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New Here - Some Advice Needed!

Postby bestofluck777 » 30 Sep 2013, 09:06

Hi I'm a 31 year old male who has suffered with anal fissures for about 7-8 years. I have one fissure which causes me pain everytime I go to the toilet, the problem is I also suffer from IBS too. I'm pretty sure my high stress life has played a big role in this but its all very well saying to someone to destress, its very hard. I have been reading lots of stuff about how people are in severe pain and thankfully I'm not, its just uncomfrotable and a little pain when I go. I had a bout of food posiong 2 years ago which sent my digestive system into complete spasm where I was going literally 50 times a day for a month. I've had MRIs and things to check theres nothing really wrong and there isnt, although they want to perfom a colonoscopy on me sson just to check - I dont have UC or Colitis or Crohns, I know this - its just a form of IBS I have which is set off by eating the worng things. I'm still in 2 minds whetehr or not I want a Colonoscopy, I'm scared at the thought and dont like being put to sleep.

My fissure has started to hurt more recently and I have good days and bad days, to be honest it feels more a bruised feeling in my anal passage rather than the searing pain of the fissure, but that could but linked or because I go alot and have to wipe alot ( i sue wet wipes too now).

Recently I've been to the doc and he sas my fissure has tried to heal and has subsequently turned into a fistula, which he wants to cut open and inject with botox. I thought a pile had appeared and thats why I have this brusied feeling but he said its a fistula. Its been like this for about 2 months and its not very pleasant, and I find myself alternating between creams with Hydrocortisone and things like Germmaloids, but I'm steering away from HC now.

Does anyone have any advice for me, I have IBS but its rarely diarrhea so sometimes its hard stools which cause this bruised feeling - overall I've just had enough of it. I'm lucky i live in UK and lucky I have private healthcare which will cover these proceedures but I would like to avoid having them. I have tried that Diatelz cream but that just causes me to itch unbreably thorugh the night so I wont ever be trying that again. IS there anything else I can do, I read that laxative drink is good but not sure if people with IBS or digestive complicats should use something like that.

Thanks guys sorry for the long post!
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Re: New Here - Some Advice Needed!

Postby Scientist2516 » 30 Sep 2013, 09:42

Hi bestofluck,
I'm so sorry you are going through this, and have been for a long time.
I don't know about fistulas. It may be that you have to have an op for that.
But I wonder, have you tried any of the alternatives to diltiazem? Dilt. made me itch unbearably too. I tried its close relative, nifedipine, which was ineffective for me (but could work for you), and nitroglycerine, which was effective, and in fact seems to have cured my fissure, along with the other things I was doing.

A lot of people get headaches with nitro (I didn't), and some docs are reluctant to prescribe it because of that. However, everyone is different, and that's why it's worth trying these other drugs to see if either of them works for you.

The IBS must make life very difficult, but you must get your stools soft, (but avoid diarrhoea). Have you tried fibre supplements and/or laxatives? Is there anybody that can advise you on which OTC fibre/laxatives are OK for your IBS?

Do you drink enough water? Staying super-hydrated is essential to soft stools, because it's the dryness that makes stools hard. It's not just the pain you have to worry about with hard stools, but also re-tearing and spasms, which delay healing.
Stay away from tea, coffee, caffeinated sodas and alcohol because they are diuretics, and dehydrate you. Also, the longer you go between BMs, the drier your stools will be, so go at least once a day.

Also, my magic cure - heat. Or rather, warmth. Sitting on a very warm hot water bottle or heating pad does wonders for soothing the pain. One cause of fissures is a relative lack of good blood supply to that part of the anus. This lack of blood supply also makes healing more difficult. Warmth relaxes the anal sphincter and relaxes the blood vessels, and helps to improve the blood supply, as well as easing the spasms that cause pain and tearing. This is what diltiazem, nifedipine and nitroglycerine do as well, so one of these drugs in conjunction with heat, can really work wonders.

Once I got on the nitro and started using heat two or three times a day, I was on the road to healing, and just got the OK from my colorectal surgeon last week. I only had my fissure for 5 months, so I was lucky (didn't feel lucky, but I know I am).

You can start your own thread, where you document what you eat, other things you try, how effective they are etc. You can solicit comments on your progress. Also, trawl this site for advice and tips. There are other IBS sufferers here who know a whole lot more than I do on what works for them.

All the very best of luck, Bestofluck, and take care.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: New Here - Some Advice Needed!

Postby bestofluck777 » 30 Sep 2013, 16:31

Hey thanks for the reply! Yes like I said my main prob is likely my food/drink intake. I drink alot of water but I tend to eat things which cause a flare up. I am quite a big alcohol drinker, but my doc says its unlikely to cause what I'm going through on its own. I put it down to stress mainly coupled with my food poisoning and food chocies + alcohol. I am going to try the cream you suggest, I didnt get headaches form the Dilt cream so maybe I wont with the other cream, plus I am going to double my water intake & use hot water bottles to sit on if it gets too painful. Like I said its mainly this brusied feeling which I'm getting in my passage, not so much the fissure pain - I've always thought mine was pretty mild compared to what I've read.

Lets see what the Nitroglycerine does, before I book my op - which I am dreading so anything to put it off.

Thanks so much for the help and if anyone else can chime in I'd be super grateful.

Thanks!
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