Hidden Fissure

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Hidden Fissure

Postby daveh » 20 May 2013, 06:32

Hi guys, I've been recieving chemo for Hodgkins Lymphoma since sep 2012, one of the side effects of the chemo for me was occasional constipation, in march during one bout of constipation I forced myself to go to the toilet, I had to, my stomach was cramping and I just had to go, it was a real ordeal during that BM but I managed to do what had to be done. Since then I have pain every time I have a BM and for a while afterwards. I have to jump straight in a hot bath to ease the pain but sometimes this doesn't even work. I tried pile cream and suppositories for a while without any success so I visited my GP who through fear of my cancer spreading refered me straight away for a flexible sigmoidoscopy. The sigmoidoscopy showed absolutely nothing and I was told that it probably was an AF. I have taken a look at several stories on here and looked around the net as much as I can and I can't find anything about AF's that can't be seen. Does anybody know if it's possible to have an AF beneath the skin and hidden from sight? As the Sigmoidoscopy showed nothing what-so-ever I'm relieved that it isn't a life threataning problem, but just a bit worried that nothing can be seen either with the naked eye or by an intrusive camera. All of my symptoms do seem to fit with an AF though, although I have never seen any blood. The problem definately began after I forced myself to goo to the toilet while I was constipated. Thanks in advance for any info guys.
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Re: Hidden Fissure

Postby jr2 » 20 May 2013, 14:57

Hi daveh,
Not sure what kind of doctor performed your sigmoidoscopy, but the scope used in the sigmoidoscopy can often miss visualizing a fissure. Most fissures are more easily diagnosed either by visual inspection by a colorectal surgeon, or by anoscopy, again, by a colorectal surgeon. Even then, however, it is still possible for it to be missed. Some smaller fissures can be tough to see, but can cause a huge amount of pain. If you're having a feeling like you're passing broken glass when you have a BM, followed by varying degrees of pain afterward that lasts for varying amounts of time, it sounds like a fissure.
Your best bet would be to be seen by a colorectal surgeon as they are the specialists who deal with fissures the most. Also, it is vital that you find a diet and/or stool softener regimen that keeps you regular with soft BMs that are easy to pass without straining. It is even more vital in your case to really get on top of treating this because with both your lymphoma and chemo. on board the fissure could potentially be even tougher to heal.
A colorectal surgeon can help you with all the conservative measures to try first, including diet, stool softeners that are safe for you to take with your chemo., topically compounded medications to promote healing, and potentially other treatments should conservative measures fail to work.
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Re: Hidden Fissure

Postby Ever the Optimist » 20 May 2013, 14:59

Daveh,
Have you been referred to a CRS yet rather than just seeing a standard GP with this?
They will know what they are looking for without a doubt and if they can not "see" your fissure, they will probably suggest an "Examination Under Anaesthetic", which is the best way to take a really good look in your bottom without causing you any distress (you will be asleep and oblivious!)
This is what happened to me and how they found my tear.
If the skin has torn in the anal canal, it can definitely be seen but a CRS will determine the best way of doing this for you. I too never bled with my fissure, but I had one all the same, so definitely get it checked out and get it healing asap if that's what you have (and it sounds like it by the pain it is causing you and the fact this all started for you after constipation)
It's great news that the sigmoidoscopy revealed nothing sinister. Really pleased for you to read that, and to be honest, anything really sinister generally doesn't tend to cause the pain that a fissure does!!
All the very best to you..........
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Hidden Fissure

Postby daveh » 20 May 2013, 15:51

I haven't been seen by a CRS yet, just my GP and the flex sig, I have today had a PET scan to see if the cancer has cleared up and my hematologist has said that I should wait to see those results 1st because if I don't need any more chemo then within a few weeks my body will begin to recover and I may heal a potential AF without any major treatment, he was pretty annoyed with me for getting the flex sig as I didn't tell him I was going (I knew he'd tell me not to because of the chemo) but I wanted to know for sure it wasn't life threatening. My hematologist has prescribed me DOCUSATE for stool softening but I'm currently not taking them, I've found that brown bread instead of white, wheetabix for breakfast instead of bacon butties, pure orange juice instead of fizzy drinks, veg with meals instead of chips etc have made sure that I'm getting by without the medication, so I'm gonna sit tight for the next few weeks, keep up with the diet and the baths after BM and hope that if the cancer treatment is finished my body will improve with it's own healing efforts. Ever the Optimist and jr2 what you guys have told me about fissures sometimes not being picked up so easily has confirmed for me that I most likely have an AF and that is what I posted for originally, so thanks for that, now I can at least make sure I keep taking measures to minimise the problems and give myself the best chance of healing, thanks for your responses once again guys, I'll keep the board updated
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Re: Hidden Fissure

Postby owmybum » 21 May 2013, 01:49

Hi, it sounds like you are doing all the right things diet wise... Just remember to drink plenty of water with all that fibre to keep it soft and moving!
Good luck with your scan results.. Fingers crossed its good news for you. I hope you can gain some level of comfort soon with the AF.
Keep us posted
OMB xx
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
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Internal flap July 14
EUA and polyps removed Nov 14
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Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Hidden Fissure

Postby U.K-Tom » 21 May 2013, 02:42

Get yourself a colema/enema kit... You can read my big post to give you some more ideas. All the best mate.
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