New with a few questions

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New with a few questions

Postby smh » 30 Dec 2013, 14:45

This is my first post here, although I've been dealing with this fissure off and on for almost 2 years. The past few months have been rough though. I had a re-tear and its been harder to heal. I've been to the doctor who said there was a small tear. The pain isn't there everytime, just with the larger, harder stools that I can't seem to avoid. I have no problem with constipation. Even the softer stools will hurt a bit at first. I started taking a stool softener but had no luck with it until I doubled the dose and have been doing that for a few weeks. It seems to be the only thing that can get them soft enough not to hurt. My question is how long can it take to heal? do I need to continue with the stool softener until its healed? I didn't take it yesterday and then had a re-tear today after a few weeks of no pain. Is it safe to take it for that long? Is it normal for it to be so difficult to heal? I always worry that its something worse.
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Re: New with a few questions

Postby jr2 » 30 Dec 2013, 17:24

smh

The re-tear cycle is super common with fissures because healing happens in stages. So, in the initial stages you might feel a great deal of relief from pain because the fissure is no longer as deep and the muscle isn't spasming as violently in response. But the area where the fissure is located s still very vulnerable, like tissue paper, and can easily tear again. Even a very long time after healing, that area will always be more vulnerable to fissures because it will never be as strong as it was before the injury. But, over time, it does regain a lot of its strength with the laying down of collagen in the wound healing process and won't be nearly as vulnerable as it is in the initial weeks and months.

As far as stool softeners, the majority of doctors advise they are safe for long-term use. Some people are even advised to stick with them permanently. Stool softeners work by drawing more moisture into the stools, so generally aren't thought to create the same kinds of troubles that stimulant laxatives do.

Anal fissures can be stubborn and difficult to heal and require a HUGE amount of patience and diligence with diet. As painful as they are it is normal to wonder if something more serious is going on, but really, they are super common and are rarely indicative of anything more ominous. Of course, a CRS (colorectal surgeon) is the best specialist to confirm this for you.

Wishing you a brighter 2014 that brings you forever healng.
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Re: New with a few questions

Postby suzyljank » 30 Dec 2013, 21:40

Hi, chronic anal fissures can be quite difficult to heal. Re-tearing is common. The problem with re-tears is that scar tissue can start to accumulate after each tear and healing cycle. Scar tissue doesn't stretch so a larger stool can cause another tear. Drink plenty of fluids and take a stool softener. They're safe. I will be on miralax the rest of my life. I had LIS in 2008 that failed and this past april I had a double advancement flap and I'm doing so much better. Eat food high in fiber but don't over do it and stay away from bulking laxatives like metamucil while your fissure is active. They cause your stool to be larger and stretching the area too much can cause tearing. If your fissure continues to cause problems see a CRS and please don't be afraid of surgery if it's required. Sometimes waiting too long to get help can cause more problems. Best of luck . Suzy.
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