It’s the end of another week of spending my nights sleepless and in agony.

Despite officially being one month post op I actually feel worse than I did before. I’m so tight and swollen that I went and got myself a new fissure. So it doesn’t seem to matter how soft my BM is ... or if I have a salt bath ... or pretty much anything, I have guaranteed agony for the next day , last weekend I was in pain for two days straight.

I’m losing my mind I think. I’m getting maybe 3 hours of sleep on a night. I don’t know how I’m going to continue cope with this.

I’ve gotten to the point where I can’t handle Diltziam anymore. All it does is sting and I can’t do anything but rock myself. I can’t still use rectogesic, but I don’t think it has any effect.

I see my surgeon again on June 3. Any ideas what I can ask for to try next ?

Try cold water soak since your so swollen hot or even warm soaks can inflame everything even more. Then maybe take ibuprofen it helps reduce inflammation. I'd be expecting my surgeon to tell me what's next at this point. Did you have lis? Did you have hemorrhoids or skin tags removed aswell ?

If you’re curious about what I’ve been through Missy, I’ve detailed it in my welcome post.

Ok just read it I would try sitting in cold water it helps with inflammation once the inflammation goes down then go back to warm soaks also have you tried ibuprofen? Good luck

I read your welcome post Pherianne and I am so sorry you are going through this! I know you had an exam and also surgery (so you’re CRS definitely got a good look in your rectum), but the lack of sleep, swelling, and pain from applying diltiazem remind me of what I encountered when I had an internal abscess. The pain was a constant throbbing and kept me up all the time. I was only sleeping for 4 hours a night and thought I was losing my mind! I didn’t have a fever with my internal abscess and it never had an external exit appearance (like a cyst or pimple near my rectum). My CRS thinks my fissure got infected and prescribed antibiotics. Within 48 hours I could sleep and the internal swelling subsided. Just offering my story as a possible explanation of why you are still encountering problems 4 weeks after your surgery. Maybe you can call your CRS and describe your symptoms and see if you can get in sooner? You should definitely not be suffering so much!

woeisme wrote:I read your welcome post Pherianne and I am so sorry you are going through this! I know you had an exam and also surgery (so you’re CRS definitely got a good look in your rectum), but the lack of sleep, swelling, and pain from applying diltiazem remind me of what I encountered when I had an internal abscess. The pain was a constant throbbing and kept me up all the time. I was only sleeping for 4 hours a night and thought I was losing my mind! I didn’t have a fever with my internal abscess and it never had an external exit appearance (like a cyst or pimple near my rectum). My CRS thinks my fissure got infected and prescribed antibiotics. Within 48 hours I could sleep and the internal swelling subsided. Just offering my story as a possible explanation of why you are still encountering problems 4 weeks after your surgery. Maybe you can call your CRS and describe your symptoms and see if you can get in sooner? You should definitely not be suffering so much!

Thank you woe,

I’ll make sure that is checked on the 3rd. Did they do blood work or just examination ? I’ve not had any fever either.

My surgeon is on leave until the 3 rd, so it’s the soonest I can see him unfortunately.

- Pherianne

missy moo wrote:Ok just read it I would try sitting in cold water it helps with inflammation once the inflammation goes down then go back to warm soaks also have you tried ibuprofen? Good luck

Hi Missy,

I’ve taken Ibuprofen- they give it to you in the hospital when you’re discharged here. I’ve been moved to Diclofenac Suppository- which is an NSAID , same as Ibuprofen. However when you have it suppository form it targets that area.

No bloodwork, just an exam. My CRS just lightly spread my cheeks to see where my fissure was and thought he saw a drop of pus near the fissure and decided to prescribe an antibiotic. He never conducted an internal exam. At my follow up appointment I asked him if he was definitely sure he saw pus and he said that the description of my symptoms and the swollen and red presentation of my rectum from the outside was the greatest indication of an internal infection. Is your CRS part of a larger practice? Maybe you could call the nurse line and see if someone could do an external examination. I know how awful you feel. I legitimately thought I was going to have a nervous breakdown when my infection was active. I cried all the time, felt so unwell overall, and couldn’t understand why my AF wasn’t getting better after the creams and constant baths. I hope you get some relief and answers soon.

Forgive me if this is foolish, but are suppositories really a good idea when your butt is on fire like that? Maybe try getting it in pill form?

I know some people don't have much trouble sticking things in their butt even with a fissure, but I personally can't imagine doing that with a serious fissure. I had a GP assume hemmoroids when I came in with this problem. He did a digital exam (unbearable pain) and told me to take prep-h suppositories. Unsatisfied I saw a proper CRS two days later and realized all of that was wrong & probably making things worse. So yeah there are plenty of docs out there without a clue what their doing.

For pain, have you tried the prep-h cream with lidocaine? (Not the standard with vaso constrictors that's bad. It's the "rapid relief" with lidocaine).

Also is there a reason they did Botox instead of LIS? I know people wisely avoid LIS if they can but after a year... you sound at the end of your rope. From what I've found online Botox has like a 60% success rate while LIS is something around 95%. Also isn't Botox supposed to work pretty fast if it's going to?

Hi Bloody,

They target the swelling in a specific area, so yes even with a “bad fissure” they are beneficial. If you’re swelling you can’t really heal. I’ve already been on naproxen and extra strength ibuprofen. It’s been ineffective at stopping the swelling for me.

I had lis and Botox at the same time.


Botox takes up to 7 days to start to work on spasm. It lasts for three months. You can still have spasms however.