Anal fissure destroying my life

[clg74]

Please help, I've had an awful fissure on/off since giving birth in January. Every so often I think it's healing and get 2-3 days pain free then suddenly it feels like my insides are being ripped out when I go to the toilet. The pain is getting so bad I've nearly passed out with my last few BMs and I feel nauseous with the pain every single day. After BMs as well, the pain just lasts for hours and I can hardly walk or sit properly with it. I honestly have tried everything I can think of to try get this away. I bought Prep H and Anusol cream OTC which both helped for a few days but now nothing. I've tried Sudocrem and coconut oil too and at my 6 week check was prescribed Anusol ointment and suppositories. Everything helps for a few days then it all comes back worse than before. I really don't know what to do but I am in constant fear of going to the bathroom and in tears when I do. I feel horrible and disgusting and I don't know what to do to help this pain go away as it's honestly agony. Has anyone experienced this? Any other remedies out there? I definitely know it's a fissure as I can see it when I look with a mirror (TMI sorry). I can't take things like Lactulose etc as they just give me horrid stomach pains and cramps. I'm at a total loss with what to do but I can't keep on like this, it's agony.

Just keep doing what you are doing, no straining, lots of fruit and veg etc. Prunes and figs my doc said to eat. Quite like them now. It takes ages but does ease up in time, hope quickly for you though.

I'm so sorry you are going through this. I had a fissure for 4 years since the birth of my son and a surgical accident. I'm told mine was particularly nasty but it was is the worst pain i have ever experienced -and I have a very high pain tolerance. It just wore me down slowly, pass out pain for hours after each BM. I've had four surgeries to date and would recommend you ask about the Botox. Five months is long enough to suffer with this.
I think what works can be different for everyone but for me, the creams didn't work. I tried two and my surgeon said they work about 66% of the time. Water is a must but I would not advise going off the softeners so quickly. Find one that suits you. I have never been constipated and am very health conscious so, for me, increasing fibre just results in more BM meaning the fissure cannot heal. I've kept a detailed food/movement diary over more than a year and there is always a time (usually around AF) when I responded more unpredictably to foods that helped any other time. I eat the recommended amount of fibre and use movicol and it removes any inconsistency, which is essential. Find a doctor and surgeon who listen to you.

I’ve just noticed you’ve been prescribed Senna. That isn’t a stool softener, it’s a laxative, and NOT appropriate for a fissure IMO. It does give horrible cramps. Bloody GPs

Please get yourself some Movicol or Laxido. You won’t get any cramps and it’s really effective. You need to be taking a softener daily until the fissure is completely healed.

Hi, I had fissures after my first child, it was truly awful. I tried everything, went to my GP and in the end what worked for me was magnesium tablets. The day after taking them, the pain was massively reduced, no constipation problems (they are an effective stool softener) and I just felt so much better at being able to have a shit without screaming. Some brands are more effective than others, so may be worth trying a few if you need to.

Buy the packets of juicy soft hydrated prunes, I think the California or Waitrose ones are best. Eat a couple before every meal, chew them well.
Take a bath after every BM or use the shower attachment to keep yourself scrupulously clean. This will remove the pain.

How are you doing OP? Are you feeling any better?

@MissTulipan very sore! Had a week and a bit pain free after buying some proper stool softener and felt much better. After BM yesterday however I am in agony again and dreading the toilet. Think I will have to make another appt as I cancelled my other one last week as had no more pain. Just my luck!

Are you keeping up with the stool softener? I find missing a dose can really cause problems.

Oh dear, it’s miserable isn’t it. Ask for Rectogesic, the GP can prescribe this. Try and get a referral to a specialist as well, my gp offered to refer me straight away and even if you start to feel better keep the apt just in case pain comes back.
I’m booked in for Botox now in few weeks which I’m dreading but just have to hope it heals me x

I'm so sorry you're still suffering OP. As I said upthread the thing that worked for me was diltiazem cream. My fissure developed after a forceps delivery. When the HV came and did the postnatal depression screening questionnaire I came out as severely depressed. I told her that it was purely due to the pain I was in and that if the pain went I would be fine. I remember sobbing to DH that I couldn't cope with my bottom for the next forty years and I did have suicidal thoughts. My depression score however meant that things got moving. The HV called my GP there and then and she prescribed the cream as well as co-codamol () for the pain! (Needless to say I didn't take those!) The cream started working fairly quickly and the GP also referred me to a specialist.

What I'm trying to say is that although this feels awful now it will get better once you have accessed the right treatment. I hope you have a sympathetic GP and that you can make him/her understand just how much it is impacting your life. Please make another appointment and stand your ground and ask to be prescribed the cream and referred on. I can happily say I rarely give my backside a thought these days!

@MizCracker yes have been taking it daily since switching. It had been helping but suddenly got worse again, not sure why

@MissTulipan I'm going to call tomorrow. Due to go on holiday on the 23rd so hoping I can at least get something before that to help sort me out. Good luck, hoping it goes well for you x

@QueenCity I had a forceps delivery also so I'm wondering if it might be related to that. As if the delivery and stitches weren't bad enough! I'm glad you got sorted so quickly. My partner recently said to me he thought I was developing PND but he said that after a few weeks of pain so I think it really is affecting me more than I realise. I'm going to phone up for an appointment tomorrow and hope they can see me relatively quickly (last time I got in trouble for making a same day as it wasn't classed as urgent). Thanks for your help!

I had a similar problem and I definitely found putting my feet up on a stool whilst having bm reduced the pressure and pain considerably.

What stool softener do you use? I have the same problem but for twenty odd years now and I'm fed up of doctors fobbing me off with otc haemmeroid treatments. I dont want to use a laxative for fear of diarrhoea as that makes the fissure worse!

I was using milk of magnesia as recommended by someone on here and also lactulose. My GP told me to stop these and eat prunes and figs so I now do that daily plus lots of fruit and veg and I eat less as well, smaller portions. Have lost 1 stone in the year or so of having a fissure. I also use a foot stool and drink lots of water. I think consistency is key.

Is there blood when you go?
I have had one on and off for about a year. I recently found out I was anemic and given iron tablets. A side affect for me was very loose bms which has helped with the pain a lot.

A couple of bags of salad greens (spinach, lettuce etc) a day, wheat grass juice powder in drinks for extra minerals like magnesium & potassium. A supplement you could try is an enzyme called 'Serrapetase'. I'm taking it for leg problems, but it's meant to be great at healing your body anywhere.

Oops 'Serrapeptase', should read

@cig74 what's your diet like? Are certain foods making it worse? Certain actions? When you're more or less active?

Is the fissure being made worse because you're constipated? Definitely get seen as the softener will help but it's not enough to close the fissure.
Hope you feel better soon. It's agony, don't know how you coped since January.

@user1493841671 yes blood when I wipe. I'm anaemic too since having my daughter but iron tablets make me really sick and constipated so don't seem to agree with me.

@Itsmeaga1n I've been using Dulcoease. It's very gentle, not had any cramps or anything with it.

@GourmetGold oh I haven't heard of that, I'll have a look and see, thanks. I'll try anything at this rate!

@grandmainmypocket my diet is ok but I've been trying to improve it and add more high fibre foods. I haven't noticed any patterns at all, it just seems that when I start a new treatment it helps for a few days then I suddenly have lots of pain again. The softener I bought has been helping a bit the past few days and I've had less pain than usual. Trying hard to get a doc appointment though but as I'm on holiday next week it's proving difficult to get seen this week and waiting till August seems so far away.

Op you have to get to the gp!! Over the counter treatments won't heal a fissure that you've had for this long!
Phone tomo. You totally don't need to go through this! X

I had one of these after giving birth and oh my god the pain was horrific. Mine only lasted a few weeks.

I remember the GP prescribed cocodamol which made it worse. I remember having an ointment which I applied which gave some relief. Also lactulose to make your poo softer may help?

Poor you, it’s excruciating. Please see someone for some help soon xxx

Found this while sitting on the toilet in pain . I have a bunch of prolapses (cystocele, rectocele, enterocele, intususseption, mucosal rectal prolapse and bladder falling and uterus) but I also have 3 fissures and they’re the absolute worst. I’m now on oramorph because the pain was making me start to feel suicidal (they’ve also caused haemorrhages that have needed a transfusion to sort)

So... my tips.

Never use toilet paper, only wipes and you can put them in the fridge

Get instillagel prescribed and put it in before you poo

Try and get prucalopride, it’s changed my life

Never strain