Hello all, I haven't posted on here in a least a week. Saw my CRS (the real one, not the physicians assistant I saw first time) last Tuesday and we chatted about my history.
Have had fissure(s) for over a month now, physicians assistant prescribed hyrdocortisone suppositories back when I first saw her a month ago because in a previous situation where I had a fissure I had seen a general surgeon and he prescribed me hydrocortisone suppositories and it cleared it up.
The suppositories worked for the first week or so but I had a major re-tear and called her and asked for diltiazem which she prescribed. Had been using that for a week before I saw the CRS and went from blood in toilet and awful pain during a BM as well as horrible spasms to no blood in toilet, no pain and no spasms, just a whole lot of itching. Thank God for Miralax, that stuff is amazing and really helped me heal as much as the diltiazem. Made my bms super soft.
So he explained to me that he doesn't prescribe hydrocortisone suppositories (or cream) for fissures because they initially reduce the swelling and make things feel better but they also thin out the skin and can lead to a re-tear easily. He thinks that's what happened with me.
So after our little discussion, he took a look at the area. This time was different than when the physicians assistant did so. With her I was on my side and she used an analscope three times and found the two fissures. With him I was made to get on my knees, chest on the table with my butt facing him. He simply opened the cheeks, took a look (no digital insertion) and told me I was almost 100% healed. I got dressed and went back to his office to discuss.
He said my lateral one (the bigger one) was healed and that my smaller one (at 6 O'Clock) broke open and bled slightly from his exam so that one still needs some time to heal. He said to continue keeping my bms soft, to take sitz baths often and I didn't need to continue the diltiazem. He said I might have a re-tear here and there as I continue to heal but I know what to do about it now (his words).
I asked about the itching and my raw, bloody skin around the anus and he said that was due to "stool staining", does anyone know what that is or ever heard of it? He said he suggests I take a small gauze pad and put it up against the anus often to keep it dry and soak up any of the discharge.
So I have been doing so since last Tuesday and the area is still very itchy. I have caved in and scratched it a few times which has set me right back to square one which sucks. I am using the gauze pads and when I remove them there is a brown discharge on it that doesn't exactly smell like poo, but certainly doesn't smell good.
Does anyone relate to this issue? I assume it's fecal discharge that I'm seeing on the gauze but why would that happen with a fissure? And what is "stool staining" and why would that make me so itchy around the anus?
I am very happy my fissures are healing and I am being super careful to keep my bms soft (maybe too soft, with the Miralax and four stool softener pills it comes out and looks like ribbons, maybe the looseness of the stool is leading to leakage?), I always jump right in the shower and use the shower head to wipe to avoid agitating the raw, itchy area and I am drinking a lot of water (not as much I admit, need to get back to that) and still eating better, but the itching sucks.
How long has anyone's fissures or anal area continued to itch during or after healing?

Yes - some people do have some small stool leak when having a fissure. It is due to the fact that whole area is irritated and somewhat swollen and is not than as "tightly" fitting LOL, hope you understand what I am trying to say. Also - your soft stool makes it easier for some of it to "seep out". Since the "seepage" is minuscule, it usually does not have real poop odor.
Even tiny amount of fecal matter can cause itching and burning and local irritation. I personally do not like gauze as a solution for it since it is not soft - it is almost like wearing a thong LOL. Actually, worse, since things are usually made of very smooth and silky material LOL. I was wearing thong before I developed fissure and also tried gauze after my first LIS - so I can attest that having a gauze "up my butt" caused MUCH more discomfort, actually had none with a thong
But, what I wanted to say is the fact that you can protect your anal area from irritation by using Vaseline immediately after you wash yourself or even Zinc oxide cream, or maybe A+D cream.
All of them make mechanical barrier against the moisture and fecal matter and also lubricate - I am great fan of Vaseline : )).
Did your CRS ever consider you having possibly an anussitis (inflammation) of the anal membranes ?
I wonder since you had a lateral fissure which is highly unusual and also because you were helped by cortisone so much and so fast first time around. If you did not use cortisone for more than 2 weeks I do not see how it could have caused thinning of the membranes :roll: Only prolonged use of those can possibly cause that. There are other anti-inflammatory meds that do not cause thinning , like Canasa, for example :roll:
Hope any of this helps

I might try the vaseline because you're right, the gauze is not so comfortable up there. I took a 2" by 2" one and cut it in half to make it smaller and thinner but it's still not very comfy.
CRS never mentioned anussitis (inflammation) of the anal membranes. Would the hydrocortisone suppositories help that at all?

I'm a massive fan of vaseline and have been using it for years, it's definitely the best IMO, as for the itching, well, that could be either the Diltiazem you've been using or it could well be part of the healing process, if it's the Diltiazem try reducing the amount you administer and see if the itching subsides, btw, it's a common side effect of using this cream/ointment, hopefully it's the healing process causing the itch, good luck.

Hi, I stopped using the Diliazem a week ago so it can't be that. Maybe it's the healing process, but it sure is frustrating and gross. How long can I expect this seepage and itching to continue?