by Ever the Optimist » 22 Oct 2012, 12:33
Hi Sufferer,
Anal fissures and fistulas are generally unconnected. Some of us are unfortunate enough to get them both!
They can develop through surgical incisions/ infected fissures but generally seem to result as the result of an abscess (which could form from the above if infected but this is not usual...) To be honest, getting a fistula, in my opinion is less troublesome and certainly less painful than a fissure ( I started off with one and the pain was horrible for me) Then an abscess developed (totally unrelated to the fissure and in a different area) This was painful while inflamed but burst within about 24 hours of it starting and the relief was amazing! It popped up very quickly and popped just as quickly at home. I was treated with a few weeks of anti-biotics and my GP kept an eye on things until I went back to my CRS who diagnosed a fistula as a result of this, had a fistulomy to get it healing. A fistula will NOT go on its own and definately needs surgically treating but overall, the process I went through with the abscess, fistula formation and surgery was NO where near as bad as the fissure I had with lingering pain for months. Given the choice, I think I'd rather a superficial fistula than a fissure that hurts for months, driving you mad because you don't know when it's going to end/ heal and all the pain and creams and stuff in the meantime to deal with....
An abscess can develop very quickly and then burst quickly (generally within a few days) It can appear almost as a large red bump and the pain tends to be localised than that of a fissure, which seems to make your whole bum hurt! I think you would know if you had an abscess. Once it pops all the pus comes out and it's yucky and I certainly knew it was a different kind of pain from the fissure with very different effects...
Try not to worry too much and fear the worse....most people just end up with a fissure OR a fistula, not necessarily both or the fistula a result of an abscess. Just keep up a good & meticulous cleaning routine, to keep the area fresh, clean with less risk of infection and you should be just fine!!
I used Diliatizem for 7 weeks, inserting about 1.5 cm internally along the top of my finger, twice a day and it worked brilliantly for me. I also felt mass relief about a week after using it. I was a bit scared to stop it because I didn't know if I had healed but my CRS confirmed it had fully healed when I got my Fistulomy done.
Try not to scare yourself too much by some of the other stories you might read on the web. Just focus on sorting out your fissure and don't start worrying about anything else developing!! :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups