Shall I keep trying with ointments?

is there still a chance to heal by using creams and diet?

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Shall I keep trying with ointments?

Postby Abu » 08 Dec 2014, 08:29

Hello everybody,

my name is Alex and i live in Romania. I developed a fissure 3 months ago after a hard bowel movement, caused by antibiotics and pain killers which I was administered after an inguinal hernia surgery.

The first 4 days was unbelievably painful (for me), although I reckon not like other people experienced, based on their explanations. I was thinking that I cannot live such a life if i was going to endure these pains.

After 10 days of applying nifidepine cream and drinking laxative tea i was completely cured - I was soooo happy. For two weeks that is... when it came back, caused by a somewhat harder stool. But this time the pain allowed me to sleep through the night, so it was definitely lighter.
the problem is that during those two weeks, i stopped applying any cream, thinking I do not need it anymore. back to the doc and she recommended nitroglycerin this time. I started with this and after another two weeks I was also feeling perfect. Again, i stopped applying the cream for something like 10 days when the problem, you guessed it, re-occurred. This time, the pain was even less than before. Now I ordered DrWheatgrass cream and started on this one, on my own. Also for 2 weeks after which the pain was back. this time, even less pain than before. Two weeks ago my doc said we will try with nytroglicerin for another 2 weeks and if no success, she will have to remove something which developed inside, i have no idea how it is called. But not the sentinel pile, some cartilage. The pile is very small, less than 5mm, so I am not talking about this. When I heard I said to myself: I need another opinion - so i went to another doctor today. She told me that my fissure started to develop some hard margins, but not to the point where it could not respond to creams anymore. Also she said, if it doesn't improve in a week i will have to have that cartilage removed so i have a fresh wound.

i forgot to say that all this time I kept on trying to keep stools soft with various methods, but it was enough to have just a slightly harder one to start bleeding again.

Today, my level of pain varies between 0 (when I have soft BM) and 2 when the fissure gets upset due to a very slightly harder BM.

That being said, what are your suggestions? I am scared to allow them to cut that cartilage inside my anus because i fear that the pain will be much worse than it is today. on the other hand, i do not want to live with the fear of the fissure re-opening all my life and enduring the pains when it does.

i apologize for the long post, it is my first on this forum. thanks for the help.
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Re: Shall I keep trying with ointments?

Postby Alyssa » 19 Dec 2014, 01:36

Abu,

Many people have success with healing it with creams even after two months of being on the ointment but if you've exhausted that option perhaps you need to try Botox to see if it helps.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Shall I keep trying with ointments?

Postby Jbl22424 » 19 Dec 2014, 02:12

I would not have any surgery yet. Stick to miralax and a good conservative regimen. Surgery is risky in that area and you should only do it when you feel ready.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Shall I keep trying with ointments?

Postby Abu » 19 Dec 2014, 03:04

Thank you for your replies.

I am feeling already much better for the past two weeks, so let's say I am at 95% recovered. Tomorrow I have the meeting with my doctor and I will have to take a decision by then, if i agree to remove that cartilage inside or not.

Also, what I forgot to mention is that I keep things very soft and watery and most probably this has something to do with my recovery.
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Re: Shall I keep trying with ointments?

Postby JHH » 19 Dec 2014, 14:58

I would give creams more time to work. Maybe up to 4-5 months, and I'm sure it will work for you if you manage to keep those stools soft.
One hard stool can destroy weeks of healing, so the most important thing in the fissure battle is to keep them soft every day.
If you are not already on movicol/miralax, then you should try it.

Good luck
JHH
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Shall I keep trying with ointments?

Postby Abu » 20 Dec 2014, 08:28

I went today to the doc. She told me that the fissure has healed and I have to stop any creams whatsoever.
I was extremely happy to hear this, after a little more than 3 months. But now I wonder if I should stop the ointment completely or not or if I should continue at least with coconut oil?

Can you please share your opinion?
Of course, I will continue to take stool softeners (I am using Hydro-C, imported from US).

Many thanks!
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Re: Shall I keep trying with ointments?

Postby Roidsfizzman » 20 Dec 2014, 14:59

Hi Abu,

I would recommend that you follow your doctor's direction and not use any creams in the area, because your doctor knows what the healed skin looks like. I had LIS and my doctor did want me to use any creams. After a fissure is healed it takes 3 or 4 months for the skin to back 70% of its strength. You should stay with stool softeners, diet, lots of water for the next 3 or 4 months to give you the best chance of putting this behind you.
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Re: Shall I keep trying with ointments?

Postby JHH » 20 Dec 2014, 15:49

With nitroglycerin I was told to continue 14 days after healing.
If you do not have allergic reactions, why not play it safe and continue for a week or two.

With coconut oil, I think you can continue as long as you like.
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Shall I keep trying with ointments?

Postby Abu » 21 Dec 2014, 01:28

It takes 3-4 months to reach 70%!? Will it ever go back to 100%? Do we need to keep using stool softeners for good?
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Re: Shall I keep trying with ointments?

Postby Roidsfizzman » 21 Dec 2014, 17:42

Abu,

It will take the skin of a healed fissure a year plus to reach 100% strength. Based on my own experience with a fissure that had healed off and on for three years, I would recommend at least 3 months of stool softener after the fissure is healed. You should also talk it over with your doctor on when you should quit stool softeners as everyone is different.
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