Hi, have been in agony with anal fissure for 8 weeks. Doc first thought it was piles, as did I, but pain was so intense she sent me for endoscopy. He couldnt find tear or fistula, just piles and thickened swollen inflamed tissue (which I'm now thinking was the possibly a tear with scar tissue healed over it??) so referred me for mri and also rectal exam under anaesthetic.
To cut a long story short, my mri came back clear and a couple of nights ago I was in so much pain my partner called out doctor and he put me into hospital as my appointment for the rectal exam was not forthcoming and he could see I had reached breaking point. I'm not ashamed to say this but when doc arrived and said how can I help? my first reply was "well you can if you have a gun in your case". Yes, terrible to say, but I now feel I have no life whatsoever except pain every day - and not just any old pain but bloody awful pain!!!! Pain that makes you cry like a baby, makes me scream like I'm being murdered and has turned me into the grumpiest person ever! I have had days so low I just wish I wouldnt wake up. I told the doctor who called out to see me that I would happily never poo from my bum anymore and wanted a stoma/colostomy. He actually DID NOT LAUGH and commpletely sympathised with this.
Anyway, got to hospital the next day and the surgeon found a huge fissure which she injected botox into (why had endoscopologist not found this - had it been hidden by scar tissue?). I was pleased for a while as the spinal anaesthetic had caused my bum to be numb for a few hours and it was a pleasure to be alive again - until I awoke in hosp at 3am in extreme pain (anaesthetic worn off!) and felt so stupid because I expected a miracle cure! The consultant came round the ward the next morning and he said I was to be given cream (dilitazem) and I asked him how long it would take for the full tear to heal. His reply was "how long is a piece of string?". I asked him if it was possible to have a stoma as I could not bear the thought of pooing from my bum anymore and he laughed and said no-one had ever asked him for one of these before and that I didnt realise just what this would entail. That's where he's wrong. My dad had one when he had bowel cancer. I know to him it may sound a little OTT but to me it's the only solution as I honestly dont think I can keep this up for much longer. I was already living a hellish existence before this fissure came long so it has been the final nail in the coffin for me. His attitude just lowered my mood immediately. After he and 3 other doctors left my bedside I drew the curtains round my bed for 2 hours and sobbed - not one person in hosp even noticed, that's how busy/caring the NHS is these days!
Surely I am not the only one - now that I have found this support group - who has not pondered the possibility of defecating from another area in their body? I know stomas are obviously kept for very ill people with bowel cancer/disease, but even a temporary one which may allow the tear to heal or at least give us, the sufferers, a chance to get our life back isn't too much to ask? I'm getting to the stage where I may just produce a gun to a surgeon and insist on a stoma or I take him out!!!!!!
Anyone else feel this strongly or am I just a big fat wuss??

You're not crazy at all, I said the same thing to my doctor a few days ago. Who wasn't quite as surprised as she's also been through it herself. I'm very sorry to hear about your experience, sounds like you've been through a lot.
It's such a difficult condition because the pain is so ongoing it just wears you down after many weeks and the end never feels like it's in sight.
I can't give you any comfort about it magically healing as yet, I'm at the 8 week mark too and going through a similar experience.
However one thing that has greatly helped me this week was talking to a psychologist for the first time. It's obviously not a psychosomatic pain so I didn't think it would help but it was nice to get everything off my chest. She also really helped get back into a positive, proactive mindset that is helping me through the really difficult times and making me feel strong enough to persist and be patient. We talked about some strategies like meditation/breathing/visualisation exercises to use when the pain was really bad. That might sound a little flaky but it does help with reducing anxiety, especially with this condition where some of the pain originates with muscle tension.
So if you're really feeling like you're at your wits end and doing everything possible already too it might be something worth trying for you as well? It won't make the pain go away but it might make you feel like you can manage those really painful times.
I wish you all the best and a fast recovery, do NOT let this beat you or feel like you're a wuss, you are a strong person for having gone through this and it will get better - best wishes :)

I too have been pondering...Which would be worse, having a colostomy performed...or having to recover from the surgery I may have to undergo soon. I realy can't even begin to imagine pooping with three to four sets of stitiches that go from internal, through the midline, and end up external.
I have been thinking that a colostomy bag would be strange during sex...but at least I might could enjoy sex with my husband again.
Also been wondering...if the CRS has to do such extensive work on these hemmies of mine, can't he go ahead and perform the surgery to remove the extra vaginal tissue that is allowing the rectocele in the first place. I'm on pins and needles till my follow up next week, and don't know right this sec if I can make it till then.

I hear you and can totally empathize. I went through the same exact pain you are describing. Wishing for a desperate measure like colostomy I think totally describes the level of pain and I also went through this, but for a month only so far. I was lucky to get the right diagnosis of AF on my first appointment, at least that. Got botox about 2 weeks after pain started and kicked in after about another week. Been pain free for a couple of day, AF started to heal, but then a severe diarrhea sent me back to square one. It seems botox is not powerful enough to fight back strong spasm like some of us have. Might be good for moderate spasm.
So my advice is be very careful with your BMs to help botox fight the spasm. The lesser your pain during BM, the easier for botox to hold back the spasm. Use vaseline before BM, sitz bath (body temp) and rest after. Do everything to keep the pain low, cause if it passes a certain level, botox won't be able to fight back and spasm will happen.
But eventually the only thing that works for me to live a normal life is to hold back poop. I go every 4th day, the challenge is to keep it soft, so I'm on a vegetarian diet right now. My body adapted, so I don't feel the urge to go more often anymore. It was the only desperate solution I could find, it was hard for me to explain at the office that I'm still a wreck after 3 weeks sick leave.

Thanks everyone for your replies. I did try replying yesterday but it didn't work?? I had a better day today so am hoping that this is the botox/cream beginning to work but suffice to say I'm not gonna hold my breath. Too often I have had a few days of relatively mild pain only for it to come back and bite me in the bum again (so to speak!). I'm going to try and stay positive for now - if that's possible - but if things dont improve in the next couple of weeks I'm going to head back to my GP and keep on moaning! I have been referred to a psychologist so will be seeing them next week and as you say Miss K this may help get me through the lowness I have felt since this fissure developed. Fingers crossed this post works and doesnt vanish like the last one! :)
BGD - How do you manage to hold back your poop for 4 days??? I'm lucky if I can make it out of bed each morning for about 10 mins before my bowels tell me it's time to go!!! Does this mean you have no pain until Day 4 when you have a BM?

WENDO, sorry to hear you are suffering, all of us in this forums have been in pain in one way or the other, sadly some people experience more pain than others with fissures.
Pain is the main reason fissures are so uncomfortable, having hems with fissures makes it worst.
Botox can work for many and bring relieve from fissure fast.
It can also help with healing, using the cream is very important until the botox takes over.
Now unless your doctor recommended to avoid getting a BM, I will warn you that holding the BM will only make the stools harder, that is not good for a fissure.
You, need to check on your diet, and change some things to ease the stools, take some stool softeners that is a plus, also lubricate the area with vaseline before your BM and try to keep them regular so you know when you need to get ready, sitz baths after the BM for cleaning and relaxing and then the cream.
Yes, the pain of a fissure is unbelievable and only those of us that have experienced only knows what is all about and yes you are not losing your mind even when it feels like it, this is real.
I hope botox brings you relief fast, so your mind gets a rest.
Is nothing wrong with getting help to make things easier to cope with, many members have done it.
I have my fissure for 10 months already and the pain lasted 4 months, I cope with it and allowing the slow healing take over without surgery, as that is another choice you have if things do not improve.
When fissures start to heal and the pain is less you can take back your life, but never forget that fissures can comeback you just need to learn to make sure that they do not control you.
I wish you the best and hang in there things will get better.

WENDO wrote:BGD - How do you manage to hold back your poop for 4 days??? I'm lucky if I can make it out of bed each morning for about 10 mins before my bowels tell me it's time to go!!! Does this mean you have no pain until Day 4 when you have a BM?

I think it's a combination of despair and how my body works. I've always pooped rarely and that it what brought me here in the first place, cause it would harden the stool. Since I went vegetarian to soften the stool, I did feel the urge to go daily. But I struggled to hold it back for a day at least, so that took me to one BM every other day. It still wasn't good enough in terms of quality of life, so I reduced food intake to survival mode, which helped having BM every 4th day. I only lost 2-3 kilos in weight. I'm at day 3 right now, not sure if I'll be able to hold back one more day. Sometimes it's easy sometimes not. When I feel it coming, I say to myself: relief or pain? The answer is pretty straight forward so my bum reacts right away sending poop back up where it came from.
Luckily I still get soft stools (level 5 and 6) without any stool softener. Just fruits, vegetables and water. I've even stopped prunes and flax seeds cause they made my stools too soft and too frequent, which I found it's worse cause it burned me more.
And yes, this means I only get up to 8h pain every 4th day. I think it's acceptable. The next day I'm like new, no pain at all. I know it's crazy, but I don't see how a wound could possibly heal when being traumatized every day.

marg6043 wrote:Now unless your doctor recommended to avoid getting a BM, I will warn you that holding the BM will only make the stools harder, that is not good for a fissure.

I know it wouldn't work for 99% of the people, but it just works for me. My doctor said it's my call, as long as I keep my stools soft. So far so good.

Thanks marg and bgd for your advice.
I'm having a hellish day today and had to call out the doctor again. I feel ready to end my life as cannot take the pain any longer. I'm not sure whether the botox has worked/stopped working or the cream is making it worse or what. At my wit's end. Can't get on with normal day to day life. Only managing to post this as doc gave me an injection of diclofenac and told me to take more diazepam - feel like taking the lot with a big bottle of wine to wash it down. Maybe time for me to phone Samaritans. I told Doc I was suicidal and he never said anything other than a "colostomy would involve more complications and recovery time" to which I replied "what? 9 weeks??!" since thats how long this pain in my bum's been going on for. Feel like no-one is listening. Really do not understand how you guys can take the pain. I have done nothing different today that I didnt do yesterday yet am in so much more pain. Why aren't the doctors realising how painful these fissures can be? Maybe they will if they ever have one.....

Wendo,
Sorry to hear your day has been unbearable.
I too have had very dark thoughts when my fissure pain was at its worst. I have been suffering for two years now.. And have had many ups and downs in that time.
Don't loose heart... Things WILL start to get better!
It does seem that many regular drs just don't get what the pain of a fissure does to a person mentally and physically, and to be honest, neither did I before I had one!
We all understand on this board though, and we are here with advice and support for you.
OMB xxx