My problems started early this spring. The dreaded razor blade pain with horrible muscle spasms. After being miserable for months and trying every absolutely every type of OTC medicine, I finally ended up at the GI and was diagnosed in August. I was started on .02 Nitro, told to eat lots of fiber, take stool softeners, ect. Been taking 3 Dulcolax a day, a half dose of Miralax, and the Nitro since.

Nitro took about 2 weeks to notice a change. Pain went from excruciating to more soreness and tenderness. This was a big relief! Went back to the doc after a month and was told to continue for another month with the Nitro, then I could start weaning myself off. Yay! Sounded great!

The problem is that the soreness and tenderness just won't leave. I made that first big improvement and now am wondering how long before I feel normal again? Have had one set back this week. A increase in soreness, but not the knife pain I had in the beginning. How long before the soreness and tightness fades? I sometimes go all day not really noticing any pain and bend over to pick something up off the floor and I'll feel kind of a pulling sensation. So frustrating! I know after reading alot of the posts here that I'm fortunate to not went through the agony that alot of the people have went through, but I'm just anxious to get back to some sort of normal. I also have really bad anxiety and so I tend to obsess over things like this. Does the soreness continue to fade until gone? Any help, experiences, comments would be greatly appreciated. :)

Hi Wondergirl,
Welcome! but I'm sorry to read your story.....It's all so familiar but on a personal level, it's horrible to deal with and to see an end to at times.
Because I'm guessing your fissure has now reached a chronic stage, unfortunately, it does take a few months to heal. On saying that, it also depends on the individual too & the extent of damage etc.
From reading your progress, it might not feel it, but you are actually doing incredibly well. Just the fact you are no longer getting that sheer knife-like intensity of pain says an awful lot in a healing fissure. What you are now experiencing is continued healing and the soreness & tenderness you describe is totally normal and unfortunately may continue to last for a few weeks longer. You might even experience a little bleeding, but that is also nothing major to worry about too.
The good news is though that although healing can be slow, you will see a gradual improvement in your symptoms. It's difficult and frustrating to have to be so patient, but it's the only way forward & it helps to tell yourself constantly that you will get through all this and sometime, you WILL feel normal again.
Recovery can only be likened to a roller coaster, weeks of feeling great and then the odd week, where you might feel you've relapsed and things don't feel so good again. In my opinion, it's always best to measure your healing month by month and to think back to where and how you felt the previous month......this way I was always able to plot my own recovery pattern. It might even help you to write everything down??
Just like you, my anxiety levels went through the roof and I was extremely obsessive about everything, actually to the point I was prescribed AD's to pick me back up, get me out of the rut I was in and give me the strength back that I needed, to be positive & to break through it all. They helped so much and now I am off them & looking back, I can see they were exactly what I needed to break that pattern of obsessive thinking.
No-one can say exactly when they will reach that stage of feeling completely normal again, but it HAPPENS - Honestly - I'm living proof with lots of others here and there is no reason if you maintain all the great things you have been doing that you should relapse in anyway. Just accept that it might take longer than you are expecting, but you will get there in the end. Try not too get too down or frustrated about it all and it's really important to try & channel all those obsessive negative thoughts into totally distracting activities that will focus your mind away from it all.
Look after yourself & stay strong! You WILL get better.....

Hi wondergirl,
When do you feel sore? After all BMs, or only after bigger ones? Or not related to BMs? If your spasms are gone, then the nitro worked, which is great news! Like you, even after the nitro really started to work, I had some soreness after big BMs or 2 BMs close together. Also, just like you, bending over, or just generally over-doing it, led to some pain, and forced me to take it easy again.
The good news is that 2-3 weeks after those set-backs, I feel almost totally back to normal. I'm still working hard to keep hydrated and eat fibre, but I haven't had any real anal pain for about 2 weeks. I do hope you are on the same path!

Another possibility is that what you are feeling is a hemorrhoid rather than the fissure. I developed a hemmie after the fissure started to heal, and for a while I couldn't tell the difference. The hemmie is more of a burning pain and it feels on the surface, while the fissure pain was inside. Do you have a sore lump on your anus - not the sentinel pile, but a lump?

Anyway, it sounds as though you are doing really well and recovering fast! Keep up the good work - eat fibre, drink lots of water, keep hydrated, and keep healing!

Thanks to you both for the responses!


It makes it so much easier to come here and know that I'm not the only person who has experienced this.


Ever The Optimist: I agree it is a rollercoaster. Everytime I think things are going better, they seem to get a little worse for a couple days. I too was on a AD for a while. I was actually in the process of weaning myself off of them when I got my fissure. I've often wondered if there was some sort of correlation between going off the AD and getting the fissure. I also have some stress related IBS so that doesn't help things. Thanks for your help!


Scientist2516: Great news for you!! So glad your feeling better!! I feel sore most of the time after my BMs whether they are big or small. I then notice it off and on throughout the day depending on which position I'm sitting or it I'm bent over. It's not intense pain and compared to where I was before the Nitro, it's bearable. It's more of just a annoying, nagging soreness. I do have a small sentinel pile but I haven't noticed a hemorrhoid. I also wondered if the sentinel pile could be causing that pulling feeling that I'm getting. Thanks for your help!


I'm also concerned about taking so much stool softener/miralax. Right now I know I need them both and won't stop. However I don't want to become reliant. I know Miralax is okay for long term use, but in anyone's experience is this something that I will more than likely end up needing long term? Or when things get better will I be able to wean myself off?

Hi Wondergirl
I too have a healing fissure and hate the idea of taking Miralax all the time. But I have to caution against cutting it out too quickly. I am down to half sachet a day but each time I have tried to reduce it even further I have had a set back. I am now resigned to taking it for several months at least. As others have said to me here, there are many far worse things to be reliant upon. But I will kick it one day!
It sounds as though you are on the right road. Very best wishes for a speedy healing.
Allan

Hi Wondergirl,
Yes, it's two steps forward, one step back a lot of the time, and each set-back can feel very very depressing, because we are so afraid of the pain we went through at the beginning. However, most likely you are on the road to healing, and the set backs are temporary.

I've had some great pain free days lately. I'm wearing jeans again (first time in months), yesterday I pumped up a bicycle tyre and thought nothing of it! Today, not so great, not sure why. I'm telling myself it's just one step back, and tomorrow will be two steps forward again.

Anyway, the sentinel pile, you think it might be giving you the pulling feeling - it could be. Mine feels like a little wormy sensation sometimes. It doesn't hurt, but it's a constant reminder that it could hurt if it wanted to! And that is part of what's bothering me today.

The sentinel pile should shrink over time.
It does all take time, but you are doing great, just keep up everything you are doing, and don't get despondent

Good luck!

Hey Wondergirl,

Keep going with the Miralax (Movicol); you need to keep those BM's soft! I'm doing really well right now (looking forward to posting a "success" story soon) but understand I need keep BM's soft and have resigned myself to taking Movicol at least up to Christmas. I had a fissure last year and learned a lot from that experience that setbacks can happen if you relax into "normality" too soon. Sounds like the nitro is doing the job (did for me too!) so stick with it.

I also plan to wean myself off the Movicol, but as PompeyBloo says, there are worse things to be on. Think of it as a multivitamin!

Good luck with the healing, stick to your plan and you will get there.

Hi Wondergirl,
I would almost certainly agree with Scientist that that "pulling" feeling is the Sentinel pile - this is the area where scar tissue is healing over the fissure, so instead of the open cut with the horrible knife-type pain, you are now feeling the scar tissue stretching over the area every time you have a BM or make some movement that affects that area and it will be a little sore for a while. As long as you keep everything nice & soft and don't put excessive pressure on it by forcing BMs etc. it will become more resiliant overtime and less bothersome. I certainly remember this sensation well but mine is so much better now, although it's taken time!!!
Keep taking your Miralax until you feel confident you don't need to do so. I took Lactulose for a several months but as my fissure got better, actually switched to a Magnesium supplement, 300mg at night time and this worked a treat for me, producing lovely soft stools and possibly even better ones than previously! I'll continue to take this now life-long but I don't worry about that. I also take Zinc & B-vits regularly & just consider them part of my routine now, so yes, you won't necessarily have to rely on this for life! Once you feel better & have a soft stool diet under control, you'll find you probably won't need it anymore & will naturally progress off it.
Scientist, I used to write a lot about my little "twinge" I got after BMs because like you, I felt it was also a good reminder of what I had been through and saw it as my little bum angel just warning me to keep up my good habits!......It's not a bad thing...I can now confidently write that it will also go away with time........& your worries will fade more & more. :)

Bum angel.......ha ha ha ha...........
I'll remember that!

PompeyBloo wrote:Hi Wondergirl I too have a healing fissure and hate the idea of taking Miralax all the time. But I have to caution against cutting it out too quickly. I am down to half sachet a day but each time I have tried to reduce it even further I have had a set back. I am now resigned to taking it for several months at least. As others have said to me here, there are many far worse things to be reliant upon. But I will kick it one day! It sounds as though you are on the right road. Very best wishes for a speedy healing. Allan

Thanks for the response Allan. :) Yeah, I've thought about making changes to the amount of Miralax, but I've chickened out every time out of fear of a relapse. Right now I guess I should just keep things the way they are. I definitely don't want to undo any of my healing. I pray you have a speedy recovery as well!

Scientist2516 wrote:Anyway, the sentinel pile, you think it might be giving you the pulling feeling - it could be. Mine feels like a little wormy sensation sometimes. It doesn't hurt, but it's a constant reminder that it could hurt if it wanted to! And that is part of what's bothering me today. The sentinel pile should shrink over time. It does all take time, but you are doing great, just keep up everything you are doing, and don't get despondent Good luck!

AFs are the craziest thing I've ever dealt with. I never really know what to expect on any given day. Are things going to be a little worse? or am I going to have a good day. I guess over time the good days will slowly begin to outweigh the bad. I've heard from several people that their sentinel pile has receded back so hopefully mine will too. When I asked the doctor about it he said if it was true scar tissue that it wouldn't shrink. I guess everyone is different but I'd like to think it will eventually go away or at least be less tender. Thanks

deepfissure wrote:Hey Wondergirl, Keep going with the Miralax (Movicol); you need to keep those BM's soft! I'm doing really well right now (looking forward to posting a "success" story soon) but understand I need keep BM's soft and have resigned myself to taking Movicol at least up to Christmas. I had a fissure last year and learned a lot from that experience that setbacks can happen if you relax into "normality" too soon. Sounds like the nitro is doing the job (did for me too!) so stick with it. I also plan to wean myself off the Movicol, but as PompeyBloo says, there are worse things to be on. Think of it as a multivitamin! Good luck with the healing, stick to your plan and you will get there.

I'm glad to hear you are doing better! I would probably be a little happier with the Miralax if it came in pill form. I'm not much on the powder even though it doesn't really have a taste. However if it keeps me out of pain, I can deal with it! I've been concerned about having a relapse with the holidays coming up so I'll probably stick with the Miralax until all that is over. I've been able to eat relatively normal as long as I'm taking it. Praying you a rapid recovery!!

Ever the Optimist wrote:Hi Wondergirl, I would almost certainly agree with Scientist that that "pulling" feeling is the Sentinel pile - this is the area where scar tissue is healing over the fissure, so instead of the open cut with the horrible knife-type pain, you are now feeling the scar tissue stretching over the area every time you have a BM or make some movement that affects that area and it will be a little sore for a while. As long as you keep everything nice & soft and don't put excessive pressure on it by forcing BMs etc. it will become more resiliant overtime and less bothersome. I certainly remember this sensation well but mine is so much better now, although it's taken time!!! Keep taking your Miralax until you feel confident you don't need to do so. I took Lactulose for a several months but as my fissure got better, actually switched to a Magnesium supplement, 300mg at night time and this worked a treat for me, producing lovely soft stools and possibly even better ones than previously! I'll continue to take this now life-long but I don't worry about that. I also take Zinc & B-vits regularly & just consider them part of my routine now, so yes, you won't necessarily have to rely on this for life! Once you feel better & have a soft stool diet under control, you'll find you probably won't need it anymore & will naturally progress off it. Scientist, I used to write a lot about my little "twinge" I got after BMs because like you, I felt it was also a good reminder of what I had been through and saw it as my little bum angel just warning me to keep up my good habits!......It's not a bad thing...I can now confidently write that it will also go away with time........& your worries will fade more & more. :)

Yeah, I kinda thought it might be the sentinel pile. It's not sharp pain, but just a little pull to let me know things aren't quite right yet. Every day I still hold my breath that the knife pain isn't there. Haven't felt it in a few weeks but the fear is still there. One bad BM and I'm afraid I'll be back to square one. I'm gonna leave the Miralax dosage where it is for a while. I've heard alot of people who swear by the Magnesium supplements. I may try them at some point. Thanks for all your help!