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  1. #1
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    Lightbulb My Anal Fissure Journey - info and tips

    Although I've been absent for a while, I am a long term BH member, however, for the purpose of this post, I've changed my username. I find it so embarrassing to talk about my condition, that even discussing it here, I kind of worry someone I know would link me and my old name - silly huh!

    Anyway, I thought I would post about my journey through this horrid affliction, in the hope that someone else might benefit from the information I am sharing. There seems to be very little information on the net, except for medical journals and horror stories about things gone wrong.

    I am currently what I would call in the 'management' phase of controlling my AF (obviously for this post, I refer to the anal fissure, not our good old monthly visitor). I may discuss my history in a bit more detail later, but for now to keep things short, after years of pain, I have had an initial consultation with a surgeon during a "chronic" re-occurrence. I am scheduled to go back in the second week of December, at which point he has suggested I will possibly need a sphincterotomy before Christmas. The point of this post is to share the information I have about managing the fissure, and hopefully, if I proceed with the surgery, to encourage other suffers along the way. Personally I'm terrified at the thought of surgery, but he assures me it is not that bad, and most of the horror stories stem from hemmie surgery.

    For now, I wanted to share what I know about medications and treatment or management of fissures - because I expect that if this is what you've put in the search box you are looking for help or relief.

    MEDICATION

    I have seen various posts about hemmies & fissures with varying information on cures and treatments. Here is what I have been told:

    RECTOGESIC - This is the ONLY cream that will help HEAL a fissure! If applied directly to any part of the fissure it will sting like hell (doesn't anything coming in contact with that wound hurt like hell tho!!) However, it is a 'topical' ointment and is absorbed through the skin, so it doesn't actually have to be applied directly or internally - let me know if you want more info in that regard.

    PROCTOSEDYL - is primarily a hemmie treatment and does very little to heal a fissure. The reason it is sometimes used for fissures is due to its anaesthetic effect. You can use this for relief, but if you want to heal the fissure, go back to Rectogesic. Proctosedyl suppositories (prescription only???) again, don't heal the fissure, but can be used at night time to provide greater relief/numbing for night time comfort. They are kept in the fridge and can be excruciating to insert, but the pain generally eases after 2-3 mins (when they warm up and start to melt!)

    XYLOCAINE - is a wonderful topical local anaesthetic cream. Available over the counter, a little expensive, but provides significant relief when applied. It will not assist the fissure to heal, other than to provide pain relief.

    RECTINOL - is a white zinc based hemmie treatment, with the same anaesthetic level as Proctosedyl. Good for hemmies, messy, not so great for fissures.

    PANADOL EXTRA - when experiencing a chronic episode, I use 1xPanadol Extra (with 10mg codene) and 1xPanadol Osteo together - 2 or three times a day. I find the Panadol with the codene helps take the edge off the chronic pain, but I loathe the constipating effects so I try to avoid high doses (such as Panadene Forte?). The Panadol Osteo is a longer, slower release pain relief, which gets me through if I am working and forget to take the next dose on time.

    While I think about it - I think I recently managed to overcompensate for the effects of the codene. I nearly doubled my daily dose of fibre (up from 1TBS psyllium at breakfast, up to 1TBS morning and night!) The results were severe abdominal 'aching' kinda like (now i can't say 'af' like that..) menstrual cramps, all day, and very little additional 'softening' effects. My advice is don't overdo the fibre, increase it gently or try a stool softener like the green Coloxyl....don't use the red coloxyl as it is a stimulant as well as softener and the last thing you need in the middle of a fissure episode is extra stimulation...remember, go green!

    Well, that's about all I have for now. Please let me know if you find this information helpful or have any questions, otherwise I will probably just be talking to myself for the next 2 or 3 months!!

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    AppleIsleSMum  (15-12-2013)

  3. #2
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    You have my sympathy, I've never reached chronic levels but have suffered regularly over the years. For me, it's completely diet related, if I go anymore than 2 days without serious consumption of veggies (& fruit), my body signals its not happy, so it helps me stay healthy & keep motivated to eat well. Blessing in disguise.

  4. #3
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    JungleMum, I get what you mean....although I have a really good diet, I am really bad with my water consumption, and I am also a 'fair weather friend' when it comes to taking medication....case in point - after religiously using the rectogesic as instructed the first couple of weeks, as things became more bearable, I have gone to hardly using it. I thought I was pretty well recovered the past couple of weeks, not needing any any panadol/nurofen etc, no prolonged daily pain and only a fleeting sharp pain at the beginning of my daily bowel movement, which I actually thought was just a hemmie - until today

    I went back to the colorectal surgeon today - he did a (very quick but significantly painful) exam and declared that the fissure was still a considerable issue.

    Although I had psyched myself up for the surgery, which was why I initially started this thread, when it came to the punch and he went through the options with me again today, I have wussed out and gone for the 'less surgical' option - botox.

    So the options are:

    1. small botox injection into the sphincter muscle to relieve spasms and allow the fissure to heal...apparently this has a 2/3 success rate, is only temporary as the botox wears off, but should allow the fissure to heal. It is administered under general anaesthetic, day procedure, and he can have a look around to see if there are any other issues which he can't assess at the moment due to my extreme sensitivity. He mentioned botox is practically the only solution now offered in the UK health system. I go home the same day and 'back at work in 24 hours' - luckily I am self employed, home based business No downside, worst case scenario it doesn't work and I am up for option 2!

    Option 2 - anal sphincterotomy, which involves a small (but permanent!) incision into the sphincter muscle to stop the spasm....90+% success rate, 2-3% increased risk of incontinence later in life (normal female risk of ac 8%!) General anaesthic day surgery. 2-3 days recovery time.

    Option 3 is a much more involved surgery involving a skin graft over the fissure - not even considering that option - several WEEKS recovery!

    So, although I had well and truly thought I would go through with Option 2, at this point in time, I think I will take the slowly, slowly approach, and I am off to get a wrinkle free bum on Monday!

    (OMG - I typed this all out 3 days ago and thought I lost it when I hit some random button!!! Just come back to update and here it is - yaaay!)

    So, not much more to add - off to the hospy in the morning - nothing to eat or drink after midnight tonight, have to be there by 6.30am for 7.30am procedure. Kids are at nanny & poppys for a couple of nights

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    Good luck!! And thank you for taking about it. I has a sphicterotomy and hemmie removal (oh. Dear. God. The hemmie removal was excruciating). Have been left with as equally debilitating condition as a result of constant cream use for years... Which I can't bear to type here, I'll PM you. My advice, do something sooner rather than later. Hope your butt enjoys it's wrinkle free status haha!

  6. #5
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    EDL - I'd love to hear from you on PM....I know I could still be up for the sphincterotomy later on down the track, and the surgeon has suggested he could 'tidy up a few other things' while he is there, so any info you can share would be great. I'll look out for your pm. xx

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    Oh good luck!! I had to have 4 banded when I was preggers they were so bad, and looking at more permanent options for fixes now. Had troubles all my life down there, and now my 6 month old has the same 'pooper problems' :-(
    Now they are going to look into the cause :-/

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    Hi there,
    Thanks for sharing your journey. I needed to know for how long do u have this problem and what's the reason that it has gone so far??

    I have 15 months old son. After my delivery, I developed constipation and didn't realised I was doing the daily need till 9-10 days ( even I was fasting for first 5 days, was only on milk and fruits). When I did after so long it was.....
    i just couldn't get anything out after a while and it was such a pain. My GP told me that I had developed a fissure and prescribed me rectinol and movicol. It took a week to get rid of it and maintained my diet with at least 1 apple and some high fibre cereals for 6 months. No problems after that till now.

    Are there any chances of them getting back??

    thanks

  9. #8
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    Rupz, I've had problems on and off for the past 3-4 years. I managed to control it for a good 12 months without any problems, but earlier this year it came back and I just haven't been able to get rid of it completely. I had about one week, pain free just before my colonoscopy, and then one day driving around for work I could just feel it coming back - that splitting, tearing feeling, like a knife blade cutting open. It was at that point that I decided to take the next step. I have a very healthy diet - we cook most meals from scratch, I exercise regularly (have lost 10kg of long overdue baby weight in the past year) although I am more careful about what exercises I do. I am taking about 2tsp of psyllium in a glass of water/cordial/juice each night, just to keep things easy, but it is amazing how easy it is to forget, or sometimes eat bad food and things get a bit 'hard'. My specialist said many people have no idea how soft a BM should be, but if you have no issues you are lucky.

    I suppose once you have a fissure there is a chance that area is weak and it may come back, but of course it depends what caused your fissure and by the sounds it was only small. By the sounds,your constipation caused the tear, whereas my muscles have spasms which tear the inner lining - I had no idea I had these spasms, its nothing I've ever felt - except perhaps from the surging pain when the fissure is chronic? The idea of botox is to stop the spasm, increase blood flow and allow the fissure to heal.

    So, on that subject, I am home already from the procedure this morning. Early start, arrived at hospital 6.30am, waited at reception for half an hour to admitted to the hospital, the onto the next waiting room to speak to the nurse, then onto the next room to change into the sexy green gown and wait some more, then met by the anaesthetist, surgeon and the rest of the crew. Finally wheeled into surgery, had a lovely sleep and before I knew it I was being woken by a screaming toddler in the bed next to me in the recovery ward - poor kid, but not a pleasant way to come out of GA!....then waited around about 60-90 mins in post recovery, had a drink and sandwich and discharged at 11.30.

    At the moment I am totally pain free, the surgeon said he gave some 'extra local anesthetic' for comfort and I have been given some special (not Panadine but similar) Forte pain killers if needed later. So now I'm just chilling out at home, child free, hubby has cleaned the kitchen, and if I still feel good, I might drag hubby out to a special restaurant tonight that I've been dying to try.

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    Zabella  (17-12-2013)

  11. #9
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    Well I can tell the local has worn off, but all in all I am feeling fantastic actually! A slight 'prick' where the needle site must be, but no worse than the fissure is generally, and even that is feeling pretty good.

    We actually managed to duck out and do some Christmas shopping this afternoon - no wonder they say don't sign any legal documents after having a general anaesthetic - I must be soft in the head because I bought somewhat expensive items we had been um&ahring about! Or it could be because Christmas is just around the corner and i'm a little over it. Unfortunately the special restaurant was closed, but we managed dinner at our favourite Chinese, followed by chocolate churros fondue :P

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    Zabella  (17-12-2013)

  13. #10
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    Randon541.. Thanks for the reply. I am glad that u got rid of it and may you get best of your health.


 

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