Good Morning all!
Thank you for this wonderful support page, since my daughter's diagnosis 3 weeks ago...I have been researching endlessly. After giving birth to my beautiful grandson, she is suffering with 2 posterior fissures. Having a great deal of bleeding, coloring the toilet water red. Horrid pain!
She also has EDS, and I have some real concerns about surgery. She is now scheduled for it in 1 week. LIS surgery. I know her pain is severe...and the bleeding is severe also....but....she has only been working on a resolution for 3 weeks...and now surgery??? I have a few quick questions....if you don't mind...and can help...I would really appreciate it.
Have any of you tried White Oak Bark? Does it help?
She has a burning sensations with a cream prescribed....doctor was amazed by that...saying it is mostly vasaline....can't imagine why she is burning...mmmmm...this comment worried me at bit...any info/advice?
He was totally against a fissurectomy...saying "nobody does that anymore" is this a true statement?
I really want her to try Botox instead...I mean.....what if??? and no surgery.....but I am not doing the suffering she is.....and for 6 months....she has really been through it....very very bad! Do you feel this would be a good option and why?
She is taking Citrucel, and has had some relief in her pain during her BM's...how long would it take a fissure to TOTALLY heal....on this regiment?
With her EDS, healing is 2 times as slow.....and complications...2 times as high...bleeding is a real big problem. Would you choose the surgery? Why?
Any help...advice....insight....right now ....would be so appreciated. I am uncertain of this surgery...she is only 20...I am worried...about 20 years from now...and cutting this muscle....where will she be after another child? Thank each of you...this is truly a wonderful sight...and you can feel the care and the compassion all through it!
Have a blessed day,
K

Hi Heavensblessings, welcome to the board. I ended up not having a fissure (hemorrhoids instead), but was diagnosed with two at first until it was confirmed that it wasn't later. I know that there are alot of wonderful people here who will be able to help you.
But, I did notice you said that the cream was burning. Do you know what type it is? I used nitroglycerin cream (nitro-bid) on and off for a few months and it burned. It was mainly vaseline based. I called to see if I should keep using it and the doctor said as long as I could stand it to keep using it. She said some people feel the burn and that means it's working. Oh, I should say she had me putting it up inside not just on the outside. The burn would only last a short time, maybe a half an hour or so.
I'm sure you'll get some great help here. And I pray your daughter feels better very soon.
Julie

It does seem that the surgery is coming down the pipes rather quickly. In most cases, the CRS waits until the patient almost begs for it.
No, the statement about the fissurectomy isn't true as a few here on the board have actually had it. But does seem to be rare.
It would help to know what type cream is causing the burning, I suspect it may be diltiazem or nefedipine since its in a vaseline base.
Bleeding can be a problem for those of who don't even have EDS. Remember, a little blood can look like a lot and bleeding is par for the course for a fissure, so I wouldn't be too terribly concerned unless it is in obvious copious amounts.
A fissure can heal in 6-8 weeks but only if there is adequate blood blow to the fissure site. I went seven months with no healing despite everything I tried and caved in to the surgery, which gave me my life back.
I can't speak for the White Oak Bark but like many "possible" cures I doubt it will have any real efficacy for most people.

Hello, and welcome! I'm sorry your daughter is suffering so much it must be a terrible worry for you. I went through 7 months of agony before I had to have LIS and I only had it then because I got an abcess then a fistula, but I would reccomend having it done as it stops all the spasm pain which is truly dreadful.
Apparently, the longer you leave it without it healing, it develops scar tissue which then makes it extremely difficult to heal.
The surgery really isnt as scary as it sounds - I have to go in for more! and while I'm scared, I'm not as scared as last time because I know what to expect.
I haven't heard of white oak bark either, but I'm not really into miracle products which claim to heal, because I tend to believe the fissure would have healed anyway, with or without the cure, it was coincidence it healed while using it.
Good luck!

Hello Heavensblessings ,
Sorry to hear about your daughters problems.
I've been dealing with this a few months and my drs really want me to give the Nifidipine ointment a try for several months before the next step, botox is my next step. I was told that the ointment could burn for awhile but to keep using it. Mine is mostly made up of vaseline, and it does burn for a bit, but not enough for me to quit using it. I am hopeful that it will start letting me heal.
The first two drs I saw did not do botox, I searched for one who did, am now on my third dr. You may have to ask current dr if he does botox, he may not since he is recommending the surgery.
Blessings to you and your daughter.
Jo

I feel for your daughter. Being in pain with a baby is such a horrible way to live. I didn't have a fissure from pregnancy/childbirth but I had terrible rectal pain afterwards and feel like I missed out on so many early weeks.

It does seem like surgery could be helpful. I did not have surgery for my fissure but it took 4 months of baths, diltiazem and a real dedication to eating fiber, water, and a very strict existence. If I had been a candidate I probably would have done it though because the pain is unreal.

The botox does seem to be offered more and more but usually takes a few rounds and doesn't always completely do the job. Fissurectomies are done though not uniformly.

I would ask your doctor about the cases for surgery and more conservative approaches.

I wouldn't think that having the surgery would cause problems for her with future pregnancies or childbirth-it might actually help prevent it from happening again. I can understand your concern though. You don't want to cut a muscle down there just willy nilly, but I think at her age she her body will adjust and she wouldn't suffer any long term effects.

It is a scary decision to make. I guess she needs to decide how quickly to end the agony. The surgery will help get rid of the spasms but it will still take 6-8 weeks for the fissure to heal. How far post-partum is she?

I am not sure what EDS stands for? That might alter my answer a bit.

I used nitro for awhile and it burned too much for me to continue. For most people it is tolerable and subsides but for met it did not.

Take care,
Lecia

Welcome Heavensblessings.
So sorry to read about your daughter,
I really do feel for her too, this is an awful thing to happen when it should be the most enjoyable time in her life and yours :(
I dont know what EDS is either !
You have had some great advice here, I do hope it has helped and you and your daughter find a way through this
x

I got the following from Google, but it may not be the same "EDS."
Ehlers-Danlos syndrome (EDS)
Type: Term
Pronunciation: ā′lĕrz dahn-los′
Definitions:
1. a group of connective tissue disorders characterized by hyperelasticity and fragility of the skin, hypermobility of the joints, and fragility of the cutaneous blood vessels and sometimes large arteries due to deficient quality or quantity of collagen; the most common types are inherited as autosomal dominant, caused by mutation in one of the following genes: the collagen V alpha-1 gene (COL5A1) on chromosome 9q or the collagen V alpha-2 gene (COL5A2) on 2q or COL3A1 gene on 2q.
Source:
http://www.medilexicon.com/medicaldictionary.php?s=Ehlers-Danlos+syndrome

I am thinking in that case I would perhaps go more conservatively. I would think that would be the case with any surgery in her case.

I don't see the harm in her trying surgery right away. Botox usually takes a few times before it really heals the fissure and doesn't have as high a success rate as LIS. A few of our board members have had some limited success w/ botox, but most people end up going back for more rounds or even surgery. If your daughter is having horrible spasm pain, LIS just may be what she needs. I found no point in trying the nitro ointment, fiber, baths, etc. None of that helped at all after i'd had my fissure for over 6 months. If your daughter's already had hers for 6 months, chances are it will need surgery to help it heal.
I had my first LIS at 24 and my second just after I turned 25. I've had no incontinence issues or any problems from surgery, except for a small wound which is refusing to heal. For the most part, LIS is a safe and effective surgery and many of our board members have had great success with it. I've never had kids so I'm sure there's no problem with pregnancy/childbirth after LIS otherwise my dr would've said something when i asked about that....
I dont know anything about EDS but i think she has nothing to lose by having the surgery. Most people end up having it anyway, no matter how long they try to hold out for.