Fissure pain...how long to heal?

[Nancynew]

I was wondering if anyone else has had the misfortune of experiencing anal fissures (sorry!) after childbirth/constipation following childbirth, and could help? I have posted on similar before (as it is an issue which causes me a disproportionate amount of distress sadly). What I wondered was has anyone else experienced them and found that they did heal on their own? I had DD1 nearly 5 months ago, and the fissures are still painful and a fair amount of blood. I am sure I am doing the right things with regard to fibre and liquid intake IYSWIM and have a proctosedyl cream from the GP. Sometimes the fissures seem to ease up, but rarely for more than a couple of days and then they flare up again. They are bad again right now. I did wonder if when I ease up on breast feeding if this might help? I only say this because when I went to see a consultant about slow healing second degree tears she said the tissue was thin, "which is to be expected whilst breastfeeding". Are they likely ever get better after 5 months of pain (which feels like an eternity!) I will go back to the GP, but wanted to give it some before doing so. Not sure what else I can do, but the prospect of fearing the toilet forever is really worrying me.

I had a fissure which (touch wood) has healed with proctosedyl and I have stopped taking fybogel and lactulose. I can't suggest anything, but I did find out that slow healing is due to low oestrogen levels following pregnancy and during BF. My GP gave me the proctosedyl and said come back in 2 weeks if it isn't better as using it for a long time will cause more problems.

I really hope you get better soon.

Nancy, I had this and you have my sincere sympathy/empathy as I can recall with horro the pain from the spasms mine cause and the shock and seeing the bleeding. My doctor prescribed glyceroltynitrate (GTN) which is a drug used for cardiac patients in a cream form but had a nasty sideeffect of headaches.

So I ditched this and after lots of research decided I didn't want an operation so persisted with a high zinc cream - sudocrem would you believe! I used it half a dozen times a day every day and eventually it did heal on its own. If you google the subject you will find some really good support sites but just be aware that it may throw up some adult content results!

LJ29 thank you for your glimmer of hope. I am running upstairs for the sudocrem now! Really sorry to ask (TMI), but did you put the sudocrem directly on the fissure i.e. just inside?

I put it anywhere I could get it! Mine was also complicated with piles which did return with subsequent pregnancies but thankfully not the fissure.

I've got another fissure and I feel.your pain. I had a third degree tear when I had DD four years ago and developed the fissure later. I eventually had surgery where they injected botox into the area to paralyze the muscle so it could heal. I'm currently on the Gtn cream and the headaches are a killer. L29 can I use sudocreme as well as the Gtn? I'm considering surgery again as the pain is so bad :(

Sorry LJ29

Nancy - I too had that nitro stuff and the headaches were awful. What sorted mine out (finally when DD was about 8.5mo IIRC) was taking Movicol (amazing stuff) twice a day to ensure that everything coming out was nice and soft, and the same cream you are using. I am now free of pain, blood, movicol and cream and a much happier person for it! It is such a grim and painful thing, but it will pass (no pun intended )

In fact I think I posted on your last thread too :)

I'm not sure BBT because I resorted to the sudocrem due to not being able to cope with the gtn so I had stopped using it when I started. Maybe ask a pharmacist?

I think I will have a chat with them tomorrow. I've got a prescription for movicol but I've been reluctant to take it as I have IBS and get diahorrea at the drop of a hat.

Yes, hello again TitianTinselTemptress and thank you for posting again. Like BBT I have been a bit reluctant to take stool softeners as I had to stop taking Lactulose as it made me go so often. However, perhaps Movicol might work in a different way and not have this side effect - I remember you said that Movicol was better than Lactulose. Can you get Movicol from pharmacies or is it only on prescription?

I got mine on prescription but it is worth asking at the pharmacy to see I'd you can get it.

You know what, I have some spare that I can post you if you like - pm me your address, tonight if poss, and I will send you it!

Tis a subject close to my heart as you will all understand so anything to help a fellow sufferer :)

Why not start with a half dose and see how you go? I was taking a whole dose morning and evening but you may well not need as much.

It looks as though you have been offered lots of good advice, but I wanted to offers my sympathies. I had a fissure after having DS two years ago. It was honestly the worst thing I have ever experienced. From what you and others have said it sounds as though I was lucky in that mine seemed to pretty much heal up within two weeks of using the proctosedyl cream. I had an appointment about eight weeks later at a 'bottom clinic' in the hospital where they checked everything. I was told to continue with the cream and go back if it was still troubling me and I could have the botox injection that someone else mentioned. But tbh I don't think I used the cream at all after that as I wasn't in any pain.

If I were you I would keep on at the gp until they get the problem fixed.

Best wishes

Thank you so much TTT. I would like to check with my GP about Movicol's suitablility for me first, given I seem to have quite a sensitivity to Lactulose . I am so grateful for everyone's advice, and it makes me feel less on my own, and not exaggerating the pain and anxiety these horrid things cause - honestly I thought no pain would worry me after the birth, but it seems that was easy compared to this (and it really wasn't!). I really hope I can post back with some happier news soon. Hope you are coping okay BBT?

Hi - coping not too bad at the moment. Only problem is I'm back to work today and so can only use the GTN cream at night as the headache is too bad to be going to work with. I'm a bit worried as I've been using the cream for 4 weeks and the pain is still pretty bad

Hope your gp says that movicol is suitable for you and that it helps. You are NOT exagerating the pain. It is bloody awful. Hope you get some relief soon.

Funny how nobody talks about this sort of thing when you are pregnant. Can't recall seeing an article in those nicey nicey preganancy magazines about split bums

That is probably a good idea, twas a bit hasty of me to tell you to just try it and see!

BBT

I had a 50 hour labour, a forceps delivery, lots of stitches, lost 1.5litres of blood, had a dural tap (excruciating) and then a d+v bug when bf DD was only 3 wks old. I can honestly say that the fissure was by far the worst out of all those things! So you are not exaggerating at all.

Good luck to both of you :)

Nothing to add but lots of sympathy. I am at last getting my second fissure under control and as you know, it's utterly unspeakably painful. Luckily for me lactulose has sorted it along with 4 slices of brown bread each day and two extra pints of water on top of usual drinks. It's hard to get the balance between softer poo and passing so frequently it keeps opening up. I really hope you get better soon - keep on at the GP.

I have suffered with the same problem for over a year following a difficult delivery. I was prescribed lots of different creams including the headache one (horrible!) and felt like it was just getting sorted when I got pregnant again and it has reoccured with a vengence! Movicol makes it just about bearable. I am dreading giving birth and making the whole thing even worse!!! You all have my sympathy, it is horrible, but it's good to know I'm not the only one!

hi- i had been wondering tonight if i may have this - i gave birth 1 week ago and when i need to go to loo get a really bad pain in my bum - like a spasm - i am taking lactalouse and have been able to go to the toilet, but get pain - no blood - please let me know if you think this could be fissure or am i jusr recovering 2nd degree tear x

Juliec26 the pain I have is a cutting pain - it feels like the BM is sharp / scratchy(sorry TMI). I sometimes get blood, sometimes not. I too had a second degree tear and after only one week post birth everything was painful! Could be piles too?You have my sympathies. I actually bought myself a mini bidet (you put over the toilet) which I LOVE. Sitting in some warm water after a BM is really soothing and helps keep the area really clean, and with a little one I don't always have time to run a bath. Usually fissures resolve themselves without medical treatment, but if it doesn't improve it would be worth seeing your GP as there are creams they can give to help, although the more powerful ones not suitable if breastfeeding I believe. A GP will also be able to tell you if it is a fissure. Drink plenty of water to make sure movements are soft, especially with tearing. I found holding a pad over the torn area when having a BM helped. Also I found lactulose helpful initially, but then it made me go too much which made everything worse, so just keep an eye on this (but I have a history of IBS so I think I might be a bit intolerant of it). All the best. It really is the last thing you need with a new baby to look after I know. Congratulations on your little one. x

I had my son 22 months ago and still suffering from fissures, I just had THD surgery for internal hemmroids that never went away cuz i pushed for bout 3 hours.
i had an episiotomy which extended and i believe i got stitched up too tight :( My muscles in my whole perenium keeps spasming and tightening all the time without my control, it keeps causing fissure to come back and never heal, i guess ill need to take stool softeners for the rest of my life then..intercourse with my husband is ok, we just have to use lots of lube..lol. I dont know what to do, its my first child and this has put me off to have another one.

Hello.
Stumbled across this thread while desperately looking for answers. It was posted a while ago but am hoping to get any answers!
Glad to see I am not alone when it comes to the pain from anal fissures.It has ruined my life.
My babygirl is 7 weeks old and I feel like I can’t enjoy motherhood.
Just looking for answers on how the fissure eventually (hoping so) healed and how long did it take. Is there light at the end of the tunnel?
I am currently on movicol and applying sudocrem which I found to have helped. Pain has eased but how long do I continue with this routine.
Any answers would help xx

@Samouha2566 - I suffered terribly for 4 months after having DS. Totally ruined my whole early motherhood experience!

Ask GP for Rectogesic or Diltiazem. These are ointments specifically designed for slow-to-heal fissures. GPs are bloody terrible when it comes to fissures and more than one fobbed me off with hemmoroid cream which was useless! You have to use the Rectogesic for 6 weeks (2x day) and its a bit grim but it is the only ointment that will actually help and also takes away the pain somewhat.

Also, mine didn't heal until I was taking quite a lot of Movicol each day (2.5-3 sachets!) to make everything VERY soft. I kept this up for a few months after pain went away just to make sure that I didn't retear, then I reduced down. I do still take it now though, 4 years on (1 sachet/day) but I think this is because my bowels were never as regular after having DS (and I was prone to constipation before DS so likely just an issue I've got).