by thisfissurecankissmybutt » 09 Mar 2012, 15:52
Disclaimer: I am not a doctor, so you should check with your CRS before implementing any of these changes, ESPECIALLY since you are breast feeding, but these are the recommendations my CRS has given me.
According to my CRS (by the way, make sure you are going to a colorectal surgeon, not a family doctor or general surgeon - you want to go to someone that deals with fissures all day, every day), most people (80% to 90%) do NOT need surgery for a fissure (meaning, conservative measures usually work). DAVO is right - the burning sensation you are experiencing are spasms. The idea is to reduce the spasms, which will allow the fissure to heal over time (sometimes weeks to months). This is where medication and other conservative measures come in.
Each CRS has a favorite medicine of choice - Nitroglycerin, Diltiazem, Nifedipine, etc. - and they will usually have you try it for at least 6 weeks before they even consider Botox, surgery, etc. I am currently on Nifedipine and it has really helped reduce the spasms and protect the fissure during a bowel movement.
In addition to the medication, you can take NSAID's (i.e., ibuprofen) for the pain and Valium to help with the spasms.
You also want to make sure that your stools are soft and well-formed (i.e., easy to pass). An ideal stool should leave very little to no "residue" on the toilet paper when you wipe. If not, the excess "residue" will irritate the fissure and make the spasms worse.
My CRS put me on MIRIALAX and BENEFIBER. The MIRALAX helps keep the stool soft (stool softeners, such as Colace, NEVER worked for me) and the BENEFIBER helps keep you regular and the stool formed. I take a half dose of MIRALAX every morning and 9 grams of BENEFIBER throughout the day. You may have to experiment with the MIRALAX to see what dose works for you. By the way, I tried METAMUCIL, but it made my stool too large, which made me have to strain too much to have a bowel movement. Sometimes the spasms will make your sphincter muscles tight, which can cause you to strain. I love BENEFIBER. The combination of MIRALAX and BENEFIBER has made all of the difference in the world for me!
I also get additional fiber in my diet (i.e., high fiber oatmeal, Fiber One cereal, Fiber One brownies, etc.) and drink lots and lots and lots of water.
I also take a hot bath after EACH AND EVERY bowel movement, which helps keep everything clean and reduce the spasms (at least 20 minutes). I also take a hot bath each afternoon and each night before bed.
Disclaimer: I am not a doctor, so you should check with your CRS before implementing any of these changes, ESPECIALLY since you are breast feeding, but these are the recommendations my CRS has given me.
Good luck!