There is so much info on this site. Which is good. But it can be confusing. One person says use this another say don't us it. You don't know what to do. But I am confused about a few things. I have a fissure with a seniel pile that I have had for 35yr. Most of the time it does not bother me. It would flair up maybe once a year or less and be gone in a day or two. This time it is really bad. Has bleed on and off. Hurts all day and all night. It fills like I tear a scab off daily with a BM. I have been taken Prilosec which is a PPi and have had loose stools. Sort of. They will fill hard but when you look all I see is sawdust. Like I am having a loose and regular at the same time. Or I would have a loose stool followed by a regular stool. Here are a few things I am confused about.

1st Sitz Baths - I don't really get them. Took one but it feels like I am streching my bum to much and the fissure hurts. For me it is like sitting on the toilet with your bits in water. I did not get much relief. Am I doing something wrong.

2nd Everything says stay dry but so many people are using ointments and oils. How do you stay dry using an ointment.

3rd If I use Vaseline before a bm how do I get it off after? It seems it would just make a miss and you would be wiping more. I don't wipe but use wet ones and blot.

4th Since I seem to be having loose and regular stools I am confused about fiber and stool softners.

5th I got some zinc oxide 40% but it has perfume in it. Should I use it?

6th I know you are not suppose to use scented toilet paper. I got some Zinc Oxide diaper cream and it has some perfume scent. Is that going to be a problem?

My fissure is on the left 9 o'clock. When I am going I try to hover and pull that check gently away from the bowl movement. Is that a good idea?

Hi Splits,
yes, it is very confusing. One reason there are so many contradictory pieces of advice is because what works for one person may not work for another.

I can't answer all your questions, but I'll try to help.

1) sitz baths. some people love them. I hated mine. I gave up after the second one, because it caused me such pain. Personally I found a warm hot water bottle to be far more soothing and helpful. Some people like to lie in a hot bath. If the sitz bath doesn't help you, stop doing it and try the hot water bottle or a full bath.

2) If you are using an ointment like nifedipine, diltiazem or nitroglyerine, you must use it. Dry well first, without rubbing or pulling. Some people like to use a hair dryer, because it is thorough without being rough. Then use the ointment.
I really strongly recommend seeing a doctor and getting a prescription for one of those medications. It may help, and avoid the need for surgery later on.

3) I don't know.......maybe someone else has an answer. You could try using a panty liner to avoid getting grease on your underwear.

4) Fibre will bulk your stools, and stool softeners will make them runnier/softer. Fibre is good for keeping your bowel movements regular, but too much can make them painful to pass. Whatever you use, you need to drink plenty of water so your stools won't be dry.

5) I would not suggest using any perfumed products. I did not find zinc oxide to be helpful, and it is very messy. Also, if you are using any of the ointments I mentioned before, you will not want to use zinc oxide as well.

I hope that helps. Again - see a doctor. You should be able to get help. 35 years is a long, long time to live with a fissure. Please see a specialist.

Hi Splits :) welcome (sadly) to the forum!

As scientist says - we all try EVERYTHING and you slowly work out what works for you. WOW 35 years! You poor thing.

1. Sitz baths work for some and irritate others. I for one love mine, it relaxes me and it immediately duls the pain after a BM (could be placebo but I don't care!) but at the start when I was in tremendous pain, I couldn't sit on one and had to have a full bath after a BM. Try placing a small towel on the bottom of the bath to take the pressure off of your buttocks.

2. I had varying results - when I stayed away from medication and stayed dry, I suffered from being too dry and rough. When I used the medications and ointments sometimes I was too wet and actually irritated myself more ending up with chafing. You must experiment and find what works for you, I dry sufficiently and dab a small amount of ointment on, that ends up the perfect mix for me.

3. I ALWAYS use vaseline and it was a godsend for me. If I forgot to take it with me somewhere I think I would have a panic attack. I do use it around and inside, and I just really lightly wipe after while cleaning and I actually think it makes cleaning up after less rough and easier as it just slides. I don't stress about removing every smidge of vaseline residue either.

4. Fibre, stool softening and BM regularity IS confusing for everyone. Sadly again, it's trial and error for most of us, but as you say you are having loose regular stools you probably don't need to stress too much - although if your stools are too loose you could be irritating it with that.

5) I also would not use anything perfumed. Diaper cream may help relieve some pain but it's not going to help long term. I suggest going to your GP, get a referral to a specialist and get some ointments known to assist :)

Sorry that you are in pain, fingers crossed for you x