I attended my GI hospital appointment a couple of weeks ago. I've had a fissure for 10 months now. It appeared after a course of antibiotics and spells of frequent loo visits - possibly IBS. I have a flexible sigmoidoscopy scheduled for next week, but my fissure tears every month prior to menstruation and is sore and bleeding for at least a week. It wasn't like this when the Dr looked at it, but it's very sore now, even though I am using the GTN ointment. I don't think I could tolerate the prep and intubation with such an inflamed bum. I also fear it will make the fissure worse. Has anyone had this procedure when their fissure is flaring? Would I be wise to cancel or is there nothing to worry about? The pain was intolerable last December (when I finally got it diagnosed - Dr had given me cream for piles previously) and I don't want to suffer like that again.

Jenastro...
It's a tough question to answer really. You are right. Both the prep and the procedure itself carry the potential for the fissure to become much worse. Further, a flexible sigmoidoscopy usually does not involve any sedation, so the risk to your fissure is even greater because if you are awake you will feel the discomfort and your muscles will tense in response to that. If you were going to take the risk of worsening your fissure I wouldn't bother with a flexible sigmoidoscopy, which only looks as far as the sigmoid colon. I would want the colonoscopy to view the whole colon. You don't mention your age or the reason your doctor wants to do the flexible sigmoidoscopy, but if it is for cancer screening or to rule out inflammatory bowel disease, you are far better off with a colonoscopy. If you do opt for the sigmoidoscopy I wouldn't do it in the presence of a fissure without sedation. There is no reason for a doctor to put you through that.

I agree with jr2.
To be honest, I am surprised that your doctor would even attempt to do a sigmoidoscopy on someone with an active fissure. My CRS is reluctant to even use a scope or give me much of a digital exam for fear of making the fissure worse.
I would ask your doctor if there is any risk in waiting if it were me.

Thanks for your replies. I think it would be wise to postpone the sigmoidoscopy after reading your comments. I seem to have IBS without the constipation. I usually go 2 or 3 times a day but for a few days every month it can be 5 to 8 times. I'm aged 48. The fissure appeared during a course of antibiotics prescribed for a chest infection in July 2011. I was prescribed the same medicine for a subsequent chest infection and the fissure, after having healed, flared up again. Since the fissure was diagnosed I've been using GTN (4 months). Before this the Doctor gave me cream for piles, which didn't work and made the pain unbearable - my bum was on fire!. The fissure seems to heal up but retears every month. I have not been offered any other treatment for the fissure. The GTN has stopped the spasms but the retears are a causing problems :(

Did you have this same bowel movement frequency before the first round of antibiotics? With your history of antibiotic use have you ever tried adding a probiotic to see if it might help with the frequency of your bowel movements? Antibiotics alter the ecology inside the intestinal tract, and sometimes wreak havoc on the bowels.

Hi,
I find my fissure gets worse in the run up to menstration too glad to hear that others are affected this way. I did have a sigmodoscopy, with the fissure it was VERY painful, the effects of the enema lasts a while too. It was done because at the time I had unexplained acute abdo pain so I think he was looking for a blockage or divaticulitus so there was a degree of urgency, found neither! Best to postpone if not urgent but discuss further the need for the test and if you could be sedated and a local anasthetic used. on the area.

I did notice a gradual increase in bowel movements long before the antibiotics - frequency in the mornings. 3 times a day has been the norm for me for quite some time. However, I've only needed to use a public loo twice in 7 years! Once a month (it can be just before, during or just after menstruation) I can need to go to the loo between 5 and 8 times and this is when my fissure re-tears. I never saw any blood or had a fissure until I took the antibiotics. I do suffer from anxiety and this has affected my gut since the age of 9. I would have to dash to the loo if I was nervous about something. Aged 16 to 18 I suffered intolerable abdominal pain and bloating. I was treated for a peptic ulcer by my GP, who then sent me to a see a GI consultant. The consultant said I couldn't possibly have an ulcer at my age and it was probably just anxiety. This condition miraculously disappeared the day my mother moved to another country! When I saw the GI Dr a few weeks ago my fissure seemed healed, but it's since flared up along with cramps and bloating some days. I've been taking Colpermin for this and it's worked very well to calm my gut. I do feel very anxious about having the flexi sig in case it makes the fissure even worse, the anxiety is probably making my gut play up more; contributing to frequent bowel movements that cause the fissure to re-tear, so I end up postponing the procedure. I can see this happening all over again if it's rescheduled - vicious cycle. I need it to heal and stay healed until I can get this procedure over with.

Jr2 - yes I consumed live yoghurt whilst on the antibiotics, more the second time :)

Yes mothers moving to another country does help with anxiety, unfortunatly mine came back!! but have total empathy with you, and am sure anxiety has an affect on my 'bowels'. With the flexi if the GI is concerned there may be something wrong in you bowel then best to find out now and get it treated. Yes my flexi was painful, the emema was actually the worst before the flexi due the verosity of the bowel movement. The pain for the flexi was short lived though, when the scope was initally put in yes I grabbed the nurse, however once in it was tolerable and after I felt like I had been kicked but within a couple of hours I was feeling better. It really depends on you pain threshold I suppose. If they find something with the flexi at least you can move forward. My fissure has not healed with treatment and I am now scheduled for surgery later this month. I am hoping this will break my vicious circle, I can't say I am looking forward to it and trying not to get anxious about it, though my gut is telling me different at the mo! I keep trying to think long term in that yes it will be painful for a few weeks but I try to focus on the long term relief I should get from the fissure. Good luck with what ever you decide.

Peachy - Thanks for your direct response. You can't get this from the health professionals, so it's much appreciated. My mother is back too after 22 years in Spain. The Health Service is better over here apparently. Phone rang at 2am this morning, mother having suspected heart attack and admitted to hospital. I may have to postpone my ordeal and my day on the loo, as I'm probably going to be needed elsewhere now. I wasn't too concerned about the scope element of the procedure. It's the explosive, watery, bum-stinging bowel movements and the further injury they could cause that I fear. I've heard that you can coat your bum in vaseline but it's not that easy getting anything up there when things start to get inflamed and tissues swell. I sometimes have difficulty applying the GTN. I'm grateful for your comments. :)