Question about chronic fissure?

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Question about chronic fissure?

Postby Jimoffy » 31 Jul 2017, 19:49

Hey guys. I've had this last chronic anal fissure for about 2 years. I'm 23 and have had this before along with hemorrhoids when I was 17, but it went away after 6 weeks. The last 2 years it seems like the same fissure has re opened, and it won't completely go away.

My first doctor checked and said it was a fissure and put me on movicol stool softener, and some hemorrhoids relief cream called protys something (lol) anyway, the stool softened really helped with the pain, but as soon as I did a slightly harder or dry poop, the pain comes right back.

Anyway I saw a colorectal surgeon yesterday for the first time, he listened to my symptoms and told me it sounded like an anal fissure, he checked it with his finger and confirmed it was, and everything else felt good (no hemorrhoids).

So basically he told me to use this new cream 3 times a day called diltiazem paraffin 2% for 6 weeks, and to stay on the movicol. He expects me back in 2 weeks to see how it's all going, and advised me to use the cream for 6 weeks straight and not to stop. I asked him about crohns and he mentioned once its healed ( if it heals or not), he would still like to do a colonoscopy in the future just to rule out crohns.. this scared me.

I have no other real symptoms of it other than my poops are slightly thinner (maybe half inch width) and I'm sure that's from the tightening of my anus along with taking fiber and stool softener, which the specialist confirmed and said not to worry about it. So I'm just wondering if anyone else has had something similar and it wasn't any ibd ? I would rather not have this done in the future if I can avoid it as I don't have health insurance, and every visit to the specialist is costing me 180$.. thanks guys. First day today using the diltiazim..
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Re: Question about chronic fissure?

Postby Jimoffy » 31 Jul 2017, 19:51

Basically he said to me that he doesn't THINK it's related to anything further than just a chronic fissure, because I had it now for 2 years with no other problems, and also had similar about 5 years ago.

My diet ATM isn't healthy either so that mixed with the stool softness makes me have soft loose stools constantly and 2 or sometimes 3 times a day, I don't eat very healthy or regularly at all ( I smoke weed and can't resist the munchies at 1am before bed lol)
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Re: Question about chronic fissure?

Postby dmcff » 01 Aug 2017, 02:38

Sorry that you're still experiencing pain. The colonoscopy probably isn't essential. I had a sigmoidoscopy, which is slightly less invasive - there is also the option of scans like CT and MRI. Doctors will always want to rule out things like cancer and Crohns, so some testing is inevitable.
2014 Anal fissure
2015 CAT scan, EUA, sigmoidoscopy, 2 MRI scans - 4 hospital stays
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
2021 Better, but AF is still a recurrent problem
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Re: Question about chronic fissure?

Postby Jimoffy » 01 Aug 2017, 02:49

dmcff wrote:Sorry that you're still experiencing pain. The colonoscopy probably isn't essential. I had a sigmoidoscopy, which is slightly less invasive - there is also the option of scans like CT and MRI. Doctors will always want to rule out things like cancer and Crohns, so some testing is inevitable.


Ok cool. So it's not for sure I have Crohn's, even though I have this chronic fissure?
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Re: Question about chronic fissure?

Postby dmcff » 01 Aug 2017, 02:59

There's no direct connection between AF and Crohn's, but fissure can be a symptom of Crohn's, and the doctors always want to make sure that Crohn's isn't there. If you don't have any other symptoms like bleeding and/or diarrhea, Crohn's is probably less likely.
2014 Anal fissure
2015 CAT scan, EUA, sigmoidoscopy, 2 MRI scans - 4 hospital stays
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
2021 Better, but AF is still a recurrent problem
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Re: Question about chronic fissure?

Postby Mypoorbutt » 01 Aug 2017, 06:07

Hi I have had crohns for well over 15 years and only got a fissure 2 years ago.
There is no direct link just the fact that going to the toilet 20+ times a day with explosive BMs will eventually cause issues for the skin down there.
Peri anal crohns is fissures and fistulas that go from one or two to quite a lot in a short period of time.
Docs always like to be on the safe side but if your not having bloody BMs or very liquid BMs more than 10 times a day I doubt it would be crohns
You have a choice whether or not to take the colonoscopy I have 2/3 a year and flatly refused to have one while my fissure was bad. It's up to you but it might put your mind at rest to have a check
Good luck
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Re: Question about chronic fissure?

Postby Jimoffy » 02 Aug 2017, 04:01

Thanks guys this makes me feel at ease... thanks to everyone who commented. Does this diltiazem cream have to be inserted inside the anus? I really have trouble getting even my pinky in there, without further upsetting my fissure (I actually think I hurt my previous fissure on the other side of my anus now lol just from trying to insert the cream) and my anus just seems so tight to be able to get anything in there
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Re: Question about chronic fissure?

Postby Bum_UK » 02 Aug 2017, 05:57

That depends on which CRS you ask. Some say to insert it into the anus and some say to apply it around the anus externally. I applied it externally and it seemed to work until I got a rash.
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