Fissures

[matty]

fissures

hi everyone. Was wondering about fissures. I read about and knowthe things to do but after a bm do you clean up before you do the sitz bath. Stupid question but i read not to irritate that area. I;m not sure i have one but the symptoms are there, after having extreme constipation for 3 days and pushing hard each day. ALso do you stay away from enamas or hemmi ointments when you have one.

 

[matty]

please someone some advice. Seen dr. today and said small tear. Of course after seen dr. it got slightly more pain. All dr. said was to take metamucil and use vaseline on it and don't bother it. Its sore and now the metamucil is making my bum feel like its boiling d but nothing comes out. Do the stool softeners wrork better and not make stomach sore or d. I could just kick myself for bringing this upon myselt, but its the only way to learn a lesson.

 

[Mik-Dog]

Hey Matty,

I had problems with fissures myself. I had an abscess that ended up rupturing...it was terrible. You might want to try the stool softener instead. Do your best to keep the area as clean as possible. This will help to prevent infection. It is tough given the area. Do your best to not push and grunt your way, the extra pressure won't help the tears. Basically, you need to try to be as gentle as possible. I feel for you on this one. It is definitely tough.

 

[Mountaingem]

Something that works great for me as far as fiber goes is canned pumpkin-not pumpkin pie filling but pure canned pumpkin from Libby's. Try to eat a helf a cup a day.

The fiber is really gentle (no cramps or pain moving through) and helps keep the stool soft. I mix in a littlw pumpkin pie spice, spray on a little I Can't Believe it's Not Butter and microwave it for 30 seconds-and you pretty much have crustless pumpkin pie, YUM.

Ok, on to the other end-I always wipe afterward with Tucks medicated pads, which is really soothing, and then add Calmoseptine. I seriously love this stuff; it's cooling and forms a protective barrier so when you go again, it doesn't hurt to wipe and is less irritating, too. You have to ask for it at the pharmacy window but it is an OTC product. Also get some gloves for the application, it's more hygenic and Calmoseptine is kinda hard to wash off (which is why it works so well) lol.

I always add a cup of Epsome salt to my sitz bath which makes it heal up faster, in my opinion. I got the idea from my Grandma who said that it's an old-fashioned remedy for healing up after having a baby.

Sorry if this is TMI but sometimes it has to get graphic in order to help!

 

[PaulsPain]

I have battled with fissures for years. They suck big time....

-Keeping the stool soft but formed has always been key for me. If to loose it irritates and hard to clean. To hard and it tears open. I take fiber supplement to try to gel my stool. As mentioned, pushing is a big no-no. It took me a long time to train myself not too.

-A hand shower is the best way to clean. I wipe very gently with a wet wipe and then use the hand shower to finish cleaning.

-Sitz baths help immensely. When I was really suffering I would try to soak 3 times a day if I could.

-Ok, this is going to sound goofy - but using a blow dryer on a low setting to dry after the bath works really well.

-When my fissures were really bad I couldn't handle putting anything on them. Now that they are partially healed Calmoseptine does seem to work nicely.

Good luck.

 

[PaulsPain]

Also, I should add. Be careful that you don't bulk things to much with the metamucil - which could cause things to tear more. I only take 1 does a day max. For me, I found Citrucel worked better in not bulking things to much.

A really good anal fissure forum with lots of good info and tips is: http://analfissure.editboard.com/

 

[matty]

thank you so much for replies. Yes the metamucil does bulk up my stool, i've been taking 2 doses becasue i'm so scared for it to get hard. Today i had a soft bm, didn't really have to push much, just that it was kind of big. Tomorrow i'm going to take only 1 dose. In order to purchase many items i need i have to go at anywhere from 1/2 hr to 1 hr to town. THe closest one is a bit expensive. I do the sitz baths also. I may make the trip tomorrow, i have no wipes, could you use unscented baby wipes. I haven't put anything on it yet, i'm just scared to deal with that, this is my first fissure. Does the fissure make you urge to always have a bm or maybe its the metamucil. I should have asked dr. yesterday for stool softeners but i think you can buy them over the counter. My mother use to use red gels and i never asked how they were, i was well at that time and my mother passed away a couple years ago.

 

[Mountaingem]

Inflammation is what makes you feel like you have to constantly go. Baby wipes I find hurt-the Tucks have witch hazel which is soothing. Maybe your GI could prescrible some Cortifoam or prednisone suppositories-these work great.

If you have to travel far to get supplies you can order Calmoseptine, Tucks, and anything else from Amazon.com-the shipping is reasonable and quick!

 

[matty]

I did go to town and bought the wipes. Its not too bad. But now today i feel like d coming on, i went today and its very soft, not formed. I'm scared to get d to make it worse. I take metamucil once daily now, was taking 2 before when i was constipated. The fissure site paulspain suggested is very good and i've been reading alot. Its both helpful and discouraging as some can't rid of there's. Its also kind of hard as its different for everyone on what helps. What makesit worse is have ibd. We can't just eat anything. This is my first one and i've not looked there since dr. dx it last week. Also everyone on the fissure site say to see a correctol surgeon, do i have to see one. What do i do. If i want to see one here, its going to take awhile. So far all i'm doing is the sitz baths 3x a day and using the wipes and metamucel. I read somewhere for the acute ones to just increase fiber intake. Please some advice. Also i don't see no blood yet and its not really painful, mostly burning.

 

[matty]

Forgot to mention that when i have bm, it feels like after some comes out it shuts and i wait for few minutes for some more to come out.

 

[matty]

okay just checked in bum because have been feeling burning more today, thinking an hemmi also. it looks like acoil, i quess askin tag. does this mean i'm not healing and do they go away on its own.

 

[Mountaingem]

No they don't away because it's an abnormal growth due to inflammation, constant wiping, etc. What will happen is as the inflammation goes away, and it stops flaring up the pain and constant irritation will also go away. Pretty soon the only time you notice it is when you bathe.

I don't know if there's anything significant about the shape but the burning can mean inflammation, so does the feeling of not finishing your BM. In my experience when it's at this stage only cortisone cream or Proctofoam would really provide some relief for you

Give your GI a call and see if he can prescribe some for you. Sending healing thoughts your way, I know how miserable it is to have this!

 

[PaulsPain]

The stopping and going could be from the internal sphincter muscle(involuntary) going into spasm. My main symptom from IBD has been fissures starting 6 years ago. I would get spasms so bad that I could barely walk.

That is what is hard about a fissure is if the internal sphincter muscle goes into spasm it pulls on the fissure and decreases the blood flow to the area. It is a vicious cycle.....

Under 6 weeks is considered acute so hopefully you get it healed. A CRS is the right person to see since they treat these everyday. Can you call your GI and ask him/her to prescribe one of the many ointments to treat fissures - nitro paste, nefidipine, diltiazem. These help by relaxing the inner sphincter muscle and increase blood flow to the area.

Also, a skin tag can form from a chronic fissure - sentinel pile. It is the body's way to try to protect the fissure.

Wishing you quick healing.

 

[matty]

thank you again for replies. I still have not seen a gi, but have an appt in 2 weeks withthe surgeon who does colonoscopies. I see family dr. tomorrow and will ask him to refer me, but i knowits going to be a long wait. Paul, i was just dx 1 weekago with fissure, how could it be chronic. I know i didn't have one before, just last week when i has severe constiopation with large bm's wheni started having this pain. Does a skin tag ever form on a early acute one. I will be asking my gi tomorrow for the cortisone for the burning. I'm still kicking myself for not treating my constipation, and having the bladder scope mad it worse.

 

[matty]

Paul i am a bit scared to try those ointments as i read the side effects. I'm a severe no pill taker, i haven't even tried any pills for my ibd yet. I only used the cortisone enemas. I really hate side effects and i seem to always get them.

 

[PaulsPain]

Yes, your fissure is so acute I wouldn't think the skin tag is from that so soon. Sorry, I didn't mean to imply that the skin tag was from the fissure but after awhile it could form if the fissure becomes chronic.

Good luck with your appt.

 

[PaulsPain]

Ya, I tried both Nitro and nefidipine. I healed up once taking nefidipine orally. I had minimal side effects with it since they use a low dose. The nitro paste helped but gave me headaches and made my heart race.

I have battled chronic fissures for years. If I knew back then what I know now I would have done every thing in my power to get it healed in the acute phase.

Good luck and I really hope that it heals fast.

 

[Princess0809]

I had one that required surgery

Okay so I had developed a fissure that required surgery because it was so far near the muscle. The bad part about the whole thing was that my Crohns was severely acting up and the fissure could not heal due to all the activity down there. So my advice is getting the crohns under control first. I had to go on Remicade. Which got the Crohns under control and the place where the fissure was cut out finally healed. Before I got everything under control, Sitz baths with witch hazel were my friend. I would have one after every bowel movement. Granted that was a lot of because of the crohns activity but that was the only way I got comfort. Also, use the wipes not toilet paper. Toilet paper will make it worse cause it is too harsh for the site. Good Luck

 

[Mountaingem]

Good advice! I'll be sure to try that!

 

[matty]

well saw family dr. yesterday and i showed him the fissure to check if infected and he said no. I said what about the skin tag and he said its from an old hemmi. I also asked if i shoudl see a correctol surgeon and he said no, its doing good and not worry about it. I also asked about the ointments and said not to use them just do the baths and leaveit alone. I could just scream at dr.'s when they make light of things. I quess maybe becasue i told him its not too bad, just the burning sometimes and i quess he's waiting until its gets really painful then he may refer, i don't know that just what i think. If its mild do you still have to see a correctol s.

 

[matty]

also awhile back dr. gave me asacol but was going to try it after my urologist visit. But this happened after that visit so now am scared to try this pill, scared to get side effects like d. So far not so bad becasue i'm watching what i eat. Please don't stop giving me advice as i know i'm really stubborn at taking pills, but right now i don't want to make anything worse. hopefully this fissure will heal and i can start the asacol. I am doing the baths 3x daily and metamucil once daily.

 

[Mountaingem]

Asacol won't give you diarrhea; it treats Crohn's so if anything it will alleviate it-definitely start the Asacol and see if start seeing improvement.

You need to take it at regular intervals and not skip doses if you want it to work; it's effectiveness is dependent on it and with regular use it will become even more effective over time. You probably need at least 4 weeks to see improvement; maybe much less time since you are new to these meds.

 

[Rivers]

I have a chronic anal fissure with a large skin tag. I wish I had a bidet, but I use the handheld shower attachment after every BM to clean up and under the skin tag. My doctor gave me a Rx for this cream you insert after a bowel movement and 3x a day it is called Nifedipine and works by increasing circulation to the area so it can heal. I also had the Botox for the fissure, which worked for about 4 months until it wore off and tore open again. Sitz baths help but the cream can totally heal it! I tried the nitro ointment(didnt like it) I get zero side effects from the Nifedipine.