by Ever the Optimist » 12 Jun 2013, 12:38
Igrik,
Sorry to read this but Congratulations on the birth of your son. That is truly wonderful news but sad that his birth has the shadow of your fissure hanging over this. Please try to enjoy him and the pleasure of having a newborn child as much as you can.....
Where are you from? It's hard to imagine that there are no remedies there to help you? Diltiazem is another suggestion you could make or Rectogesic (that is Nitro) but another name that might be familiar???
If it is possible for you to find another CRS? as that would be really helpful especially since your last caused you further damage?
Botox assists the healing as it is directly injected into the internal sphincter muscle, generally under general anaesthetic, which relaxes the muscle and the spasms accordingly & promotes blood flow to the area to help the fissure heal naturally. It lasts around 2-3 months which is felt to be sufficient time to allow the tear to heal.
LIS actually makes an incision/ cut into the internal sphincter muscle again to reduce the resting pressure of the muscle (reduce the spasms) and improve blood flow to promote faster healing. This is seen as the the most effective & successful procedure for treating chronic fissures but a CRS will suggest this, generally, as the final stage if all else fails. It is normally a very successful & simple procedure with possible side-effects of incontinence.
When the internal sphincter muscle is in a state of spasm or tightens, it pulls on the wound edges of the fissure, which causes all that horrible pain and if it is in severe spasm, causes pain that lasts for hours. Because of this and reduced blood flow to the area, it makes the wound healing slow & difficult. It's a very difficult cycle that often needs intervention in helping break it.
The above methods therefore, help relax the internal sphincter muscle (and spasms), promote blood flow to the area, helping the healing process although they do not heal the fissure directly.
Some really helpful tips you might want to try to help, are to pre-lube your anal opening prior to every BM with Vaseline to help coat & protect the fissure & ease elimination of stools. Never strain and never wipe hard with tissue - Dab with baby wipes or clean-up with a shower head.
"Sitz" baths or sitting in a hot bath are really beneficial in dealing with spasms because they help get the blood flow moving to the area.
Coconut Oil/ Manuka Honey, Zinc oxide/ A&D ointments have all been found to be really helpful by others in just providing relief.
Hopefully, like you say, because some of your fissures are acute, with soft stools and easy to pass BM's, they may well heal quickly, not having yet reached a "chronic" stage but PLEASE stop straining & pushing when you go!! This will only make things worse & create new issues. If you are having an issue passing stools, ensure you are eating lots of fresh fruit & veg, drinking lots of water and taking a stool softener - Olive Oil helps (orally) as does Magnesium supplements. This is essential!!
All the very best to you and let us know how you get on.....
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