Can fissure be healing even if there is still some bleeding?

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Can fissure be healing even if there is still some bleeding?

Postby joleen » 06 Jun 2014, 08:19

Hi all,
Thanks so much for this forum. I have been reading it for the past 5 weeks or so, which is when my problem began, and it has been helpful and often reassuring.
I'm writing today because I hope to get some insight into what the healing process is like and how to monitor setbacks, etc.
Background:
A month ago my fissure started after a day of constipation and a large BM that produced a sharp-pain, blood (not so much), and burning, throbbing, itching, and soreness almost all day. I had also been under a lot of stress (still am) with a potential move, plus work, and I had been straining and rushing in the bathroom and wiping too much and causing irritation. In any case, I thought this problem would resolve quickly because similar things had happened to me before after some straining or constipation with no long term issues. But this time for 3 weeks straight I would feel that sharp pain when having a BM, have some blood and burning and itching (oh my, the itching was the worst). I took sitz baths, kept things clean, upped my water intake, and tried to ignore it.
After 3 weeks though, I decided to make an appointment with a gastroenterologist just to make sure nothing else was going on. A few days before my appointment, the bleeding had subsided a bit and I thought I was probably healing, of course right before I was finally going to see the doctor.
The doctor saw an area of irritation, but no visual tear, so she also said it was probably healing, recommended Colace for 2-3 weeks to keep things soft and get me through my impending move and career change and that that should do it. She mentioned it takes around 6 weeks for these things to heal if they are going to do so on their own.
The next day, about 1 month to the day of initial problem, I had bleeding again, a sharp pain (which had not ever really gone away) and burning, etc. It definitely felt like a setback. However, the pain was nothing like the initial problem, but still it was completely demoralizing.
Now it's about 5 weeks in, I had no bleeding but pain yesterday, today I had very little blood but with pain that subsided very quickly after a BM. In other words, the bleeding is not going away, although not increasing necessarily, but the pain and burning after BMs, and from sitting, seems to be subsiding quicker and I'm not suffering from spasms or itching, etc.
My question is whether or not blood is a good indicator of healing, or if there can be bleeding even if things are getting better? How do you all judge the healing process? What does it look/ feel like?
Thanks in advance for taking the time to read this and for any input you may have.
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Re: Can fissure be healing even if there is still some bleed

Postby Roidsfizzman » 06 Jun 2014, 09:11

Hi Joleen,

I would recommend that you make an appointment with a Colon Rectal specialist for an anal issue. Blood is typically not a good sign of healing as there is an open wound. Sometimes there can be blood with no pain (internal hem). The typically process for me with a fissure issue was to have some pain and bleeding at the BM time and after pain. My first indication of healing was for the blood to decrease and then stop during the BM and next the phase was for the itching, burning and pain to decrease and then go away. I have also had times where there was no bleeding and a lot of pain (thrombosed hem). The stools had to be soft durning the healing process as one hard stool and I was back to square one. Hope this helps.
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Re: Can fissure be healing even if there is still some bleed

Postby joleen » 06 Jun 2014, 12:19

Thanks for your input, Roidsfizzman.
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Re: Can fissure be healing even if there is still some bleed

Postby joleen » 10 Jun 2014, 06:05

Roidsfizzman, thanks again for telling me about what your fissure process is generally like. After reading your post and having some bleeding still for a few days I have been a bit down thinking that I'm not getting better and am worried I never really will. But, I was wondering if anyone else has any insight into my initial questions, as the past few days the burning and general discomfort seem to be decreasing consistently, but still I have a touch of pain and small amounts of blood after BM. My questions: is blood a good indicator of healing, or can there be bleeding even if things are getting better? How do you all judge the healing process? What does it look/ feel like?
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Re: Can fissure be healing even if there is still some bleed

Postby Apes » 10 Jun 2014, 06:28

Joleen, what I have been told, and believe, is that you can be healing even if there is blood. Your best guide is your pain level, if that is getting better then I think you are healing. Stick with a good diet and drink a lot of water. Did your CRS see anything else, like internal hemmy that could be the source of the bleeding?
Fissure 2/13/14 from Colonoscopy
Nitro no help
Nifedipine no help
Botox 5/5/2014 work in progress
HEALED 10/2014
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Re: Can fissure be healing even if there is still some bleed

Postby joleen » 10 Jun 2014, 06:50

Thanks, Apes. I really want to believe this too. I went to a gastro, not a CRS, and she didn't see/ feel anything at all, not even the fissure, just a small area of irritation outside. It has been just under 6 weeks, so I guess I'm still in the timeframe for it to be acute, but seeing the blood and thinking that this is always a sign of retear/relapse/etc has kept me from getting into positive healing mode mentally.
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Re: Can fissure be healing even if there is still some bleed

Postby Scientist2516 » 10 Jun 2014, 10:28

Fissures don't always bleed (mine didn't), and bleeding doesn't necessarily come from a fissure. As Apes said, it could be an internal hemmie. These generally do not hurt. Hemmies and fissures tend to exist together, as they can arise from the same cause (straining).

I agree with Apes, that pain is the best indicator for how your fissure is doing.

However, depending on how much blood, and how often you bleed, I also agree with Roids that you should get it checked out.
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: Can fissure be healing even if there is still some bleed

Postby Savaici » 10 Jun 2014, 13:31

You might suggest Diltiazem or Nifedipine ointment/cream to your doctor to aid in the healing. To catch it in the acute stage is something that doctors seem to take no notice of. Mine did not know what to look for, saying "I think I see a fissure but not sure". If I knew then what I know now, I would have insisted on the cream in the beginning.

I bleed fairly often...I would worry less about that and make an appointment to see a CRS if you cannot get more than a suggestion for Colace. This window in which you might heal from an acute fissure is very small.
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Re: Can fissure be healing even if there is still some bleed

Postby joleen » 10 Jun 2014, 19:38

Thanks so much for the insights!
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