Is this what the start of a fissure feels like?

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Is this what the start of a fissure feels like?

Postby MarkN » 25 Feb 2016, 14:59

I'm a 44 year old male.. and I've had IBS-D for a few years now. I always feel pressure in my lower abdomen like I need to have a BM... in the past sometimes I strained just to get something to come out... this is what probably led to the hemorrhoids

I had hemorrhoid surgery in May 2015 to remove 2 hemorrhoids. After the surgery I was left with a large skin tag .

For the most part I was fine after the recovery but the area with the skin tag has always felt odd, and now it's burning.

About 2 months ago I started having a burning sensation whenever I had a BM. The burning sensation started out lasting about 20 to 40 minutes. Now the burning sensation lasts the entire day. About 3 weeks ago the burning got much worse... My family doctor examined the area and put his finger inside and did not see or feel a fissure, and the ER doctor also examined the area about a week after and also put his finger inside and did not see or feel a fissure... the ER doctor told me that it's most likely a muscle spasm and prescribed Petroleum Jelly with 2% Diltiazem. The area is very pink.

I'm usually a little better in the evenings and able to get to sleep but as soon as I have the first BM in the morning it starts burning again and gets progressively worse throughout the day after each BM.

Taking Sitz baths for 20 minutes at a time relieves the pain temporarily and I pass a lot of gas when sitting on the Sitz bath because I guess the sphincter muscle is finally relaxed. Most of the rest of the day I'm bloated.

I've been reading that with fissures people usually have an itching sensation and a lot of blood... Mine doesn't itch, it burns a lot though. And if I apply any ointment it starts burning immediately... so I think there is probably a break in the skin (as applying the same cream on the palm of my hand produces no sensation) It's very sore whenever I touch the skin, feels very raw. The only blood I've seen is a couple of drops the size of a pin head on the toilet paper but no drops when I have a BM...

Not sure if this is the beginning of a fissure or if it's Anusitis or something else... I would think if it was a fissure there would be a lot of blood.

Does the Petroleum Jelly with Diltiazem generally work? and I've been reading mixed comments about whether it's supposed to be used internally or just externally...
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Re: Is this what the start of a fissure feels like?

Postby Savaici » 25 Feb 2016, 21:56

:wel: . Sorry you're in such pain, but believe me, we know exactly how it feels...

It is not necessary to use ointments (Rectogesic/Rectiv/GTN//Nitro or Diltiazem/Nifedipine) internally. They go into the blood stream so it's not necessary to subject yourself to added pain. Not uncommon for GPs not to see AFs. For such a small cut the pain can be excruciating and continue for hours hours. Like a cramp in your calf - that goes on and on!!

Quite common to bleed with fissures. 

Skin tags, sadly, form after surgery.

Diltiazem works. If you have only had your fissure for two months, it is just going from the acute to the chronic stage and can still be healed. Use our search above between FAQ and Portal and search by topic. You will find a lot of information there. 

Sitz Baths are excellent!

This link (though we have loads of info on here) is a good one for an explanation of fissure-in-ano:

 http://davidrosenfeldmd.com/brochures/fissure-in-ano/
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Re: Is this what the start of a fissure feels like?

Postby MarkN » 11 Mar 2016, 16:04

So I still have burning around my Anus every day, but I've never had any bleeding... so not sure what the cause of this pain is but it's likely not a fissure. And my doctor doesn't seem to have any ideas what is causing this burning sensation in my rectum and surrounding area.

I've been to my family Doctor twice where he just prescribed different creams with various levels of hydrocortisone, and this week got a prescription for ProctoFoam which you shoot up your rectum. First of all the ProctoFoam also burns but it's even worse because you can't wipe it off since it's inside... also because you're squeezing liquid into your rectum it feels like you need to have a bowel movement right after...

I tried Diltiazem for a couple of weeks but it did not make things any better in fact it made the burning far worse... it's really odd if it was an allergic reaction I would guess that it would burn when it touches my hand... but it only burns when it touches the skin on my butt.

Every cream I've tried makes the burning even worse... the skin is crazy sensitive.

I tried talcum powder just to keep the area dry and that made things itchy... and even tried Zinc Oxide but that didn't help either.

The only time that I'm able to sit comfortably is in the Sitz bath... I've been doing Sitz baths 3 times a day for a week... I feel fine when sitting in the sitz bath but within 20 minutes of drying off the burning has started again.

If it's not a fissure does anyone have any ideas what could be causing all of this burning.

Also I don't see many people reporting that the Diltiazem cream made the burning worse.. but it did for me...is this very common?
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Re: Is this what the start of a fissure feels like?

Postby dmcff » 12 Mar 2016, 08:01

I have tried to use the diltiazem 2% cream several times, but have always had to stop because of the burning and irritation. I get the same result with proctofoam, sudocrem, and even with lidocaine/prelocaine. I think that sometimes in AF the skin of the anus is just too sensitive to tolerate anything on it.

I'm not a doctor, and you should go back and consult your family physician again - if nothing is visible to the naked eye maybe ask him to arrange a sigmoidoscopy, as the burning you describe does sound very much as though you may have a recent fissure.
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays, severe pain until August, then moderate to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Now in biofeedback treatment
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Re: Is this what the start of a fissure feels like?

Postby scotty909432 » 16 Mar 2016, 21:42

Hi, im having the same symptoms, i started washing after every BM without soap, just water, no tp, i use designated towel to dry, and at the end i drop some potato flour around area. works great. im able to keep burning under control for few months now. just wanted to share.
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Re: Is this what the start of a fissure feels like?

Postby Benny Lee » 22 Mar 2016, 09:14

Hey MarkN how is the burning going? I am experiencing the same, even with health products like Aloe. I don't use soap either, and thanks scotty909432, might try the potato flour altho...used cornflour once and that stung!
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Re: Is this what the start of a fissure feels like?

Postby MarkN » 22 Mar 2016, 09:23

Burning has gone down a little bit... the bigger the BM the more it burns, so I've been eating smaller meals. I think I have some kind of allergic reaction to Hydrocortisone... every time I apply any cream with HC my skin turns red and burns even more. I've also been wiping with Tucks (basically a small flushable wet wipe, but even the moisture from that seems to burn. I'd love to know what caused this in the first place, I think it was probably aggressive wiping a few months back.

One thing that was helping was placing a small piece of gauze in that spot, seems that I was even getting burning from the two sides of by butt touching each other. The last few days I've been placing a little big of vaseline on the area after each BM, and that's helped a little bit. At least I can sit down for a few hours at a time.
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Re: Is this what the start of a fissure feels like?

Postby Benny Lee » 22 Mar 2016, 09:43

Me too I am totally hypersensitive to HC. It's the worst for me. I think what increased all this for me was straining one weekend after I'd stopped movicol (and taken too much chia seeds without enough water I guess), and then two weeks of runny stools as I tried to make up for it by using too much lactulose and then (holy crap!) magnesium citrate which was explosive. Sigh. Now back on movicol as of today, tho managed few days of (painful, runny) BMs without any softeners, but wasn't eating much, and overdoing liquids perhaps! I'll try your gauze idea as it hurts when the sides of my butt touch too. I felt sure the pain on the 'left' side, and the GP confirmed that's where the fissure is (I thought it was 'above', where a tiny skin tag is). As we're dealing with 'anoderm' here, here's a dictionary definition...


1. Lining of the anal canal immediately inferior to the pectinate line and extending for about 1.5 cm to the anal verge; it is devoid of hair and sebaceous and sweat glands, and so is not true skin, although it is squamous epithelium; it is pale, smooth, thin, and delicate, and shiny when stretched; it is especially vulnerable to abrasion (as from coarse toilet paper) and chemical irritants (soaps), and is amply provided with tactile and nociceptive (pain, itch) endings innervated by the inferior rectal (pudendal) nerve.

Ouch! It figures that will 'reject' all kinds of stuff, I guess. Still, our bodies know how to heal if we let them!
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Re: Is this what the start of a fissure feels like?

Postby Walking Wednesday » 07 Jul 2018, 13:50

How have you all come along on this? I too have the internal anal burn. For me it seems it’s as my bowels are moving in place for the next days evacuation. Comes and goes.
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Re: Is this what the start of a fissure feels like?

Postby Walking Wednesday » 18 Jul 2018, 10:44

I get this too off and on. I noticed gassy foods caused it more , beans etc. it was a sharp pain.
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