- Joined
- May 28, 2014
- Messages
- 2
Hi everyone,
I've had an excruciatingly painful anal fissure for 3 months now. I don't know how I've lived with this much pain for 3 months.
I had no idea about Crohn's or anything like that as a possible diagnosis for me, but I noticed a little bleeding around Feb after a bowel movement, I had a period of about 2 weeks of alternating constipation and diarrhea and thought it was IBS, the pain got worse and worse down there, I went to a proctologist/colorectal surgeon mid march, he probed w his finger and said it was an anterior fissure, didn't scope since he said it would be too painful, gave me diltiazem ointment and psyllium husk and sent me on my way, the psyllium made things much much worse, I had night sweats the days I used it and terrible painful diarrhea the next day, two weeks later (first week of April) at my follow up I told him I had been having canker sores like crazy since Feb, he then asked for an endoscopy/colonoscopy, I had that done end of April and he said he saw an ulcer in the ileum, the GI guy said he saw peptic ulcers in my duodenum that should go away with omeprazole, but combined with my fissure I think their guess was ileocolic Crohn's disease. Biopsy verified it. The proctologist said it looked mild, said he wasnt going to do anything for surgery and that I should go to a GI and be treated for Crohn's.
This is where I get confused, he wasn't clear, I asked "why?" he said "because your Crohn's caused your fissure"
But what he wasn't able to really elaborate on is, did my Crohns cause the fissure "inside out"? from the muscle to the lumen? or did my Crohn's cause diarrhea and constipation that created a fissure just as any other persons anal fissure would develop?
he said "if you treat the Crohn's it will treat the fissure", but that didnt make sense to me, I always thought I had IBS, I suppose you could say I was in "remission" the last 3 years, but whatever this last "flare" was, its now gone, and I'm left with this fissure, so I have Crohn's and it caused my fissure, but the Crohn's disease is the reason why nobody wants to surgically treat the fissure?
Anybody out there have lateral internal sphincterotomy for anal fissure with Crohn's disease WITHOUT (or WITH) complications? what are the complications?
I went to a general surgeon (mid May for a second opinion) who has worked with a lot of crohn's patients and has dealt a lot with anal fissures and he looked and said its now an "anal ulcer", "its down to the muscle" and he gave me nitroglycerine, said it should work in 4 to 6 weeks and I ask "or else what?"...."then we do surgery"
even then, if its contraindicated for Crohn's patients, why do it? I've read that anterior fissures arent particularly caused by increased sphincter muscle pressure, those are usually going to cause posterior anal fissures, and I've heard (from the surgeon as well) that you could have a "non healing wound", I didnt bother asking if that was from the surgery or the fissure itself.
what other options are there? A GI family member living in another state, an IBD specialist GI and the general surgeon all said 5-ASA would not help my fissure, so is the lateral interal sphincterotomy (LIS) my only real choice? its so successful in other patients (96%) and yet there is so much fear around Crohn's patients, please if anybody with Crohn's on this forum has experience with LIS please let me know here or through PM what you experienced and any advice you wish you had early on. Thank you.
I've had an excruciatingly painful anal fissure for 3 months now. I don't know how I've lived with this much pain for 3 months.
I had no idea about Crohn's or anything like that as a possible diagnosis for me, but I noticed a little bleeding around Feb after a bowel movement, I had a period of about 2 weeks of alternating constipation and diarrhea and thought it was IBS, the pain got worse and worse down there, I went to a proctologist/colorectal surgeon mid march, he probed w his finger and said it was an anterior fissure, didn't scope since he said it would be too painful, gave me diltiazem ointment and psyllium husk and sent me on my way, the psyllium made things much much worse, I had night sweats the days I used it and terrible painful diarrhea the next day, two weeks later (first week of April) at my follow up I told him I had been having canker sores like crazy since Feb, he then asked for an endoscopy/colonoscopy, I had that done end of April and he said he saw an ulcer in the ileum, the GI guy said he saw peptic ulcers in my duodenum that should go away with omeprazole, but combined with my fissure I think their guess was ileocolic Crohn's disease. Biopsy verified it. The proctologist said it looked mild, said he wasnt going to do anything for surgery and that I should go to a GI and be treated for Crohn's.
This is where I get confused, he wasn't clear, I asked "why?" he said "because your Crohn's caused your fissure"
But what he wasn't able to really elaborate on is, did my Crohns cause the fissure "inside out"? from the muscle to the lumen? or did my Crohn's cause diarrhea and constipation that created a fissure just as any other persons anal fissure would develop?
he said "if you treat the Crohn's it will treat the fissure", but that didnt make sense to me, I always thought I had IBS, I suppose you could say I was in "remission" the last 3 years, but whatever this last "flare" was, its now gone, and I'm left with this fissure, so I have Crohn's and it caused my fissure, but the Crohn's disease is the reason why nobody wants to surgically treat the fissure?
Anybody out there have lateral internal sphincterotomy for anal fissure with Crohn's disease WITHOUT (or WITH) complications? what are the complications?
I went to a general surgeon (mid May for a second opinion) who has worked with a lot of crohn's patients and has dealt a lot with anal fissures and he looked and said its now an "anal ulcer", "its down to the muscle" and he gave me nitroglycerine, said it should work in 4 to 6 weeks and I ask "or else what?"...."then we do surgery"
even then, if its contraindicated for Crohn's patients, why do it? I've read that anterior fissures arent particularly caused by increased sphincter muscle pressure, those are usually going to cause posterior anal fissures, and I've heard (from the surgeon as well) that you could have a "non healing wound", I didnt bother asking if that was from the surgery or the fissure itself.
what other options are there? A GI family member living in another state, an IBD specialist GI and the general surgeon all said 5-ASA would not help my fissure, so is the lateral interal sphincterotomy (LIS) my only real choice? its so successful in other patients (96%) and yet there is so much fear around Crohn's patients, please if anybody with Crohn's on this forum has experience with LIS please let me know here or through PM what you experienced and any advice you wish you had early on. Thank you.
