeling so depressed.

I've really hit rock bottom here and sometimes I wish I don't wake up for the next morning as i can't handle this anymore..... any help would be appreciated..please..

I'm sorry I can't advise you on fistula after care, but after reading this I just wanted to give you a cyber hug! You have been through so much already... I really hope this time everything heals up well for you.
Hopefully a fellow fistula sufferer can chip in with some words of advice for you.



OMB x

i don't want to come out sounding too emotional or anything, but your reply helped me alot mentally... thanks for your sympathy, i wish my surgeon had the same level of empathy and compassion towards me like yours...

And please i'd be so relieved if any one can chime in.. I think i've started to have anxiety attacks lately specially before every BM.. i don't know if i should see a doctor about it or not, but all i know is that it keeps getting worse..

HI FITO
I HAD a bad abcess this came as a result of a blocked anal glan which I got from botox for an anal fissure ,this was bad and it led to a fistula which went through my internal sphincter ,I had the abcess cut out and all the bad stuff cleaned out ,my sergeon put in a draining seton ,which kept the fistula clear and over 2 months it drained out all the other bad stuff ,I then saw my sergeon who said ok lets do the final op to cut out the fistula tract , I had this it was highish fistula he layed it open ,basically deroof the fistula and make it into a fresh wound ,like a fissuer,over the next 3 months it healed ok very achy at time and I went to see my sergeon serveral times ,he said it was all fine ,
I also saw an other sergeon in august this year for his opinion on it all ,he said it had healed fine all good ,but when he cut the muscle it has left a a gap so I do get some debris trapped in it some times ,he also said that it was not a high fistula at all , I still get some soreness and irritation ,I always still jump in the bath to use my shower head to finish cleaning after a bm ,like a bidet , I think it may just be my ocd that I do this now lol ,
but I know the pain and all the mental anguish it causes ,and I think ill always remmber how much pain and anxiety I felt ,and still do sometimes ,

You don't sound too emotional at all! Sometimes all we need is a kind word and a bit of re assurance when were feeling low and vulnerable. Unfortunately, that's all I could offer you.... But hey..... Have another hug!!

richibeno wrote:HI FITO
I HAD a bad abcess this came as a result of a blocked anal glan which I got from botox for an anal fissure ,this was bad and it led to a fistula which went through my internal sphincter ,I had the abcess cut out and all the bad stuff cleaned out ,my sergeon put in a draining seton ,which kept the fistula clear and over 2 months it drained out all the other bad stuff ,I then saw my sergeon who said ok lets do the final op to cut out the fistula tract , I had this it was highish fistula he layed it open ,basically deroof the fistula and make it into a fresh wound ,like a fissuer,over the next 3 months it healed ok very achy at time and I went to see my sergeon serveral times ,he said it was all fine ,
I also saw an other sergeon in august this year for his opinion on it all ,he said it had healed fine all good ,but when he cut the muscle it has left a a gap so I do get some debris trapped in it some times ,he also said that it was not a high fistula at all , I still get some soreness and irritation ,I always still jump in the bath to use my shower head to finish cleaning after a bm ,like a bidet , I think it may just be my ocd that I do this now lol ,
but I know the pain and all the mental anguish it causes ,and I think ill always remmber how much pain and anxiety I felt ,and still do sometimes ,

sorry to hear that you had to go through such pain, but im also glad you made it safely, or lets just say you're almost there..

could you tell me about the regime you followed post op's that helped you to heal, and how was the pain level specially after your fistulotomy.. Do you still have to jump in the bath tub after each bm like me (which will obviously make think twice before having a bm when you're outside) what pain killers did you use on a bad day to manage your pain? because for me none of the mentioned pain killers work on me when the pain is on full volume, and it's hard for some people to believe that morphine sometimes doesn't work with me.

owmybum wrote:You don't sound too emotional at all! Sometimes all we need is a kind word and a bit of re assurance when were feeling low and vulnerable. Unfortunately, that's all I could offer you.... But hey..... Have another hug!!

thanks for the hugs, much appreciated......

once the abcess was cut out and all the area cleaned out most of the pain went ,infact mine burst also that why my surgenn had to semi rush me in to operate ,after it burst the pain went ,they said I was unlucky ,a blocked up glan
keep your food soft no hard stuff no white bread or red meat ,take a stool softner I used to use movicol ,still do sometimes ,drink loads of water ,before a bm I lube up using vasiline,and after I use wet wipes in warm water ,to clean ,then jump in bath and use shower head to rinse off ,as I said I have a gap in my internal sphincter muscle like a small crease which get some debrise in it ,and I have to go back after an hour or so to have a quick clean ,I use cream as a barrier ,