Unusual tearing near anus

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Unusual tearing near anus

Postby gc3452 » 06 May 2012, 12:42

I'm writing in the hopes that someone out there has maybe heard of this, because I am going through it and there is really nothing online that is helpful.
I had a small fissure in May of last year with a skin tag. Had no idea what it was and probably waited too long to get to a doc about it. When I did, I went to a proctologist/CRS here in the states who was a DO, NOT an MD, nor board certified. Big mistake. He basically put me on 2.5% hydrocortizone cream for 8 months. It took forever, but in December, all I had left was a little remnant of the skin tag, which I can totally live with. Great. Life was back to normal.
Now it gets weird. Around mid-January I developed these paper cut type of tears in the perineal area near the anus, but not touching the anus. They were really not painful, but confusing. I used some of the Hydrocortizone cream on them and although 2 of the 4 tears went away (they were only about 1/8" each), 2 of them seemed to worsen and move closer to the anus...remember this is all happening on the front of the hole, on the perineum side, opposite the tailbone side.
I saw my GP and he said to just take a warm soak each night and put A&D ointment on it. My BM's have always been perfect so I was not having any issues with hard stools or straining, etc. I did this for weeks with absolutely no change. I decided then to see a board certified colon/rectal surgeon about this. I live in a large city and he has been practicing for nearly 30 years, so I was not going to see some slouch by any means. I told him my whole story and he listened very closely and took notes. Then he went on to examine me. I thought possibly yeast was a culprit from things I have read, but he said he saw no indication of yeast or a fungal infection. He also said I had a small (about 1/8") tear on the backside of my anus, but it was over 1/4" away from the hole! He said he really never saw anything quite like this but was going to treat them as he would fissures. Also said he will not even consider any surgery for this matter. I got a prescription of a gel that is 2% Diltiazem and 2% Lidocane to use twice a day. He said to give it a month and if things were not better to come back. I'm on day 24 of this and in that time the rear fissure went away, then re-appeared for no reason that I can tell. The front tears which at first were looking about 3/8" long have receded a bunch but by the hole, it is still red and itches when I do not have the gel on it.
I have no pain with my BM's...just maybe a slight itch. The front tears do bleed ever so slightly even though I clean myself very gently with hypoallergenic wipes. Other than that, I was instructed to only clean the area with water in the shower and at night before applying the gel to just dab with a lukewarm wet washcloth and dry by patting gently and air drying. I have been doing everything, but it seems like after the initial healing (which took about 12 days) that I am now at a standstill.
Does anyone have a clue about this? By using ointment alone, should I expect a longer healing period? I am so confused, frustrated, depressed, and truly feel like nobody else has experienced this. I'm able to function, but this mess for some reason is always on my mind! I want it healed or at least to know that things are going to be ok with it when I give it enough time. Any words would be helpful. I'm sorry this was so long and I appreciate your time in reading if you made it this far.
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Re: Unusual tearing near anus

Postby jr2 » 06 May 2012, 14:30

just a couple things come to mind...
the long term topical steroid use may have caused skin thinning and other changes that may have made you vulnerable to these skin tears. Given that they aren't fissures of the anus it is curious that the CRS would prescribe a treatment for fissures. One note of caution. Longer term regular use of topical lidocaine can also further damage the skin, something you really don't need on top of your already confusing problem. Since the CRS couldn't really tell you what you actually have going on, and it doesn't appear to be an anal fissure issue, I would recommend a dermatologist consult at this point. A dermatologist will have had a wider range of exposure to other skin conditions including yeast variants, lichen sclerosus, dermatitis, allergies, or may have something else to advise if this is the result of the steroid creams. It might be worth a try, anyway.
Wishing you the best of luck in getting some more definitive answers. As if it isn't hard enough to deal with something when you do have a diagnosis, it's even worse when you don't know what you're dealing with. But there has to be an answer to what is going on with you. You aren't alone. Many people have these kinds of things happen to them. It can just take some time and the right doctor to get it figured out.
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Re: Unusual tearing near anus

Postby gc3452 » 06 May 2012, 15:51

Thank you for your comments, jr2. I think I am safe on the thinning skin issue from the hydrocortizone, for I used that on the opposite side, and very little of it at that. Plus, when I applied it, the medicine would then get covered by the skin tag.
I was unaware that long term lidocaine use was harmful. Hopefully a month is not going to be too long, for that is when I would go back to see my CRS if I choose. I have considered a dermatologist as well. I'm just wanting to get the issue resolved. I have read that things like this can come about from stress and anxiety - of which I have a ton every day. Working on that as well.
Thanks again for your input and kind words. It is reassuring to know that many people have these kinds of things happen to them.
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Re: Unusual tearing near anus

Postby gc3452 » 16 May 2012, 17:41

Ok, I went to a dermatologist about the strange tears described in my initial post. Apparently I was not treating it right, even with possibly the right stuff (the 2% Diltiazem and 2% Lidocane). As gentle as I have been with the area, I was still doing something so simple yet so wrong...looking at it with a mirror! That's also how I was applying the ointment to make sure I was accurate when doing so. I didnt even mention this to the dermatologist and he said "don't be trying to look at it in a mirror". Plus, the way I was looking at it was to put one foot up on the sink and hold a small hand mirror so that I could just look down and see what was going on...well, what was going on was stretching of the area each time! So, whatever the original cause of the tears may be, I was not allowing them to heal. thinking I was being thorough was just spreading the whole area, and that's not good for my weird mess, nor fissures. Only makes common sense, so I guess I'm a bit short on that.
Anyway, he prescribed Pramosone cream 2x/day and NOT to wash before the night application. Keep the stools soft (which I am a master of thanks to my fissure last year) and only wash the area by splashing water on it in the shower. No soap. After BM's, wipe only enough to be clean, don't over-wipe b/c that can re-open any wound back there. Just saying all this because it is a good reminder for all who have standard fissures as well. I have been there and did that wrongly as well and took 6 months to heal a fissure that could have healed much faster. Oh, and I learned that dry is not good for healing. Always head a debate on that. Some people say "let it get air" while others say keep it moist. From a very well-respected doctor in a good-sized city - keep things moist to heal.
Anyway, that's my report for now for anyone interested.
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Re: Unusual tearing near anus

Postby 44alegna44 » 16 May 2012, 18:57

Hi Gc,
Thanks for posting the update. I'm sure this visit brought you much relief :D ... Must have been extremely frustrating to not know what you were dealing with or how to properly treat it. Did you actually get any indication at all as to what the strange tears are or could have possibly been from? In any event, it's great that the doc was able to provide you with the information about what's right and wrong when trying to heal this. I'm sure that must have been a holy crap moment when you heard what you're doing to try and be so thorough about something as simple as applying cream, was actually working against your healing. Just really glad you got it all straightened out...and yeah, my crs said keeping the area dry, for my fissure, is what I should be doing. I get so frustrated with the conflicting advice I've heard here from people saying there doc said to do one thing..and a different doc said do something completely different. I mean, we're all trying to heal a fissure...so why aren't these doc's on the same page overall as to proper home care. Image
Again, so glad to know you're on your way to healing this issue. Image
Best Wishes,
Angel Image
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Re: Unusual tearing near anus

Postby jr2 » 16 May 2012, 19:54

gc
I'm so glad you got this checked out. Yes, spreading the anal area will definitely cause tearing of the skin. Many if us want to look down there to see what's going on, or to apply creams, but this is an important post because it is very important for everyone to understand you can tear the skin this way. And I agree with your doctor about keeping things moist to heal. Wounds need moisture to heal. Very good advice!
I hope this means total recovery for you very soon. Thank you for coming back to update us!
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Re: Unusual tearing near anus

Postby gc3452 » 27 May 2012, 13:08

Quick update...probably my last. After the first 6 days by using the new method on my weird fissures/tears/cuts, I'd have to say they were very much improved. I didn't peek, but having no bleeding from wiping, itching, or stinging while showering speaks volumes. Today is day 10 and all I can say is I could probably ride a bicycle now with it feeling this good. I can even wash (still without soap) beyond just splashing the water from the shower, but now I actually lightly wash it with the water and my hand, as in rubbing the entire area - no pain, no nothing. Hopefully this simple story might help some others who are having slow healing and not sure why.
Thanks so much for the replies!
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Re: Unusual tearing near anus

Postby Baba » 27 May 2012, 18:00

I only just now saw your post. What you describe is what I get in that area when I accidentally ingest gluten even in the smallest amounts. I get them healed first by avoiding gluten ( or they won't heal at all) then by sitz bath, applying aloe vera gel and keeping the area very dry - the hair drier is wonderful for that.
Have you ever been tested for celiac disease? Celiacs are prone to fissures inside and out.
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Re: Unusual tearing near anus

Postby gc3452 » 02 Jun 2012, 14:00

Yes, I was tested for celiac earlier this year and am negative.
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Re: Unusual tearing near anus

Postby thankssomuch » 01 Aug 2014, 00:04

I just wanted to thank you so tremendously for your post. I have the SAME issues currently and could not for the life of me figure out what was going on. Little paper cuts right in the perineal area. They were starting to freak me out because they aren't going anywhere. I feel like it would heal and then I would - like your doctor told you not to do - look at it with a mirror and get all annoyed because it would still be there! Now I know I was just making it worse by looking! I really cannot thank you enough for your post. It's made me feel so much more at ease and grateful. I do have one question though - during the healing process has anyone mentioned witch hazel to you? I was reading some info on episiotomy healing and I've heard this is a good alternative.

Let me know what you know.

Again THANK YOU

~Paranoid as hell - now relieved
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