Hi everyone!

First of all, let me say that 1) my paternal grandfather had colon cancer, and 2) I have anxiety disorder and panic attacks, so I always assume the worst.

For years and years (I'm 44 years old), I have from time-to-time had issues where I would feel a particularly hard bowel movement, and would have bleeding and some small pain. If I was nice to myself, it would heal up in a few weeks to months.

In August of this year, I started having more difficulty with pain, itching, and feeling like things were never healing. I went to my doctor, and he said I had external and internal hemorrhoids. He prescribed a steroid suppository (Anusol HC). I used it a few times, and it didn't really help.

The first of October, I developed an extremely swollen and painful bulge around my anus. It was a thrombosed hemorrhoid. I had to have it cut open and a clot the size of a prune was removed. Afterwards, things felt MUCH better. My bowel movements no longer hurt, and I didn't feel like I was ripping something open with each toilet sitting.

A couple of weeks later, I had a bowel movement that was particularly large and hard. It literally got stuck on the way out. Afterwards, I had pain and some bleeding. I haven't been the same since. I have tried suppositories, creams, coconut oil, Desitin, stool softeners, fiber supplements, increased water intake, and sitz baths, and it seems to keep getting worse. It feels like passing glass when I have a movement, and it lasts about 15-30 minutes afterwards. Sometimes there is streaking blood on the tissue, other times there is not. I can tell if there is going to be blood by the amount of pain I experience as the stool goes through.

Being the worry-wart that I am, I started wondering today, "What if it's cancer?" I got in with my primary care doctor and told him about what was going on. He said it sounded like a fissure. I told him I was worried about cancer. He said this time we would go to a surgeon and get it looked at once and for all. He gave me a digital rectal exam, which was excruciating and made me yell out loud twice! It hurt for a good 30 minutes afterwards. He pulled off his glove and said, "There's no anal cancer in there," and then asked if I had a preference of a surgeon. I said no, and he said he would see who he could get me in with. I asked him, "I know you can't say 100%, but do you think there is something serious going on there?" He said, "No, but we'll let them look at it."

After about 15-20 minutes, his nurse came back in, and said I have an appointment with a surgeon first thing Monday morning! I also got a prescription for more Anusol HC 25 suppositories to use three times a day. My first concern is: what the heck is going on? Secondly, why does he feel I need to get into a surgeon so quickly? I thought they only got you in with a specialist that soon if it was something gravely serious (like cancer).

Does anyone have any helpful advice as my brain spends the weekend coming up with all kinds of scary scenarios? BTW, surgery itself is a scary scenario for me--I don't do well with general anesthesia. Just knowing that someone else had been through something similar would help me tremendously.

Thanks in advance for your input and support!

It is most likely not anal cancer. General doctors can easily miss fissure, but he wouldnt say it is not cancer, if he wasnt sure. Fissure can hurt like hell, but there most likely isnt anything serious going on. Maybe surgeon just happen to be free, so you will get to see him soon.

I hope you're right. Why would I have had a fissure all these years, and it only hurt like this now, though?

Most likely you just tore a little bit bigger or deeper fissure now than before. Of course there is a small possibility that fissure could be infected, but most likely it is just a little wound that is very painfull because the area is full of nerves and blood vessels. Fear also makses the pain worse. At least for me the pain isnt worst part but the fear of pain is.

I was referred to a surgeon quickly also - it is a good thing! I think most general practitioners can't do too much with a fissure beyond what you've described that you've been trying. Likely the surgeon will prescribe you a cream like nifidepine or similar which helps to relax the sphincter muscle and allow blood flow to the area to promote healing. My first fissure sounded very similar to yours, and was easily cleared up with this cream and fibre/stool softener in a couple weeks.

The surgeon will be able to help you further if you give that a try and it doesn't work, so it's great you have them from the start!

Keep doing what you're doing, I know it's no fun at all but you'll find relief! I have anxiety also and found that to be one of the most difficult parts of having a fissure. Feel free to PM me or just ask if you've ever like to discuss that aspect of things - and coming to this forum will likely be of great help on that front!

Thanks so much for the feedback! It has made me feel a bit better. I have been anxious all weekend, but am ready to go see the surgeon tomorrow and get it over with. I keep telling myself that I have thought I've had various forms of cancer and heart disease all my life, and have been correct a total of ZERO times. But you're right--the anxiety is the toughest part of it. If I just knew it was harmless, I could live with the pain and bleeding!

No problem! Try not to think too far ahead, one thing at a time. That's my biggest problem - I extrapolate into the future way too much. Do you have a friend or family member you can tell who can help keep you distracted? My dad will come over and watch movies with me when I'm really bad and it makes me feel so much better.

Keep us updated!

Well, I just got back from the surgeon. He was very nice and informative. I was scared to death, as my blood pressure showed. He examined me (along with a nurse and a student), and said that I have fissures (he corrected my pronunciation to "fizz-ures", not "fishers") at the 12 and 6 o'clock positions. The first course of action is to use a nitroglycerin ointment at both locations each day. He did warn me about the headaches, but said to just take Tylenol. He said the next step would be Botox injections. He said he hasn't done an LIS in 15 years because his Botox injections are so successful. I am to stay on stool softeners/laxatives, and to discontinue the steroid suppositories my PCP gave me--they can slow healing and thin the skin. He said I will be on fiber supplements the rest of my life, but he said that's great, because you can't OD on psyllium.

He did recommend that after they get me "all patched up" that I get a colonoscopy. He said that what I have is a perfect textbook case of fissures, and he felt absolutely nothing unusual in his exam, but with my age and family history it would be good for peace of mind.

I'm a bit worried about the nitro. How bad are the headaches? Any other obvious side effects I need to be aware of? I don't want to start panicking again.

I go back in four weeks. Thanks again so much for the support! I don't know what I would have done without it!

Hi,
I use nitro...in fact it's my best friend....yes it does give you headaches mine were quite pounding for the first week but keep going as it does stop the spasms and the headaches ease off...and trust me the headaches are nothing at all compared to the spasms.
I'm sure the nitro will work great for you

That sounds like a great plan scaredycat, congrats on getting that visit done and out of the way. I bet the cream will help immensely, and as mpb says just stick through it. Some people have mentioned using a q-tip or finger-cot/glove to apply the cream so that it is does not absorb into your finger also, that may help keep the headaches reduced - but I'm not sure as I never had them on nifedipine.

It will be great if you can wait until your fissure is in better shape to have the colonoscopy. It was do-able with a bad fissure, but the prep certainly not pleasant. I had one two or three years ago pre fissure and the Prep and the procedure were both much easier than I had expected! I actually felt really good after haha!