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.
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!!