Hello All;
This may be a completely off the wall question, but I'm gonna ask it and hope someone can chime in with some insight. Does anyone know if coumadin can affect things down there? Cause increased inflammation, pain, etc.?
Here's why I ask . . . Long story short, AF occured end of June, began treating with steady improvement over the next 4 weeks. Admitted to hospital July 31st and diagnosed with PE's and DVT's in left leg and started on Heparin, then transitioned to coumadin in August for six months.
About 1st or 2nd weekend of September I had two awful days (literally screaming in pain and crying) and thought I had a setback with the fissure. [Edited to add that I have been religious with stool softeners, water and fiber and have not had a hard BM.] The pain was different though and I had be so limited in my diet and regimented in my healing routine that I cannot determine what caused the flare up. As I said the pain was different, it felt more raw, farther up, like the rectum was actually disturbed, not just the area where the fissure was. I actually didn't feel pain from the fissure most of the time and felt no pain or discomfort when applying vitamin e oil to the fissure.
Since then, I have made very little progress with this other pain and it has increasing irritated the fissure. I've been trying to figure out if I've done something wrong and why suddenly the treatment was doing no good. I've been religious with it but making no progress since the beginning of september.
I've replayed the weeks over and over in my mind trying to figure out what I missed . . . there must be something. More and more in my mind the last couple of days I realized that the change took place about 3-4 weeks after being on the coumadin and I've begun to wonder if that it responsible for the pain I'm feeling and difficulty progressing.
Follow my logic for a moment . . . one of the things they continually tell me to watch for is unexplained bruises anywhere. I had two small ones show up on my arm this passed Saturday. I noticed the first one because I felt a slight sting when pushing my sweater sleave up. I looked and there it was. Now I'm wondering if my rectum lining or something is bruised (no bleeding, though) and that's what's causing my pain and I can't make any progress because it keeps being re-irritated with each bowel movement.
I'm gonna ask my surgeon's office tomorrow, but if that's the case, how do I deal with that? I'm gonna be on coumadin til February. Any thoughts . . . possible, ridiculous, plausible, suggestions . . . anything?

I really can't say what's causing the pain although I feel pain very similar to yours, it feels higher up in the rectum and most likely is, sometimes fissure pain can radiate further up because of all the nerves in that area, there are thousands of them!! It could even be internal hemmies, scar tissue or enlarged papillae, I would ask my CRS for examination under anaesthesia, which is BTW, my next course of action.

Thanks for the reply. I'll ask about that today.

Interesting, just found some information online about anal/rectal bruising which can be caused by other trauma or in those taking anticoagulants as well as something called anticoagulothopy (I think I spelled that right).
It's worth a call to my doctor's office. Until then, I know the ice sometimes soothes and is the primary treatment for bruising, so I'm going to incorporate that alternately with heat and see how I do over the next few days.