by Ever the Optimist » 21 Sep 2013, 16:24
Hi Arginile,
Sorry to read that you are now having to deal with a fissure whilst recovering from hip surgery.....Everything must feel pretty uncomfortable right now.
Have you had your fissure diagnosed properly yet by a CRS (Colon & Rectal Surgeon?) because if not, that's definitely the best starting-point.
Depending on their diagnosis, it's very possible that a CRS would initially want to prescribe you either Diltiazem/ Nitroglycerin (Rectogesic) or Nifedipine as a first option. These creams work to relax the internal sphincter muscle, thus breaking the spasm cycle, which prevents the fissure from healing, and promotes better blood flow to the area to allow the fissure to heal. They might also suggest Botox and will definitely discuss the benefits of a high fibre and fluid diet with you to prevent the risk of constipation and keep your stools as soft and regular as possible.
Surgery is generally considered as the last option (unless you have an ongoing chronic fissure or a history of fissures, which retear or just can't heal by any other means) Treatment really does depend on each individual case though, which is why it's so important to get a proper diagnosis.
Please just scour this site for valuable advice & information - There are some great success stories here (myself included) of individuals who have healed without surgery and the sooner, you seek the help you need to get the healing process started, the better. Fissures over a couple of months old become "chronic" and these do tend to take longer to heal than those diagnosed quickly and treated quickly. On saying that, every individual case is very different!
In the meantime, just strive for soft but solid stools by watching what you eat (again - check the site!) ensure you are drinking lots of fluids to stay hydrated, use a stool softener, please don't strain on the toilet! and lots of hot baths or Sitz baths are great for promoting the blood flow down in that area to encourage healing. It's also really helpful to apply Vaseline to your bottom before a BM - just to help lubricate the area and coat the fissure too......
You will definitely survive this! - Just follow all the important tips you find here, stay strong & positive and rest as much as you can too after your hip surgery. Wishing you all the very best in getting this sorted out soon......
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