Hello all,

I'm new here but I just got diagnosed with a fissure & I'm shocked by how much pain I'm in. I'm actually feeling dizzy & occasionally nauseous. Does anyone experience this?

What do you all do for pain?

I seem to have constant pain not only after BM. Is this normal?

Hi Trenzalore,
Sorry to see you have had to join us over the Christmas period. It's such a horrible thing to have to contend with but you are in the best place to be :)
Fissure pain is shocking! You would never expect this to happen to you in a million years since people know very little about it until they actually experience it first hand and for generally, for such a small "paper-type" cut in your bottom, the pain is awful....
This is possibly the worst stage you can go through because it's new and painful but things do get better with time, but it can take a while depending on how chronic your fissure is. If diagnosed recently, it might be that you can heal this quite quickly but you do need to be taking the right medication & measures and if possible, be seen by a CRS )Colon & Rectal surgeon) Have you been prescribed any cream to assist your healing?
At this stage, it's essential to keep your BMs nice & soft, so they "slip" or "fall" out rather then you having to strain or push them out with effort - Scour this site for ways to help you do this using stool softeners/ ensuring you are eating all the right things to produce good stools (fruits, veggies, brown bread, rice) and up your fluids to at least 2.5 - 3 litres per day so you are constantly keeping your body hydrated. Really important! Another great tip is to apply a generous amount of Vaseline prior to your BM, just to lubricate the area more, protect the fissure and help the stool pass through more easily.
Never over-wipe with harsh toilet paper, use a hand-held shower if possible to clean up or baby wipes, and at this stage, you might find using Coconut Oil helpful if you have not been prescribed anything. It would be helpful for you to get hold of either Nitro/ Nifidipene or Diltiazem to start helping the area to heal.
Heat is amazing as a pain relief, so use a hot water bottle or heating pad to apply to your bottom for the spasms that create the post BM pain. Alternatively, soak for a while in a hot bath or use a Sitz bath to provide some relief.
General paracetomel or Ibruprofen can help take the edge off the worst of the pain but it will cause you some discomfort in the earlier stages still. It's all about putting all the above into practice as soon as possible to help speed up the healing process so you reach a stage where things become a lot easier & more manageable for you.
Sadly, most people underestimate the mental effects a fissure can create, especially those who have never experienced this. I'm pretty sure most of us relate to how you are feeling on this site, which is why it makes it such a welcoming and comforting place to be when suffering. Someone will always be able to relate to how you feel here.
Personally, I became depressed and obsessed with the whole thing and ADs actually helped me through my own experience, along with a lot of positive self-talk, meditation and keeping a diary to record what produced the smoothest BMs and less painful experiences.
Panic attacks/ shaking/ nausea/ anxiety & depression are common mental issues when having to deal with this but if you can control your anxiety, stay as calm as possible and realise that it is just a fissure and you will get through it, it helps a lot. Remaining in control mentally is half the battle but it can be hard, so come back anytime if you need that support. That's what we are all here for :)
Everything you are going through is normal, you are so not alone and no matter how awful it all is, you have to stay strong and tell yourself that it is temporary and nothing will remain as bad as it might be right now.
There are many many success stories on this site, so please use it to help you get through this and gain reassurance & comfort that you will get through this in the end......
Wishing you all the very best and just focus your strength & determination on positive actions to get better and better.
Take Care & hoping you get through your ordeal very soon :)

Hi,
Just to add after your last post - Please ensure you see a CRS if you have only seen a GP who has diagnosed this.
They really are the specialists of the anal area and will be able to tell you exactly what you are dealing with and the best way forward in terms of treatment. Standard GPs do not always have the expertise required to deal with this and can actually misdiagnose as I discovered myself.
Fissure pain for me was always 100 times worse after a BM, lasting for a duration of 2-5 hours but I'm pretty sure in the beginning that it felt like my bottom hurt all the time! A fissure can be compounded with internal hem issues, so you must get it checked thoroughly if you haven't already done so. :)

Hi Trenzalore,
I'm so sorry you are suffering and in pain. We all know what it's like, including (as ETO says) mental effects like depression, isolation. I think nausea is a fairly common response to severe pain.

Yes, sadly, it is normal to have severe pain for hours after a BM. These are muscle spasms of the internal anal sphincter. I don't know why they sometimes take an hour or so to start after the BM, but then I think it's a cycle of pain leading to spasms, which are painful, so causing more spasms in a vicious cycle that can take a long time to resolve. Anything to relax the sphincter is good. ETO recommends heat, which is an excellent muscle relaxant, just don't make it too hot. Warm baths, a warm sitz bath, a hot water bottle, all these are highly recommended.

As ETO says, do get checked out by a CRS if you haven't already. Hopefully you'll be prescribed a topical muscle relaxant like nifedipine, diltiazem or nitroglycerine, as well as topical painkillers.

The really important thing is to keep positive, and if one thing doesn't help, try another. You'll find by reading here that different things work for different people. Especially in the matter of diet. You must keep your stools soft but not runny, and it can be a trick to find the right combination of foods and laxatives to accomplish that. Keep a diary of your diet and stools (as weird as that sounds). Lots of people find that really helpful.

Drinking plenty of water is essential. Your colon is designed to recapture water from your stools, so 1) the more dehydrated you get, the drier and harder and more painful your stools will be, and 2) the longer your stools stay inside, likewise the drier they will be. Hence, water, fibre and laxatives are all important to your fissure fighting.

Good luck! Keep us posted on your progress. Vent if you need to, and let us know your successes.

Thank you so much both of you for your kind words. I am so relieved you replied, I was in tears. I have found a heat pack and it's helping.

I haven't seen a CRS, I need a referral and didn't get one. I've been given proctodosyl (?) suppositories & told to take one a day. It's a steroid I think.

I think I will go back to the GP tomorrow about the pain and get a referral. It's now midnight & my last BM was about 10am. Still too much pain & spasming to sleep. I know my anxiety about it isn't helping anything though

I'm really grateful for your thoughtful responses.

Hi and welcome here.

Sorry about your troubles, but I see ETO gave some really good advise.

Regarding proctodosyl, then dont use them. They are for hems, not fissures. Yes, they are steroids, and can thin the skin. Get some diltiazem or rectogesic instead. That will help your muscle to relax and provide bloodflow to the area to assist healing.

Besides that, read and learn. In my experience, the info in here are better than any CRS I have seen.

Good luck!

JHH