Hello All -

I am new here. I am recovering from surgery (Hysterectomy) which landed me in this position (was constipated, which is atypical for me) and I have limited stamina for sitting at computer now. Please forgive me if these have been asked and answered. I have spent some time searching the forum, and will continue to do so, but if anyone can answer any of my questions I would appreciate that.

1) For the between bowel movement pain, do you take Ibuprofen or Acetominophen? Which do you find helps more?

2) Prior to the surgery, I worked out intensely 4-5x per week. I won't be cleared to work out for at least 4 weeks, but I'm reading here that intense exercise may be unwise if you have an AF?

3) Prior to surgery, I ate a lot of salads. I understand that I should cook everything now...but for those who have healed fully, did you go back to raw veggies and was that ok?

4) I have nifediprine and lidocaine. Some folks talk about putting it on the fissure itself. Others say just the anus is ok. How do you actually apply creme to a fissure? I cannot see my fissure. The best I have been able to do is put the creme on a q-tip and put that inside.

5) For those of you who found nifediprine helfpul, how long did it take to start giving you some relief?

6) I had AF one other time about 20 years ago. (I have a narrow anal canal) My dr. at the time gave me a glycerin suppository (I think it was glycerin) which seemed to help. It took a few months but I healed fully. That no longer seems to be the treatment -- has anyone been prescribed this?

Hope everyone has a great day. Thanks for taking the time to read this.

Karen

hi i'm a total newb here but i'll try answer these just using my own personal experience

1) Ibuprofen works really well for me. I take 400mg when i need, or if i'm in constant pain i take 400mg every 6hrs or so. When in full AF crisis mode, I set my alarm an hour or two prior to waking up and take Ibuprofen ahead of my morning bm.
I never found Acetominophen to be very helpful, that said I might not have taken high enough doses. I will be trying it again because Ibuprofen is hard on the stomach/GI track, and induces more bleeding, and god knows i've used a lot of it these days.

2) i also use to be very active, well mostly as an avid cyclist. those days are over..heh. i haven't moved much since all this started but i'll be preparing an at-home exercise routine doing anything i can for toning so long as i don't feel like i'm tightening/clenching my bumhole. i think it takes mindfulness and paying close attention to your body. stretching everyday at least should be possible. flexibility is strength.

3) i'm no dietitian, but I feel veggies like lettuce, skinless cucumber, maybe celery and fresh green onions should be fine raw. i'm definitely cooking my other veggies tho, even spinach. i can't imagine salad is bad if it's just lettuce, cucumber, olive oil, salt, pepper, lemon juice. eating salads probably helps to hydrate your guts since it's full of water.

4) i'm not sure myself about this one. i think it depends if your pain is mostly inside or outside. if you're able to use a thin, lubed applicator of some kind (q-tip might work so long as it's very lubed up and that you fully relax the bum when inserting and taking out, because the cotton tip might rub and irritate), then you can insert it an inch or less and apply the medicine just inside the bum, not far from the outside. if it's too uncomfortable, then apply on the outside only and seek further advice from doctors or others on here. i try to apply things inside but sometimes i just don't feel up to it.

5) i've yet to try that med. i use Diltiazem but it's been irritating my butt's skin so now i mostly practice mindful bum relaxation until i can see a doctor again.

6) i'd like to known the answer to this one too. glycerin suppository sounds nice to me...but will it do anything? idk

I hope others can answer your questions further. my advice is only based on my own limited knowledge and experience so far.

Thank so much for taking the time to reply, I really appreciate it. How long have you been dealing with AF? I had it once about 20 years ago and it took a few months but finally resolved. This time the pain is worse. If I could only get everything out in one BM, instead of going 8-10x each morning, I think the tear would have a better chance to heal. I think the inner sphincter just clamps down and won't let much out at a time. Oy.

I hope yours resolves soon!

Karen

Hey no prob :)

I've had acute fissures for the last 6 years, on and off, and they were mostly painless. Then last summer the fissure became chronic, and terribly painful. I guess it finally tore really deeply, leaving me with a sentinel tag, and it's not healing on its own anymore (hence chronic). I've had this chronic fissure for 10 weeks now. I'm not sure but it seems as tho I also have hemorrhoids (will need confirmation from a specialist).

I'm sorry you have to go that many times...ouch! That will definitely irritate a fissure. I too have a tight bum and my stool is often small. evacuation is incomplete unless I push...which is what caused my fissure (the pushing), even if my stool is soft. usually i only go once in the morning but sometimes i go twice. in the past i went as many as 5 times per morning when i had an anxiety disorder.
Pushing is absolutely a no-no, which can be frustrating and lead to more trips to the bathroom, or annoyance and discomfort from your bowels not having been fully emptied.

If your transit in such, perhaps you need to experiment with insoluble fiber supplementation+ water (if you're not already) to bulk and slow the stool a little?

also lubricating the inside of the bum prior to every bm is very important. if you can use and applicator and lubricant jelly to lube up the rectum everytime, do it. I'll be buying myself an applicator soon.

and of course, deep relaxation when the bm comes help void the bowels more fully. so no clenching.

good luck to you!

hey Kari, new info on question #4: according to a moderator on this forum, nifediprine can or should(?) be applied on the outside. just wanted to let you know, since you were having difficulties with that. i'll be asking whatever future doctor i meet for nifediprine since what i'm on rn gives me a rash. if you can, let me know how it's working for you~

I hope your recovery is going well

PS. also, an ER doctor told me lidocaine can also be applied just on the outside. i think it might be better not to use them at the same spot or time since they might somewhat interfere each other's absorption (just a guess)

Hi Pita Girl,

I think I my fissure is getting better very slowly. It's a bit of a two steps forward one step back situation. Maybe I am just coping better with the pain? The first few days were sheer hell. I read a post in this forum that helped - the person said keep doing what you normally do as much as possible, don't just lay around in pain. A little harder for me since I am also recovering from surgery lol. But today I walked 2 miles and went into work and ran a payroll, so I feel like a productive member of society again. :-) I think the nifedine is helping the muscle to relax. It did take a few days to see a difference, and I still get the spasms, but not as often. I am not really using the lidocaine at all, since the nifedipine is compounded with lidocaine.

Sending healing thoughts your way.

Karen

Oh that's wonderful!
I totally understand what you mean about two steps forward one back: same deal for me! a bit of progress..then oops relapse, then slow healing progress...relapse. but each time the relapse is a bit more bearable i think?

yes going out for some fresh air is important for morale. resting is important too...so a nice balance :) some days i just can't move, and that's okay.

omg they can compound nifedipine WITH lidocaine?? wonderful news there

Hi Kari. Firstly I think everyone is different and everyone's fissure is different to some extent. For me, exercise is the best way to ward off spasms and it's good to know i'm helping move my bowels along in the process. If you feel up to exercising, do it as much as you feel you can do comfortably. It's getting the blood flow to your bum so it's really good for you. I had to google Acetominophen, i'm from the UK and we call it Paracetamol. It doesn't work for me at all really. Ibuprofen on the other hand definitely helps to quite a big extent. I take it as I need it, usually at night after my 6pmish bm. Coupled with a hot bath it doesn't leave me pain free but it definitely takes the edge off.

I was using optilube, similar to lidocaine during the actual bowel movement but I didn't think it helped much so now I just use lots of vaseline for the deed.

Kari-bee wrote:Hello All -

I am new here. I am recovering from surgery (Hysterectomy) which landed me in this position (was constipated, which is atypical for me) and I have limited stamina for sitting at computer now. Please forgive me if these have been asked and answered. I have spent some time searching the forum, and will continue to do so, but if anyone can answer any of my questions I would appreciate that.

1) For the between bowel movement pain, do you take Ibuprofen or Acetominophen? Which do you find helps more?

2) Prior to the surgery, I worked out intensely 4-5x per week. I won't be cleared to work out for at least 4 weeks, but I'm reading here that intense exercise may be unwise if you have an AF?

3) Prior to surgery, I ate a lot of salads. I understand that I should cook everything now...but for those who have healed fully, did you go back to raw veggies and was that ok?

4) I have nifediprine and lidocaine. Some folks talk about putting it on the fissure itself. Others say just the anus is ok. How do you actually apply creme to a fissure? I cannot see my fissure. The best I have been able to do is put the creme on a q-tip and put that inside.

5) For those of you who found nifediprine helfpul, how long did it take to start giving you some relief?

6) I had AF one other time about 20 years ago. (I have a narrow anal canal) My dr. at the time gave me a glycerin suppository (I think it was glycerin) which seemed to help. It took a few months but I healed fully. That no longer seems to be the treatment -- has anyone been prescribed this?

Hope everyone has a great day. Thanks for taking the time to read this.

Karen

Hi!

1) Ibuprofen is the gooood stuff. I take upwards 1800mg daily if I'm having a really REALLY bad time. Not recommended long term for your stomach and it can make my fissure bleed too.

2) Yeah intense exercise (for me at least) was bad. I could walk here and there but my butt hurt too much to do anything.

3) I still don't eat anything raw. I've been having smoothies with coconut and today, hello bloody bum again :/. I can't eat: salads, spinach, coconut of any sort. I eat rather modified low residue diet.

4) I mix my lidocaine with petroleum jelly and slather it all over the fissure/ my hemorrhoids/ and even about an inch into my rectum. I do it before and after I poop. It helps a bunch.

5 and 6 no idea. I hope this was helpful!

Kat