Hello

I'm jousting wondering what every does to cope? How do you not let the pain, fear and anxiety of it get to you? Do you have a self talk, breathing exercises etc. I find my thoughts are consumed by this, it has been 1 week and I don't see any improvements. I have has many fissures but they were never overly painful and healed in 3-4 days. I'm very open to ideas on how to calm down

Also what do you do or what have you done to help healing? Currently I:
- use proctosedyl (sp) twice a day
- take two stool softener per day
- two magnesium a day
- just started two vitamin d a day as I am deficient, I've read a lot of people take vitamin d, what is the association between fissures and vitamin d
- inner Heath plus
- 2 litres of water per day

I have heard of rectogesic, I am tempted to get it but it gives you headaches and I'm breast feeding my little bub. I've see rectogesic wipes and they don't give headaches do thought I would try them. I am also seeing a naturopath tomorrow. I've heard orpf sitz bath, how do I do this. How much Epsom salts, can I have a full bath and out my entire body in it then rinse in shower after, how long should I sit in there for? I could only do one a day cause of bub

Thank you so much for all your help so far.

Tell us more. Have you been to a doctor/colorectal surgeon with this?

Are the stool softeners working? At least for me, stool consistency should be like toothpaste. This helps a great deal.

What about a vasodilator like 0.2% nitroglycerin? This made all the difference for me the first few months but required a prescription. If I use nitro immediately before bedtime, I don't notice the headaches.

As for coping, first hang around this site for encouragement. Also, if so inclined, I found the Serenity Prayer always helped while heading in for the next dreaded BM.

Ouchie, since you are breastfeeding, you need to ask your doctor about the right anal fissure medication.
Nitroglycerin (rectogesic) might be fine, but please check carefully.
I mentioned in your other thread that nifedipine doesn't get excreted into breast milk. You could ask your doc for that.

Anal fissures cause a lot of us to get anxious, depressed, obsessed etc (I got very obsessed, spent hours doing web research on causes and cures - it really interfered with my work!), so don't feel alone. It's a very normal natural response to the pain. But, I think treating your hyperthyroidism (other thread) should help with your anxiety.

Plus, a week isn't very long in the process of healing a fissure. It would be realistic to think in terms of several weeks or months. As Now66 says, soft BMs are key. Reduce the trauma to your bottom and it should heal over time, but since that trauma happens every day, it does take a long time!

Don't be anxious because it doesn't heal in a week. Mine took several weeks, some take months. Don't worry - you won't be in this agony for several months. Things will improve, and gradually you'll be in less and less pain. It's frustrating! Especially when you get a set-back, but each set-back is easier than the one before, and heals faster, so while there might be pain for a while, the extreme pain should be over soon. Believe me, as long as you keep your BMs soft, you will feel less pain.

I feel for you. And also with a new baby, I imagine you barely have time for yourself. Just take one day at a time. Is what I did to avoid becoming crazy with this. I have been battling with my fissure for a year, but I only healed 4 months ago. Miralax and Rectogecic were a god send for me. They stopped my pain and spasms during and after BMs so my fissure had time to heal. I was very reluctant to have Rectogecic because I suffer from migraines. But my doctor told me to use a pea size amount and rubbed it, in the external part of the anus(not inside) at night. I never had a headache. But everybody is different. You have to try and see if it works for you in case you can use it. About the sitz baths, they are very good too: Fill up your bathtub, with warm water. The water should be warm enough to be almost uncomfortable, but not warm enough to burn. The water should be just deep enough to cover your buttocks and hips. I added 2 table spoons of Epsom salts. You should stay at least 20 to 30 minutes and relax. Take a book or some music to hear. Don't rinse and don't shower after that. Also if you can fill a bottle with hot water and apply it to your butt or sit in it as long as you can during the day that will be very good. Heat is very good for the treatment of a fissure.
These are some recommendations of my doctor:
1. Wash your butt only with plane warm water not soap.
2. Before a BM luv yourself with a dab of Vaseline, to make it easy to pass and to clean later.
3. Don't clean your butt with toilet paper, use warm water or baby wipes, preferable for sensitive skin.
3. Between BMs protect your butt with Vaseline or an ointment for babies to ease irritation.
4. Try to limit your BMs to one a day.
5. Avoid at all cost diarrhea or running stools.
6. Keep your BMs soft.
7. Do sitz baths with warm water one or twice a day for at least 20 minutes.

As for the vitamins, I don't have any idea why they work, if they do. But I took all kinds of vitamins people with say will be good: zinc, B12, B6, D3, you name it. I don't know if they helped me or not. The only think I am sure of, is that Rectogecic and Miralax took a big part in my healing process. I hope I have been able to help you some how. Best of luck.

Ouchie81 asked

I'm jousting wondering what every does to cope? How do you not let the pain, fear and anxiety of it get to you? Do you have a self talk, breathing exercises etc.

Yeah it's tough Ouche, and that's why we all come to this site, because psychologically
the pain can mess with our minds so we can take comfort knowing that others have,
can and will beat this.

We encourage you to stay strong Ouchie and be pro-active, so instead of just sitting and
sulking over our pain we constantly try to attack it.

Whenever I had an episode of burning or spasming and I was at work, I'd wait for the next
available moment to go to the restroom to at least try to sooth it with some medicated pads.

If at home and I'm burning up down there, I would not hesitate to jump in the showers.

So, to answer your question, it all about finding that routine of yours, that lets you find some relief
and will give you time and privacy to go in that bathroom for some TLC of your bum.

You can do this Ouchie, were pulling for you, hang in there..........

Hi Ouchie,
Every time I went to the toilet, I'd take some deep breaths and position myself comfortably on the loo seat and tell myself (out loud) that "My fissure is healing, It is getting better day by day, and have faith that this BM is not going to make anything worse. It might be uncomfortable for a while after but it is getting better"! & "It's not going to be as bad as I think it's going to be"!!
A positive mind for me and developing coping mechanisms through changes in my routine and mind were key in staying strong. I am a big advocate of Meditation and maintaining a positive mind-set! so can pass on some Meditation DVDs from another site member, if you want to try them??
I almost go into a "meditative poop" like state these days (LOL) when I go to the loo, where I'm aware of where I am and the process I'm going through but also detach a little from the situation, so I'm also observing the process rather than just being "fully" in it & worrying about it - it seems to take a lot of stress out of the situation.
I kept a diary through my worst times and looking back month by month was really helpful too.
Have you considered Yoga maybe or some sort of alternative therapy, like Acupuncture/ Reflexology/ Hypnotherapy??
Try not to worry because things really well get better for you :)

Thank you so much for your advice and replies
So with all that in mind I have
- bought rectogesic cream and wipes
- bought a hot water bottle
- investigated the fissure friendly diet (start on the weekend)
- will try a food dairy
- booked reflexology for my bowels
- booked massage for relaxation
- saw the naturopath (got a few things to try there)
- I will start positive self talk and try not to obsess over it
-still waiting for the gastro appointment in the new year
To answer some questions...I have booked the gastroenterologist for late Jan 2014, it as the soonest. He will prob do a colonoscopy and I also want to be checked for a rectocele. My bowels are odd and irregular no matter what I do. even with the mix I mentioned in the first post I can go from extreme diarrhoea to constipation without me changing much, no idea why, I hope the gastro will help me there.
Why does the runs make it worse? Also will putting Vaseline up there make it risky for infection?
thank you!!!!!!!

We'll all the positivity in the world didn't stop my fissure from tearing more just now. Bled heaps :-(. I broke down.

Ouchie says

My bowels are odd and irregular no matter what I do. even with the mix I mentioned in the first post I can go from extreme diarrhoea to constipation without me changing much, no idea why

It may be that you have IBS Ouchie, look this over...

What are the symptoms of IBS?

The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with changes in bowel habits. To meet the definition of IBS, the pain or discomfort will be associated with at least two of the following three symptoms:

bowel movements that occur more or less often than usual
stool that appears less solid and more watery, or harder and more lumpy, than usual
bowel movements that improve the discomfort

Other symptoms of IBS may include

diarrhea—having loose, watery stools three or more times a day and feeling urgency to have
a bowel movement. constipation—having fewer than three bowel movements a week. During
a bowel movement, stools can be hard, dry, and small, making them difficult to pass. Some
people find it painful and often have to strain to have a bowel movement.

feeling that a bowel movement is incomplete.
passing mucus—a clear liquid made by the intestines that coats and protects tissues in the GI tract.
abdominal bloating.

Symptoms may often occur after eating a meal. To meet the definition of IBS, symptoms must
occur at least three times a month.

Does this sound like you Ouchie, you may want to mention IBS on your next visit to Dr. Please
visit this forums section on IBS for more info and advice. Lets hope if anything that we
can rule out IBS....

The Vaseline use rarely gives anyone problems, have not heard of any reports here, our
straining with the diarrhea and its acidity makes that liquid stool burn coming out.

GL

I would say I definitely have IBS. I do wonder though if I have a rectocele too, I find it hard to poo without pushing in my perineum.

I started the rectogesic yesterday, only did half the size recommended so as not to get a headache, we'll I got one anyways. I still have it, I guess I need to put up with it till the fissure heals. How long should i take it for?