Anal Fissure Support Forum

[Adanac13]

First off, I’d like to thank this forum for helping me explore options beyond what doctors recommend, and providing me with some level of comfort and hope during the past 3.5 months. I would scour discussion boards to learn whatever I could to speed up the healing process and I’m relieved to say that I’m in the clear.

For anyone going through this, you WILL overcome this and the pain will decrease (albeit slowly at times). I know it feels like you won’t get through this but you will. The anal fissure disrupted my whole life and caused immense anxiety, but 3.5 months later I am able to eat majority of what I want, and live my life normally. There is hope.

I will document my journey at length below but I want to include a summary of what worked well for me.

1. 10 min Sitz baths with Epsom salts- I would do this 3 times a day, and always right after a bowel movement. I later reduced it to 1-2, and now I don’t need any.
2. Raise your legs and rest your feet on a stool when passing a bowel movement. Try not to push and take your time, BUT this is easier said than done especially in the early days of excruciating pain
3. Use wet wipes over toilet paper
4. Wash the area with optimal health network goat milk soap
5. Buy one of those donut seats to sit on because it will hurt a lot to sit
6. Use a mix of heat pad and ice packs for that area - whatever you find helpful
Ointments:
Note that any ointment you use should be inserted into the anus- the cut is inside and you won’t heal as well or as quickly if you’re just applying topically. It’s uncomfortable to insert your finger into the anus at first but you get used to it. You can Google how to do it.
1. Coconut oil (raw, extra virgin, organic)- I found this to burn in my early days but came back to it later on when the pain was no more than 3 or 4 out of 10. Applying it topically all over the area was soothing and helps to heal more than Vaseline. I also recommend inserting some into your anus and topically before a bowel movement to lubricate the area
2. Desitin - in the early days of excruciating pain (8 or 9 out of 10), Desitin was the only thing that didn’t burn and gave me a bit of comfort. I would apply it into the anus with my index finger and all over the area. It’s messy for sure but I found it helped. This is a diaper rash cream with a high amount of zinc oxide to help heal the cut. I used this after a bowel movement and before bed. Recommend wearing pads on your undies when using this.
3. The BEST ointment and what got me over the finish line, was the SUPER SALVE pure herbal comfort from the optimal health network. After 2 weeks of this, I had reduced throbbing/pain after a bowel movement- almost little to no pain during a BM. I would first apply coconut oil on the area, and then the super salve into the anus and around the area. Coconut oil helps with applying the super salve as it’s a bit thicker. I used this 5-6 times a day.
4. Prescribed compound of 0.5% nifedipine and 2% lidocaine. I would apply this into the anus morning and night for 2.5 months. Use this until you’re healed. This alone won’t heal you though but it’s mostly what doctors in Canada will prescribe.

Diet related:
1. Restoralax- I found that this helped sotften my stool without making it bulky or giving me a strong urge to go to the bathroom. Conversely, Metamucil resulted in bulky stools and gave me a strong urge to go which made it difficult to slow down the bowel movement. I took 1 cap of restoralax every night for 1.5 months then weaned myself off over the next month by taking 3/4 cap for a week, 1/2 cap for another week etc
2. Water- lots and lots of it. 2 liters minimum but more like 3. I found that when I started eating more carbs, having a lots of water helped keep my stools soft. Also it’s good to consume lots of water when taking restorolax.

Diet is a tough one. I went on a very high fiber diet- no bread, no rice, no white potatoes, no pastries/junk (pizza burgers), no nuts; just veggies, fruits, salads, avocado, yams, dried figs, prunes, dates, beans/pulses, chicken, salmon, and a bit of steak but not too much. I had a limited amount of cheese. I hated the diet I was on, and knew it wasn’t sustainable long term. It causes bloating, gas etc.

Perhaps it’s ok to do this initially if you are constipated (dry/hard stools- either big or in small amounts) but after a month I noticed I’m not actually constipated. I starting adding whole grain oats and brown rice cakes to my diet. Eventually I decided after 3 months of little to no carbs, to bring back whole grain bread AND to indulge again- I had pizza, burgers, mashed potatoes etc. I was off of restoralax by then, and my stools were still soft!! I felt relieved to be able to eat what I want again. I always make sure to have lots of water and if I have white bread or simple carbs, I offset it by having avocado, dried fruits etc. which are high in fiber. I also started drinking coffee again, which helps me go.

My learnings with diet are to eat the following:
1. Healthy fats are key- avocado, salmon, extra virgin olive oil. This made passing stools less painful
2. Leafy greens like kale, spinach; and vegetables like broccoli, carrots, yams
3. Water
4. Fruits like raspberries and blueberries; dried fruits like figs, dates, prunes.


Don’t overdo the fiber. It’s a tough diet to be on longterm.

Eventually, when the pain isn’t as high, bring back whole grains and then get back to your normal diet assuming it’s full of healthy fats, whole grains, etc and indulge here and there.

Things I tried that weren’t as beneficial:
1. Neosporin aka triple action polysporin. I found this burned a lot and stopped using it after a week.
2. Metamucil - see above for why restoralax worked better for me
3. Amerigel - to clarify, this could have worked but I only used it 2-3 days before starting on super salve which I found worked better.
4. Vaseline- this helped reduce burning sensation after a bowel movement BUT I would also insert into the anus before a BM hoping that I wouldn’t cut/bleed but I always, always bled. I would say to use this if you have lots of burning but it’s not as good of a lubricant as coconut oil.
5. Prune juice- it’s nasty and I had a bit too much and it absolutely destroyed my stomach. Had diarrhea, and also fell asleep for a few hours as it may have sleeping inducing properties

All in all, to anyone going through this, I recommend the following:
1. Sitz baths 3x a day
2. Super salve ointment into the anus and around the area 5-6 times a day. In fact use all the products from the optimal health network if you need to- the super salve was amazing and they have other products to help you heal quickly. I thought natural products wouldn’t be effective but it’s what saved me.
3. Wash area with goat milk soap
4. Coconut oil inside the area before a bowel movement and topically before applying super salve.
5. Restoralax - just ween yourself off eventually. Most doctors will say it’s fine to take this long term but I’d rather go back to a normal diet


My story:
I’m a 32 year old female living in BC, Canada. I gave birth 5 weeks early to my first child, and had to push for over an hour. For moms out there, you know that pushing your baby out uses the same mechanics as going #2. I didn’t tear, the doctor made a 1cm incision which healed very well. Once I gave birth, my stools were fine and I ate more carbs than I usually would. At 1 week post partum I passed a BM with blood but no pain. At 2 weeks post partum, I passed a BM that felt like I was pooing glass. It was excruciating pain that was a notch under childbirth pain. In fact, I couldn’t believe how painful it was. It was so difficult to go #2 slowly to not irritate the area because all I wanted was for the BM to be over. I bled 100% of the time when I would go and eventually it got down to 50% of time and now I’m almost
Never bleeding. I experienced endless throbbing and pain after a bowel movement (around 5-8 hrs). I couldn’t sit and could barely walk. It would burn, itch and throb. I even had anal spams in the middle of the night (3-4 times), and I recall crying through one of them as it reminded me of birth contractions. I remember the anxiety around going to the bathroom, being so scared to leave the house in case I have to go in public, and just how much this impacted my day-to-day life negatively.

Initially, I thought I had hemmorhoids and for the first 4-6 weeks, I was applying anusol, preparation h all over the area. I tried inserting anusol suppositories which burned like crazy. I felt these lumps at the anal opening and tried pushing them back up but they just would keep coming out. As a first time mom, I was going through an entirely new experience- up every 1.5 hours so I’m heavily sleep deprived, trying to breastfeed (which was also painful) on a diet full of fiber which affected my breast milk and affected my baby boy who would cry from gas - needless to say I had a few breakdowns where I just didn’t know how I would manage anymore. Thankfully I had the support of my husband and family. This was easily the most challenging and painful period of my life.

After about 6 weeks where everyday I’m experiencing an 8 or 9 out of 10 level of pain, I go see a doctor who tells me that I have an anal fissure, not hemmorhoids! She said the lumps I feel are actually skin tags. From there, my healing journey began. She prescribed me the compound I mentioned above and I started using all types of ointments to heal. It took me a total of 3.5 months with the first 6 weeks being the MOST painful.

I hope this post helps and I’m happy to answer any questions. Don’t lose faith that you will heal, and remember that hard times will always pass.

[Helpplz101]

Hi there

Thanks so much for your post.

I am 20 weeks pregnant and experienced awful constipation in the first 3 months of pregnancy and developed 3 fissures. Everytime I have a slightly large stool my fissures reopen. My doctor says it's common and that my pregnancy is contributing to the problem worsening. I feel so despondent and feel I will never heal. I too had dried prunes recently that resulted in the worse diahrrea and made my fissures worse again after weeks of no bleeding.

I have some questions,

1) did you experience any pelvic floor issues? My anal muscles are so tight from trying to avoid pain and bleeding I feel like I can't relax anymore. I'm scared to go to the toilet or be away home incase I can't go comfortably.

2) did you ever experience occasional mucous? I see mucous occasionally when they reopen.

3) how many fissures did you have? Just one?

Thanks for sharing

[Adanac13]

Hi there,

I’m sorry to hear you’re going through this while pregnant! It’s really such an up and down process. Since this post, I’ve had a few subpar bowel movements- minimal pain and a bit of bleeding when my stool is more solid. Now I’m about 6 months post initial fissure, and seems like the end is very close. I will say I started taking restoralax again every night and it’s helped so much- I never have pain or bleeding when I’m on it but I am trying to wean myself off.

If your doctor allows you to take a laxative that softens stool, I highly recommend it. It’s much better than taking additional fiber.

To answer your questions:
1. Absolutely had the worst pelvic pain of my life during my pregnancy. I was doing pelvic floor therapy to cope, but my therapist would only stretch the vaginal area, never the anal area. Further, I got checked a month ago by a surgeon and he said I have the tightest anal sphincter ever that I almost laughed out loud. I had no idea but he said I need to try to relax it. The anxiety you’re experiencing with wanting to avoid the pain, not go to the washroom and not leave the home is totally normal and part of the first horrible
Phase. It’s truly awful but this phase will pass. I can’t stress taking restoralax enough because the softer it is, the less pain you’ll feel

2. Umm I don’t think I had mucous but I vaguely remember maybe having it once? The issue is maybe it was vaginal discharge so I don’t know for sure

3. Once I got checked by the surgeon , he said I have 2 fissures- both large and one really large. He said the back one is super large and the front one is smaller. He also said by this point (so I got checked about 4-5 months ish after the tear happened), the fissure looks more like scar tissue. He didn’t recommend surgery because it appeared I was healing.

[staypositive]

Thanks for sharing your story. I find myself in a similar boat with you, mis-diagnosed for hemorrhoids after giving birth for 10 years. And finally realize I have been dealing with Fissure just early this year. After 3 months of excruciating pain, I went for botox and it helped dramatically and I was pain free for 9 months. Couple days ago I missed one day of BM and boom wasn't even constipation, just slight push and I ruptured it. Now I'm really scared, pain level isn't too bad but just really worried it will get worse. Sits bath, nipedifine cream, polysporin, infared light after BM. I just order this natural topical remedy "Force of nature Fissure control", will give this a try. I'm also considering Super Salve. Hopefully this fissure will cure in a few days. Learning how to live with this condition.

[Adanac13]

It shouldn’t get worse, and shouldn’t ever go back to the excruciating pain of the early days- at least in my experience. I think it’s just a very long process to heal unfortunately I won’t go off restoralax because when I do, I risk getting a BM with a bit of streaks of blood, and mild discomfort while pushing. It’s
Not ideal to be taking that every night but need to live my life without anxiety and pain. I think you have to do whatever helps you live day to day without it taking over your life.

[Adanac13]

It’s been 7 months since I last posted. Not taking any restoralax, and I’ve had 2 incidents since. Both times, the pain was a 1 or 2/10, and there was a bit of bleeding for 3-4 days. It healed up quickly. What I realized is that both times this happened was because I was forcing myself to go to the bathroom; I had a flight and wanted to pass a bowel movement before. I’ve realized that it’s best not to force it ever. Even if it means you go a whole day without a Bowel movement. Once you really feel the urge, go. Both times were me pushing and straining. Lesson learned. And I do need to ensure I don’t eat too many refined carbs for a long period of time either but that’s a healthy way of living anyways.

[harrisonab90]

First, I want to say thank you so much for sharing your story. My story is identical to yours even down to the age. I am doing everything you recommended and it was really working but unfortunately I’m experiencing a minor setback currently due to adding potatoes to my diet. I bought the super salve you recommended but I have been hesitant to use it because I am breastfeeding. Do you know if it is safe to use while breastfeeding?