Anal fissure support

[SadFace2]

I know this isn't an unreasonable debate but I'm posting for traffic because I really need some help here.

Had surgery for piles which is all sorted now but suffered a tear during my surgery. I've been struggling ever since. 5 weeks now. Doesn't sound long but I am starting to go under.

They gave me botox during the surgery and since I'm not doing well I'm assuming more Botox in the future wouldn't be especially helpful. I was using diltiazem cream but that's now started to react badly and really set me back.

I'm being careful with food, barely eating to be honest. I'm on movicol so I'm not constipated and I don't have diarrhea. I'm using a footstool to go to the toilet and I'm having baths to encourage blood flow and healing.

I don't know that there's anything more I can do but I'm starting to lose my mind so had to post.

Even if you don't have a miracle cure I think I'd just appreciate some support at this point. I don't think I've ever been so low.
Thank you.

Thank you @Waxlyrically .
Well, I've discovered I'm allergic to leeks (I knew about garlic already) - so the past couple of days haven't been great as any food rushes through, causing a whole lot of discomfort and having to try to slow every BM to prevent more tearing. On the plus side, though, generally less pain overall at the moment. Hoping I'm out the other side of this flare. It's the uncertainty and variability I hate between flares (and the excrutiating pain when they happen).
Yes - let's hope we are all in a better state by Christmas.

Sorry to hear that @USaYwHatNow - you have our empathy and we all understand.

@LavaBum sorry to hear you’re still suffering but glad you feel it’s getting better overall. I hope the allergic reaction settles soon.

Welcome to the thread @USaYwHatNow but of course I’m sorry you find yourself here, and with a new baby and birth recovery on top! Your story made me wince, as a pp said upthread, you can’t know how painful they are until you’ve had once but we all totally understand.

Have you been to your GP and been prescribed anything? That would be my first port of call. I’ve also posted my ‘routine’ further up thread - it’s taken me seven months to figure it out but I feel like I’m finally getting somewhere with it all now. Sending healing vibes your way.

@LavaBum , sorry you've found another allergy that makes things worse. Why is it that when you're already battling with something, another thing comes along to mess it up even more? I'm sorry and really hope this flare fades for you quickly and settles down (for good!). Are you using Rectogesic? Sorry, I can't remember. If not, I'd recommend it, it can make you feel weird at first, but I found it got better if I used just pea sized blob, 4 or 5 times a day instead the mammoth 2.5cm twice a day that the packet says! I also still use virgin coconut oil and vaseline after every BM and have regular sitz baths, I think the baths really help. But they're a pain to have to keep doing right?!

@USaYwHatNow , you have all my sympathy. What a rotten start to motherhood you've had. Please, get to your dr they will prescribe you Rectogesic and see what I said above to Lavabum, it can take a bit of getting used to, but it does help. Along with vaseline to lubricate both before and after BMs, note you said it was sometimes urgent to go, so get some finger cots from Amazon and a run of vaseline and just put a thick blob of it up your bottom as well as all around as a matter of course, so youre always prepared. I carry a vaseline lip salve in my hand bad along with a spare few finger cots in a freezer bag! Gross I know, but it helps and then I feel safe going out. I've also found H Fissure oil very good from Amoils, but it's from the US and is expensive - £37.95 for a v small bottle, and takes forever to get here, but when it does it really helps. You may benefit from botox injection, I've had that and it gets rid of the awful spasms following a BM. Laxative wise I'm on lactulose both morning and evening plus dulcoease (docusate sodium, you can get at any pharmacy) every day to keep things soft. I've also practically gone veggie in diet, just because I've found my BMs are softer. I do have bread, but not every day and when I do its sourdough or wholemeal. Can't give up cheese though! Have cut that down, but that's all I can do there! Migranuim has also given a lot of great info as to her routine. Part of the problem is everyone's body differs so it's a kind of trial and error. It's such a debilitating condition and nobody gets it unless they've had it. I literally used to be shrieking on the toilet and then sobbing in the bath and for ages afterwards. The ladies on this thread have helped me so much in knowing I'm not the only one and you're not either. We're all here for you.

Thank you for the tips and directing me to the posts with routines, I will definitely start my own trial and error! Ahh I'm a midwife so it was always in my destiny to have a rocky start to motherhood 🥴😂

May I ask what rectogesic is? I've seen some posters say they've had really bad headache? I suffer from hemiplegic migraines so would rather steer clear if that's the case. Although, I'm willing to try anything else to numb the area as a particular low point from the weekend was my 16 year old nephew hearing me crying on the toilet... turns out spotify can only drown out so much!

Rectogesic is a kind of ointment / gel that increases blood flow to the fissure (as the bum hole doesn't naturally have much blood flow which is necessary for healing). It doesn't numb the area, I got lidocaine ointment for that, but it didn't really numb anything for me to be honest. There is another ointment that the ladies have referred to on this thread,
diltiazem I think. It works like Rectogesic but doesn't cause the same headaches as I understand it. Ahhh, I'm sorry you ended up in tears on the loo at the weekend.....been there! And sorry your nephew heard.......mind you, I used to scream so much in pain I'm pretty sure our neighbours could hear me, as we're in a semi detached house!!

Has any of you ever called in sick due to your fissure or piles?

I’m really struggling the last few days I’m SO uncomfortable.

I don’t know what to do. My job is very active and the itch and pain currently is really getting me down.

I had diltiazem and it made all the difference to me

@LibbyL92 , yes! I have absolutely gone to my dr and got diagnosed with an anal fissure and been signed off work with it. I've had other health complications as well (overactive thyroid), but I ended up going private and getting botox done, so was also signed off by my dr for the recovery from that. So if your pain is that bad, get signed off. My sister knows someone else who had an anal fissure and they were off work for 2 months with it! It's incredibly debilitating and painful and depressing, so take the time you need. Rectogesic or diltiazem cream can be prescribed by your dr and can help the fissure heal.

Thank you 😩 that’s reassuring to hear.

Hello everyone, I've've just been catching up with all the comments over the past week or so that I've missed. Life is super busy with a toddler and baby. I'm still struggling with this latest flare up. I've been like this about a month now. I have one good day and numerous sore days. I'm meant to be having botox on Friday, but I don't know if I'll be going. A family member was going to pick me up afterwards, but they've gotta go have some teeth removed! It was already guna cost me £30 one way in a taxi, but now it's guna cost me £60. I just don't know if I can afford to pay that much for taxis in just one day! Goodness knows how long I'll have to wait for another app though. I've waited about 5m for this. Oh, it would be nice if money was no object.

Forgot to add that they wanted me to have an ECG this Wednesday at a different hospital too! That would be another 20 quid in taxis, so actually it would of brought the total to £80. I know my GP can do an ECG, but they said because they were cutting it fine, they wanted me to have it done at a hospital. So frustrating!

@Chlobob27 , oh no, what a pain. Is there nobody who can help you out with a lift at all? Please, try to make the botox, it will make such a difference for you. I really hope you can find a way to make it to both appointments. My hospital did an ecg just before the op, so perhaps they could do it at the place you're having the botox?
I've had a bit of a relapse, I didn't drink enough water on Saturday as I went out with friends for the first time in ages. Didn't drink much alcohol, but also not much water. Hard BM Sunday morning was more painful than I've had in about 4 weeks and I was really upset with myself as I think I have reopened the fissure or at least made it worse again. I'm hoping I haven't undone all the work over thr last few weeks. Today's first BM was better, but still more painful than it has been. But I've been a couple more times (think I may have overdone the lactulose) and they were OK and fissure didn't seem to bleed. So I hope against hope it's a minor setback and I'm still on thr road to recovery. Nowhere as bad as before the botox though, even with the setback. But I hate setbacks and the way they make you feel like this damned thing will last forever. So @Chlobob27 , please try and get to your botox appointment, I honestly think it will help you. Gosh, why does life have to be so flipping difficult?! I have everything crossed you'll make it.

Unfortunately there is nobody else who can give me a lift. They said the ECG needs to be done before the botox can be given, as part of the pre op assessment. I guess different hospital trusts have different policies. I've been drinking 3l of water a day, so my stools are soft, yet my bottom still ends up sore after going to the loo. I never really get any pain when opening my bowels. I experience the soreness like an hour, or so afterwards. There must be a pile there as well, as everything swells up. I've put up with this for 2.5 year's now, so I suppose I can wait a little longer for botox. I just cannot afford to splash out £80 on taxis. I could of paid the £30 for the taxi one way, but not both, plus another trip to a different hospital for an ECG. It is disappointing, but I can't unfortunately do anything about it. My DH offered to help towards the cost, but his credit cards are maxed out as it is. He has to put our food shop on there. His wage, which you could consider reasonable, isn't enough to even cover the basics anyway. Guess this cost of living crisis is affecting many.

Oh no @Chlobob27 that is a nightmare for you. Is there any other way of getting to the hospital like a bus so you can use the taxi fare to get back? I'm sure you've already checked all that out but it would be so helpful for you to have it.

That said mine didn't cure anything it just brought a bit of relief. So if you can't find a way it's not the end of the world.

I'm continuing to feel sore some days and not others. Currently struggling a bit but taking heart from the fact struggling a year ago would have meant screaming and crying but now means flinching and repositioning myself a bit!

I've still not braved the rectogesic because I'm a coward!

I live far away from the hospital. It's 3 buses or 2 buses and a train. They wanted me there for 7.30 am, which would mean setting off at 6.30 by taxi, or 5.30 by public transport and the buses and trains are terrible in my area.

Yes, I know that botox might not cure me. It may only help short term, so I won't stress. I'd much rather go up the road to my GP practice for an ECG and only travel to the hospital one way by taxi and get a lift home.

I'm very much like you. I have good and bad day's. I didn't do anything differently went I managed a month pain free either. There is no rhythm or reason with these things.

@Chlobob27 I’m so sorry to hear of your predicament over the Botox appointment. I know a lot of hospitals insist on you being driven rather than taking public transport after a GA. Are there any trusts that could help? We have a local one (W. Yorkshire) called Bearders Trust who give small grants to people to cover the cost of one off emergencies like needing a cooker replacement etc. Have you spoken to hospital transport to find out if they can help at all? I really hope you find a solution or failing that, a cancellation comes up very soon.

@Rhubarb7 sorry to hear you’ve relapsed. I hope it’s short lived. I can totally relate to the emotional impact of a relapse. It always feels like such a set back.

@Waxlyrically, I’m sorry you’re still struggling. Please brave the Rectogesic if you can. It’s helping me massively.

I’m doing pretty good (touch wood - I always relapse after posting!) I haven’t relapsed since I last posted which is the longest I’ve gone since this all started 8 months ago. We had a birthday takeaway tonight so a bit worried about tomorrow. Saying that, I’ve slacked a fair bit on the diet front but the milk of magnesia is working brilliantly. I’ve just stocked up on 3 more bottles as I know I’m in this for the long haul!

Hi @Migrainium, I'm in West Yorkshire myself actually (Leeds). I had a look in to hospital transport, but I don't qualify. It's only for the elderly that cannot walk, parent's whose children are being transport and so for those who need medical assistance for the journey. Unfortunately I would have to apply for a grant and wait for a decision, with no guarantee I would be accepted. I don't claim any benefits either, so I very much doubt I fit the criteria. The longest I've gone is 9m without issues, but that was when pregnant. I managed a month recently with zero pain, but I'm now in to a month of constant ups and downs (mainly downs).

@Chlobob27, that sucks. I'm really sorry you have to choose between your health and pain and putting food on the table. I can't believe this is the state of affairs in this country the 21st century, it's disgraceful. Nobody should have to choose between their health and their budget. It's utter crap (pardon the pun). I hope you find a decent solution somehow and that your mainly downs become mainly ups.

@Migrainium , thank you. I'm not sure what's going on now, there's no pain in between BMs, a bit of pain during BMs and a bit of bleeding but only for a minute or so, then it stops. Then I wait until the next BM. So it's not too bad, but I need to be careful what I eat, as if I eat anything carby (like a pastry or croissant), that takes me to a relapse. Sigh. So veggies and potatoes and salad and soup it is. At least I think I can still have a bit of cheese. Jayz! Fed up and just want my normal bumhole back!!! Wouldn't that just be the best early Xmas present?!

@Rhubarb7 I rang the hospital and cancelled. They're going to offer someone else the app at least. Hopefully next time they offer me an app (whenever that is), I can get a lift home and have the tests done at my GP practice, which would be more affordable. It is awful, especially since we're a working family. My partner works full time, has a degree and has what some would consider a good income. However, we pay a ridiculous amount to rent our home and everything has gone up in price, so it's stretched his wage. I noticed when I changed my diet and I tried to eat healthier, I was struggling to go to the loo, despite already taking Lactulose. It does sound promising though that you're only experiencing a little discomfort when passing a stool and nothing afterwards. I'm the opposite way round to you. I have zero pain going, but soreness afterwards.

@Chlobob27 , I wonder if you have an internal pile? Pain afterwards is sometimes associated with that. I don't know, I'm no colorectal expert, but have younl tried using anusol extra up there with the applicator? Just a thought and apologies if you've already been there done that! And it's truly shocking that a working family like yours are so financially strained....I just don't know where it will end up tbh. The cost of some foods in the supermarket is atrocious, I've found myself not buying some things that we'd normally buy because I just can't afford to spend that much on one item. It's crazy.

Yeah, my pain is only during a BM. I take Lactulose too. Do you mind me asking how much you take? I take 10ml in the morning and 15 ml in the evening. Its weird because I got into a really nice routine of having soft BMs twice daily and somehow now, it's gone to one BM that's quite big daily. And the other day I went 3 times!! FFS. Stupid body. Additionally I've got what I think is rheumatoid arthritis, just waiting on further blood tests, so my hands, wrists, knees, arms, shoulders and neck are all hurting. I eat paracetamol like smarties! Wonder if they may interfere with BMs.....hmm. Plus my thyroid is out of whack. I just feel a but broken at the moment. Want my health back. I was fine all summer. Then September came along and I got all these issues (plus a load of mouth lesions just for extra fun)!

I think I have a sentinel pile, which is often present with acute fissures. I think that's the cause of my discomfort, as I do feel a lump there that seems to swell and become sore. It was never mentioned when I was examines by a colorectal consultant though. I use suppositories and cream for piles. I get both on prescription. They contain a steroid and something for the pain. They do help. I have to use them immediately after using the loo though, when I'm having a flare up.

My pain used to be when passing a stool. I'd sit there griting my teeth. It's odd how thing's have changed and now I experience pain afterwards instead. No idea why. The standard dose for an adult is 15ml x2 a day, which is what I take. I'd look up the side effects of Paracetamol. Possibly they do affect your bowels, especially if taken regularly.

I'm sorry you've got other issues on top of this. It's not what you need at all. May 2023 bring you good health.

TLDR at the end.

Hi everyone. I'm booking a GP appt tomorrow (well a triage appt) as I can't cope with the pain anymore.

On inserting germaloid cream I managed to feel where the internal tear is and it's about the length from the tip of my forefinger to my first knuckle, so a good 2-3cms which then extends outside. I had a couple of days where I managed a bowel movement okay with the germaloid cream and lots of vaseline, but I think this was under false pretences as the BM was small so more manageable.

Apologies for the TMI (if that exists on a thread like this?!) but since having my baby 3 and a bit months ago, my BM's have increased in size, and I think a mixture of the size and being constipated for my first few bowel movements post birth caused the tear which has never properly healed since. I'm wondering whether because they're so big, using vaseline may not be a good idea as it means the BM is then rushing through which may cause more trauma as it's harder to control?

I have then found that over the last couple of nights, while breastfeeding my baby and wriggling and getting comfy in the chair, I then re open the external tear which makes breastfeeding so uncomfortable which makes me so sad and being in so much pain compounds the loneliness of the early hours feeds.

My husband is amazing, and he knows what's going on and is really supportive, it's just bloody awful.

I've got myself into a right sorry state tonight, leaking breast milk everywhere because I'm clenching my hands and arms together so hard to deal with the pain, crying and then bleeding from this tear.

TLDR: Anyway... Any tips on what to say to the GP and what to ask for to assist healing? Has anyone used laxative/stool softener to decrease the size of their stools?

Thanks in advance for any advice ❤️

Oh @USaYwHatNow that sounds so hard and no wonder it’s a struggle. I can’t imagine dealing with a baby alongside this. It will pass for us all though. I really believe that as although mine is still painful at times its not comparable to the constant agony I was in 12 months ago.

I use a softener daily with meals (Cosmocol) as otherwise my BM’s get too firm. Glad there is no TMI on here! I find vaseline just lines things rather than speeds anything up - too much fibre can do that though. Listen to the friendly proctologist videos on “torpedo poo” on you tube.

Have you tried hot and cold for pain relief. When things are at there worst I alternate between an ice pack (in a sock) and my heat pad. The heat pad has been a godsend - loads on Amazon that are reasonably priced. Maybe sitting on one for night feeds would bring you some relief and relax the muscles down there?

I would ask the GP for Diltiazem or rectogesic as these work for lots of people and stool softener (unless is cheaper to just buy)

I hope you feel better soon.

Ah @USaYwHatNow , I'm sorry you're struggling, it's a miserable condition this. I got Rectogesic from my GP which is a gel that increases the blood flow to the fissure (apparently we dont get much blood flow to the bumhole, and blood flow is essential for healing) along with docusate sodium gel capsules to help soften BMs. I also take lactulose every morning and evening to help me go and to soften BMs. Rectogesic is quite an intense gel and can give you a headache (I know it's weird for a gel to do that, but it does), so I didn't take it in two big applications as the instructions suggest, but applied it in pea sized blobs 4-5 times a day. I did still feel a bit woozy and had a headache, but that passed within 20 mins of applications. I can take it without any side effects now. If Rectogesic sounds too much, there is another cream that is similar but doesn't have those side effects, I can't remember exactly what it is called, think @Migrainium may use it, is it dilitizeam?? Something like that anyway! HTH.

I am very, very tentative about saying this, but I think my fissures may have healed. There is no pain when passing BMs and no blood. But I know I am still very delicate down there and the skin will be very fragile, so I am keeping going with lactulose and docusate sodium as well as my Rectogesic and coconut oil and sudocrem. Sometimes I just use vaseline and still use that before a BM to help lubricate. But it is sooooo good to think I have healed over! In case anyone wants to know, my routine has been sitz bath after every BM, application of coconut oil, rectogesic and sudocrem (once the fissures were at a stage where they didn't sting so badly, before that I was using coconut oil, rectogesic and a fissure oil called H-Fissure from Amoils over the internet.....pricey but I found it really did help) and lactulose morning and evening. I had botox injection done under anaesthetic on 28 Oct and really think that was a turning point in allowing me to start healing. So there is definitely hope for you all to heal, I think sitz baths have also been a real help to healing. I would have them 4 times a day, including after a BM, if I went for a BM twice in the day it would be 5 sitz baths. Really warm water but not hot. My sitz bath was £6 from amazon and I just wipe it with loo paper and a sanitiser afterwards. Time consuming but really, really helps.

Well, everything was going really well. I had more or less healed and stopped taking stool softener without any issues.

Then a few days ago I got one hard stool and I tore ever so slightly. And just like that, I’m back to square one. I’ve retorn every day since and today I’m very sore again

I’m still using rectogesic but you can only use it max 8 weeks and I’ve only a little bit left. I’m so upset with myself for getting complacent when I promised myself I would keep up with everything for as long as possible. I think the next step is to enquire about Botox but my GP told me I should go straight to private.

My relationship has just ended also (my decision but it still feels crap). So, I’m having a horrible time. I hope everyone else is doing well and will be able to enjoy the festivities