I have had anal fissures since about 8 yrs ago when I was 25.. but it usually comes and goes. This time, however, it has been 2 months and it still hasn’t healed, so I finally went to the GP.
For the past few years, I have had BM every morning, and my diet is healthy in general. So I am really at a loss of how I got it this time! I think I have a hem too, which might have brought on the fissure (hem causes narrowing of opening, so it got overstretched and torn). But I think the hem has now gone. But since then, I have had pain and blood in the last bit of my stool every 2-3 days. The GP had a very quick digital examination and said there is no lump so it is probably a fissure (I think there are 2, one right and one left).
I have tried Rectogesic for a week now, it does help alleviate the pain a bit. On the instruction sheet it says that it must be inserted to the first finger joint. So far I have never managed to do that because no matter how far I cut my nail, it always seems a little sharp on the edge especially now that I have a fissure. I am really paranoid of making it worse in case I scratch the fissure with a bit of dry skin or nail.. I have thought of coating my finger with a piece of clingfilm… but that’s kind of rough at the edge too.. and I just can’t relax! thus making it harder to follow the natural opening into the anal canal. Oh, I know there is a kind of disposable “finger protector”, but they don’t seem to be available for shipping in the UK.
I have also been adhering to strict (fibre-rich/soft food) diet, 2 sachets of fybogel per day, in addition to 10ml lactulose everyday. But despite that, the first bit of my motion is always hard.. During the day I am often in dilemma between (a) trying to open my bowel again (it does feel like there is something in the rectum, but no peristalsis) so that my stool won’t get too hard in the next BM and (b) have dry and hard stool the next day.
The most depressing thing about this condition is that you can’t tell anyone about it! So my colleagues are wondering how I am on diet when there is no need for me to lose weight, but they won’t believe it that I am not trying to lose weight.. :oops:

I would try movicol instead of the fybergel'it draws In water from the area to soffen the stool and drink loads of water 'no hard foods

east_123
I hear you on your difficulties applying things up a very swollen tender anus.
Never used Recto but heck, in my vaseline wars sometimes that was a big chore just to get that stuff in there good.
you say

I am really paranoid of making it worse in case I scratch the fissure with a bit of dry skin or nail

I would give the vaseline (petoleum jelly) a try. This will often greatly cut down on the burning and pain after bm's. Your chances of making things worse may be much less. Besides, you can be much more liberal and coat the hell out of everything down there, working it good and at the same time relaxing your muscles down there.

Then after a minute of doing that, see if you cant get a pinky full of vaseline up in there. A little discomfort then and there will be a whole lot better than trying to push out yesterdays leftovers if you know what I mean.
I like you, also had problems with the start of my bm's being hard. But the vaseline helped the initial push pass the "rock quarry" yikes.
GL HTH

Thanks for the reply and suggestions! Regarding getting my finger in there, I think there maybe a psychological hurdle to overcome! (and I think I will get really paranoid in case I feel something unusual in there). but as you said, maybe I will try lots of Vaseline first, and then Rectogesic when I feel more comfortable - actually, that might help diluting the Rectogesic so that the headache won’t come on so intense.
I am not sure if I will have time to push Vaseline up there just before BM (as I am still struggling with this ‘technique’ it takes me forever!) – because by the time I get out of bed in the morning, “rock quarry” is already at the door! But I guess if I do that the night before I went to bed it should still work?

Regarding movicol vs fybogel, I have read in this same forum that one bulks up more than the other? If this is the case, I wonder if it is possible to reduce the dosage (e.g. split one sachet into two, instead of taking 2 sachets).

Perhaps the night before will work. sounds ok
Not sure but it sounds like you may be able to split dosages to decrease bulking.
hopefully someone will chime in on their experience on dosage splitting.
GL

I think the Vaseline before BM is helping, even though I don’t think I manage to get it all the way past the very tight spinchter. I have been on very strict diet and have only had fish (sea bass, salmon) as my meat source, which I believe helps the healing (and lots of vegs and water etc). So, as of today, I have not seen blood in BM for about 2.5weeks. and I am happy with it.
However, the type of pain I am experiencing seem to have changed. At the very start of it (or in the past when I had short-term AF), I was never bothered by external movement incl. exercise or heavy lifting. But now, the pain seems to have gone much deeper. I started to have pain (that won’t go away for hours) after lifting heavy shopping or just walking a little faster than usual. And from the throbbing, the pain now feels more generalized and intense (I also started having involuntary spasm/ contraction? in the middle of the night). So even though the bleeding has stopped, the type of pain suggests it is getting worse?
I really hope that the GP will refer me to a specialist. But if I go to them again and say that I have stopped bleeding, they would think that it is healed. I know that it takes time to heal and that I need to be patient, but I am worried that if I leave it for longer without seeing a specialist, the AF will get worse.
My question is, do you think I am healing (no blood for 2.5wks), or is it getting worse (more intensified/ spasmic pain)?

About dosage splitting, I have tried only having half sachet each time and it is working well.

take olive or coconut oil internally - 2 tbsps a day followed by a glass of warm water - will help with the hard stuff.

One of the first things I thought when you said the pain is intensifying and sort of hanging around deep inside was that spasms may b developing.
With all the junk going on down there your sphincter muscles are going haywire.
The tricky part is trying to figure if the spasm is interfering with the healing process which may b the case.
But the good news is that your not seeing blood which makes one believe it is indeed healing.
Your rectogesic if you are able to get it up in there should help stop those pesky spasms.
GL