Fissure, Sporadic Blood, Pain, Options

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Fissure, Sporadic Blood, Pain, Options

Postby JonnyJ » 26 Apr 2015, 13:51

I've been dealing with fissures & hemorrhoids off and on for awhile now. I seem to be mostly ok for a while then suddenly I'l have a BM with blood on tissue & it freaks me out, usually comes from nowhere. But then it can go away as quickly as it came again. It's always bright red blood, on tissue, and just immediately after stool comes out. The CRS told me he saw a fissure outside & skin tags. So the blood would come from the fissure, according to him. So why does it come and go? Also, unlike the first time I had a fissure, I don't ever have any sharp pain with BM. Sometimes I do, but nothing much noticeable. I did have a VERY painful thrombosed hemorrhoid last November though, but apparently that's healed up. The skin tags outside the anus are still quite prominent though, not painful. They just hang there pretty much. So do hemorrhoids usually come and go like that? And is it possible to have a fissure and it not be painful?

I use Nifed/Lido regularly along with Colace and Dulcolace (my savior). I don't like to depend on them so much but if I didn't I'd have hard BMs too often & it wouldn't be good. I'm trying to avoid surgery if I can because I know sometimes that can be worse.

Last night, I got this dull achey feeling from inside my lower anus, almost a throbbing. This morning, I had a BM & it wasn't painful but I did have bright red blood on paper again. Didn't last long just right after. And the throbbing ceased. Could this have been something inside that popped or something? I had a colonoscopy two years ago, aren't they good for 5-10?

I'm just debating what to do about my skin tags/fissure. My wish is to put it off as long as I can, but if I have to have surgery eventually so be it, but just not in any much pain really the only symptom when I have any is the bright red blood spotting/globs on tissue after BM, and it's not every BM, just once in awhile. So I'm as confused about what to do as ever.

What should I do? The CRS told me I could have the surgery and he could fix things, because it seems to be a regular pattern of ebb and flow as far as symptoms, but even after I go a long time, sometimes months, with no blood, then suddenly see some, but then it goes away again, it weirds me out. I'd like to avoid surgery if I can. Just wrestling with what do to.


Im not worried about cancer or anything because I had a colonoscopy two years ago, and had a polyp removed then that was bleeding, but aren't those procedures good for many years after before another is needed? And I also had an anal pap test last summer, which was normal.
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Re: Fissure, Sporadic Blood, Pain, Options

Postby msimon » 26 Apr 2015, 19:16

"...do hemorrhoids usually come and go like that? And is it possible to have a fissure and it not be painful?"

Yes they do and yes they can (so I have heard).

" I had a colonoscopy two years ago, aren't they good for 5-10?"

Usually, but depends on your family history for colon cancer, etc.

If you are not in much pain I really would avoid surgery, IMO. There are always risks with that, I know first hand. Have you tried any of the fissure ointments? Nifedipine, Nitro, diltiazem? Maybe they would help heal it up for good.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Fissure, Sporadic Blood, Pain, Options

Postby JonnyJ » 26 Apr 2015, 19:34

Thanks for the reply. I've had fissure since 2013, so close to 2 years now. At first it was a sharp cutting pain when I'd have BM, but that went away after the first 3-4 months and ever since, hardly any pain at all. Other than from the thrombosed hemorrhoid (Ouch!). I've been using Nifed/Lido, keeping the area very clean, regular sitz baths, soaks, NEVER use a dry tissue when wiping either, always moist. And the Colace, Miralax, & Dulcolace as needed. And I try to eat plenty of fruits/veggies/soft foods. So I'm doing most all the right things. But it still comes & goes.

Yea I def don't want surgery if I can avoid. Nor sure why the one CRS wanted to do it, but to be fair to him, he said I didn't have to do it RIGHT then, so the urgency wasn't really there.

I have no known history of colon cancer, or anything other than I do have hemorrhoids on both sides of my family. And constipation issues. I am HIV positive, but my numbers are good, I'm on meds for it, and no longer anally sexually active. It just wasn't worth the hassle & risk to my health anymore. So I'm doing the right things. They did tell me I had a positive pap test for HPV (not the wart kind) but they told me it was low-grade & not to worry about it just to keep having regular paps done. I had one last summer, & it came back normal, totally clean.

So I guess the blood on the tissue when it occurs is from the fissure or skin tags (do skin tags bleed)? What about internal hemorrhoid? I had a scope done last summer, & the doc said everything looked boring (his word).

I also tried Diltiazem once, & it seemed to help me a good bit, isn't it basically the same as Nifedipine? I'm on Nifedipine/Lidocaine now. The only difference was the Diltiazem was an all-in-one ointment & the Nifed/Lido are separate.

How about those dull internal achy feelings I get? They seem to come from my left side of my inner anus but I can't tell. Would that be fissure related?

I know it's not good to rely on laxatives, but I'm at the point where I'm afraid if I don't take Dulcolace every couple of days, my stool will get too hard or bulky again. So I'm using it like it's gold.
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Re: Fissure, Sporadic Blood, Pain, Options

Postby Sufferingbadly » 13 May 2015, 23:23

You are asking a lot of questions that I myself are curious as to what the answers are. I hope someone knows the answers or at least has an idea. How are you able to deal with your hemmies and fissure pains and still function in your day to day life? I will be going back to work in a month and I'm scared. I just started taking stool softeners today so I'm hoping they will keep my stools soft for awhile so that I stop getting episodes of constipation and hopefully heal!
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Re: Fissure, Sporadic Blood, Pain, Options

Postby Scientist2516 » 14 May 2015, 08:02

Hi JonnyJ, your situation sounds quite similar to mine. My fissure was agonizing at first, but then settled to more like a dull ache. As for why it comes and goes, I think of it like a cut on your lip that heals but opens up when you smile the wrong way. Mine never bled, but it used to be fine for weeks and then open up and be achy for a few days, then get better again.

I also had hemmies that came and went (only two). And skin tags, one from the fissure and one from the big nasty hemmie. I don't know if skin tags can bleed. I guess if you treat them roughly they could. I used to wear loose clothing (skirts and loose trousers, no jeans) because tight trousers seemed to irritate them.

As for what you should do - if things are getting gradually better (taken over weeks and months, not days), I'd go with it, and not have surgery. It took me about 18 months all told, and for the last year of it I was mostly fine with a few days of pain here and there. It depends what your circumstances are. LIS wounds usually heal faster than the fissure wound, but still, it's surgery, with risks of infection and incontinence.

Good luck, Jonny. Keep us posted on how you are doing.
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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