Permanent burning pain - anyone else had this?

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Permanent burning pain - anyone else had this?

Postby Gettingmedown » 08 Mar 2012, 22:17

Hi - I'm new to this forum and by the sounds of it, new to the world of an AF :-(
I had my first baby 2.5 years ago and looking back have probably had a mild fissure since then but it was totally manageable. My second baby was born 4 months ago and I guess the fissure has been getting worse since then. But then, 3 weeks ago it must have really torn and for the last 3 weeks I have barely been able to walk. After a BM I literally have the worst worst burning sensation for hours and hours. Sitting is impossible and the pain is just horrendous. I don't get the spasms that other people seem to mention but just this burn.
Over the last 3 weeks I have tried everything (or it feels like everything). the doctor offered me botox straight away as she was surprised I was in this much permanent agony but I said no for now as am scared of the consequences but I can't live with this pain - I literally haven't left the house for 3 weeks, cry almost all the time, my milk supply for my baby is affected...it is really getting to me. PLease help!! I know 3 weeks is no time at all in the fissure world but please tell me it gets better......???
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Re: Permanent burning pain - anyone else had this?

Postby Savaici » 09 Mar 2012, 10:42

Hi there, Gettingmedown! Sorry you are here, but the best place to be for fissures with lots of helpful people.
There is a member by the name of new mum. You might want to go to the memberlist, which is to be found just under the Anal Fissure Support Forum logo, and look her up, and then click on the posts that she started, to get some ideas. She got her fissure very soon after having her baby, so her's would have been acute. Difficult to know if you have had a fissure since your first baby (unless you actually saw it), or possibly hemmies? If you have had a fissure for over six months then it would be chronic, which means that it is a little more difficult to heal.
Have a read of new mum's posts and see if there is anything to help you there, and hopefully someone might come along who has had a baby recently and can offer more advice.
Baby or not, we feel your pain Image
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Re: Permanent burning pain - anyone else had this?

Postby Baba » 09 Mar 2012, 11:05

I feel your pain - I remember sitting on the sofa nursing my baby and crying from pain and hopelessness. The family around me advised me to stop nursing, but doctor encouraged me to keep going. He said to take warm baths and afterward keep the bum warm. Women's underwear is not exactly designed to keep you warm, so I borrowed some from DH. I find that sitting on a cold chair now will start spasms.
The secret to healing is to keep the BMs of a soft consistency. Because you're nursing you have to drink even more water than the rest of us do.
There is a lot of good info on this site; I hope you soon find something that works for you and heal speedily. Image
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Re: Permanent burning pain - anyone else had this?

Postby Davo » 09 Mar 2012, 12:48

Hi Gettingmedown,
The burning sensation you describe is the spasm - this normally starts within half an hour of your toilet visit and continues for at least 4-6 hours (or all day depending upon the severity) - the main medication prescribed that helps reduces the spasms is GTN (sometimes called Nitro depending upon your location). GTN should give you some pain relief within the first week however patience is the key as the course initially lasts for six weeks. If you have not used this I would ask your doctor to prescribe it however they don't normally offer it until your fissure becomes chronic (6 weeks).
Personally I would give GTN a try first before looking at Botox - GTN does have one slight drawback in the fact that a major side effect can be headaches, if you do do suffer from these then there are alternatives
Davo
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Re: Permanent burning pain - anyone else had this?

Postby Savaici » 09 Mar 2012, 14:09

Not sure where you are, but if you're in the UK GTN is Rectogesic, and in Australia too. As you'll see on this link from the NHS, they do not recommend using it while breastfeeding.
http://www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?condition=Anal%20fissure&medicine=Rectogesic&preparationRectogesic%200.4%%20rectal%20ointment
It is not usual to go straight to Botox without first trying a calcium channel blocker, such as Diltiazem or Nifedipine first, or GTN. The good thing about the CCBs is that they don't usually give headaches. Is the doctor a colo-rectal surgeon or a GP? Better to see a CRS for fissures.
Hope this helps. Sorry you're in such pain.
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Re: Permanent burning pain - anyone else had this?

Postby Gettingmedown » 09 Mar 2012, 15:14

Thank you for your replies. So if the burning is the spasm and people say they have had fissures for months and years that fills me with fear...it is literally so painful I can honestly barely sit down,walk or do anything-how does it ever heal enough to make you at least get through a day and have a life?? I hate this already...
My family also want me to give up nursing and if the GTN is the only real cream that will work then I guess I'll have to. I am scared of going to the toilet and can see it is a viscious circle. Do you really think they heal on their own or do you ultimately think surgery is the only answer?
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Re: Permanent burning pain - anyone else had this?

Postby workingonit » 09 Mar 2012, 15:34

They do heal on their own, almost always. But you have to be careful, as the skin remains fragile for many months after and that is why re-tears are common.
If you want to breastfeed, and that disallows the topicals (not sure about that?), then you might consider the botox after-all.
More important though than the botox and creams, is that you keep your BMs soft and regular. Some here like to describe the consistency as toothpaste, while you are healing.
Have you tried sitz baths with epsom salts? These are good for spasms, and the magnesium in the epsom salts is a natural muscle relaxant. I like to sit on an electric heating pad when I feel sore. It really relaxes all the muscles down there. Very soothing.
Anyways, don't get too down. The future is not bleak. Most people who have suffered for years, haven't progressively sought help, and/or have other health issues.
So make sure you get 20-25g of fiber/day (more soluble than insoluble) and lots of water/fluid. If this doesn't get your stools soft enough, consider prune juice or MOM or miralax. (not sure if miralax is safe for breastfeeding).
If it's hard to get enough fiber or it makes eating a chore, try a fiber supplement like benefiber or metamucil. Some say metamucil is too bulking and prefer benefiber.
All of these require more water, or you could do yourself more harm than good, increasing fiber and not liquid at the same time.
Sure hope you feel better soon!
-Tanya
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Re: Permanent burning pain - anyone else had this?

Postby 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!
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Re: Permanent burning pain - anyone else had this?

Postby Gettingmedown » 09 Mar 2012, 22:56

This time last month only my mom and husband knew about my butt trouble and now you have all already been so helpful...thank you! I'm sorry that you are also suffering but nice to know there are people out there who understand.
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Re: Permanent burning pain - anyone else had this?

Postby Savaici » 10 Mar 2012, 10:28

Image Yes, not many places we can talk about our bums without being 'jumped on,' but this is one! And we really do understand your pain.
Do try the heat pad as WOI suggested. It does help.
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