Healing anal fissure

[OliLondon]

Hi,

I've been meaning to drop this message for a long time, with the aim of helping anyone feeling as desperate as I was, with ongoing pain and thinking if surgery or botox was the only answer.

I went to see a private GP thinking I had hemorrhoids - something I suffered from for two decades since my early 20s - and has been applying Anusol for about a month. It turned out it was a fissure, something I didn't know the existence of until then.

This was in February 2019. I applies the GTN ointment prescribed by the GP (can't remember the name) for 5 weeks. Had a very bad headache in the beginning and felt awful. As it wasn't healing, I asked to renew the prescription for another 5 weeks.

It wasn't effective, so I started looking into any alternatives available out there and searched through every single forum for people sharing their experiences: Bepanthen, Hemosan, some wheatgrass pills + cream, hot salt baths, you name it, I tried.

Eventually, I came across an Indian research in which they had successfully treated over 65% of the patients with an olive oil based mixture. Then, I came across some other info on bee wax.

Three steps that you need to take simultaneously:

• bee wax mixture

(and you need to heal from inside!)

• change of diet
• supplements

So here is what I did in July 2019: I prepared my own little mixture of bee wax (quite expensive - get the best and sustainable that you can find) and some drops of olive oil. I applied that 6 times a day and after each passage. Then, I gradually reduced as I healed.
Bee wax is extremely healing on wounds!

If you are reading this post you are most probably concerned and, as you know, after each passage, the fissure opens and bleeds again. It's never ending. So you need to change your diet. This basically means adopting a plant-based diet. No junk. Not even vegan junk (yes, it exists).
Avoid gluten and legumes (at least until you are totally healed). You need to free your intestine.
Search for recipes on google, do a juicing/smoothie day in the week. Eat any fruit and any veggies. It's a lot of reeducation, but this is for your own good. Always start your day with a pint of warm water with half a lemon, wait at least 20mins before eating your breakfast - fruits!

Parallel to that, invest in tinctures/extracts: Dandelion, Milk Thistle, Cat's Claw, Burdock root, Nettle. Take a dropperful of each with some water. You can also drink those as tea.
Add herbs to everything you eat: coriander, parsley...
Get turmeric tablets (good quality with pepper)
Make yourself a gold milk in the evening (google for recipe, but use a plant-based milk, forget dairy = mucus).

Lastly, drink lots of water!

I was in pain every day of my life for 6 months. Some days I wondered if I was going to get through my journey to the office in the tube. Some days I screamed in pain with the spams and cried in desperation. Most often, I couldn't sit down!
There is hope! Good luck! xx

I have started taking double the amount of lactulose which is around 60-70ml per day to keep my stools watery soft otherwise it was hurting me as well. I am not sure if it’s the right thing to do but that is my only thing that has stopped the pain

Hi just checking in how are you doing @Emeralds65

Hi @mumof2bambinos I am doing well these days. Thanks for asking :)
Taking laxatives everyday, 2 fybogel sachets + 2 movicol sachets a day or 45 ml lactulose).
I try to eat one meal a day and start my meal by having a big plate of salad. So far so good and I haven’t had any bleeding or pain for a couple of weeks atleast. I can feel my external piles when I clean myself but no fissure and no pain.
Have you managed to find a bit more relief?

@Emeralds65 so good to hear! Keep at it and hopefully soon this will be a distant memory. Im still struggling. I was going to try the fybogel sachets this week but i wasnt sure if they will loosen my stools or bulk them up. I need them bulking. Whats your experience with them...im guessing your using the fybogel to bulk and the movicol to soften

I kind of think that’s why I am doing it I.e, to bulk it up and still be soft.
Bit of trial and error really.
Some days I have forgotten to take fybogel but have taken movicol/lactulose and had the same effect so I am not sure actually. I am so paranoid about having a hard stool, I don’t go to sleep without taking atleast one laxatives. I carry them in my bag just in case. I don’t know whether this is a way of living my life but having a soft BM seems to be my life goal currently. I try to eat lots of fibre like salads, pine nuts, cashew nuts, pistachios, fruits etc and try minimising carbs like rice and bread which originally made me suffer.

@Emeralds65 i found that when i only took movicol that made my stools thin but i preferred it as it didnt irritate the fissure. Bt then my bum has got used to it and now cant go back to normal. I might give fybogel a try and see if it works

@mumof2bambinos how are you doing?
hope you are feeling better.
I have a surgeon appointment today and I am dreading it, planning to say no to the internal exam and hope she is understanding enough to read the previous reports and doesn’t insist on it.

@Emeralds65 hi good luck for your appt. And absolutely say no to the internal exam. I retore the fissure this morning so on a bit of a downer. Have my crs appt tmro thats if they dont cancel it. At this point id have any surgery just to heal this damn thing. Any stool thats thin or hard just retears the area. Im so fed up.

oh bless, hope you feel better soon. This is a private appointment as I got fed up of waiting for NHS. My case isn’t a priority for NHS and I can’t keep living the life like this when I am scared of all the food but I also want to eat so much.

@Emeralds65 absolutely know how you feel. The nhs is ridiculous. I got me gp to expedite the referral so many times but when i rung hosp they said im not an emergency as theres people with cancer. And whilst i agree i dont think they understand how badly this can affect every day life. Hope your appt went well. Let us know how you get on xx

So I went to this consultant colorectal surgeon and she has said that she will write to my gp so I can have a fecal calprotectin test on NHS as she thinks I may need a colonoscopy and she can do the excision along with the colonoscopy. I have strong family history of IBD hence her asking for the stool test. She will also ask the GP to refer me to her. Whilst it is good news, I am not sure the GP will listen as they will just tell me that they have already referred me to the local hospital and this consultant works from St Marks Hospital in London which isn’t my local
hospital. I went to the private wing for St Marks.

@Emeralds65 hey i hope you manage to get the gp to do the referral. Colonoscopy is a good idea at least it will give you some answers. And stool sample sure. I just went to my first crs appt. Told her about my stools being thin and fissure never healing. The blood etc. She checked my bottom with her finger and man did it hurt! She wasnt even gentle. She goes its a healthy bottom and i cant see a fissure. And it doesnt matter if your stools are thin. Shes going to refer me sigmoidoscopy or something like that. But that can take 6 weeks she said

@catsandkid heyy how are you doing. Are you healed xx

@mumof2bambinos Yes, no pain during BM or during the day at all now. It lasted about 5 - 6 weeks straight, and I started using GTN around day 8 or so, and then used Diltiazem at around week 4 maybe (twice per day) and that seemed to really help (or perhaps it was just the passage of time). Still taking Laxido x2 sachets per day and my magnesium tablets, but I've done so for 7 years now as the fissure was from giving birth to DS1. I wouldn't be able to fully come off Laxido as it would probably open up again due to the scarring etc. In the next few months I'll wean down to 1 or 1/2 Laxido sachet though and then I just adjust accordingly to make sure BM is always very soft (TMI but mushy is what my colorectal surgeon previously said to aim for (he advised against bulking laxatives) and that does work best for me!).

How are you?

@catsandkid hi thank you for replying. So glad to hear you are healed. I have had this stupid fissure for a long time now. I got it to heal and was having mushy poos and stupidly i got it into my head that this poo needs bulking. I started bulking my poo up and it retore so bad. So am back at square one. Is it safe to take laxido for a long time. When i started taking laxido my stools started becoming thin and i worried that there was something else wrong. When in fact is was just the laxido effect. Can i ask what magnesium you are taking please. Theres so many diff ones like oxide and citrate. Im not sure which one to take

@mumof2bambinos Yes I've asked this countless times to both my GP who prescribes true Laxido and my colorectal consultant... even checked again with my midwife and Ob consultant when I was last pregnant and all say laxido is safe and absolutely fine to take for long periods. Those with IBS-C, chrons or types of IBD take it forever if it helps their symptoms and makes BM predictable. So honestly stop worrying about it.

I just accept I'll be on it for life. I don't mind that at all as I rarely have any fissure issues (a few relapses in past 7 years but only the most recent lasted more than a week) and it's worth it!

I take magnesium citrate. It helps my sleep and mood as well as assisting the laxido in bringing and keeping water in the colon to keep BM mushy (regardless of what I eat... so I can then eat a normal diet instead of worrying about eating constipating food)

*the not true!

@catsandkid im absolutely kicking myself for bulking up my poo..which was an epic fail. Thank you for that. I do remember on laxido i was eating anything i wanted. But before that i was so miserable because i couldnt do days out with my kids cos of the pain or eat holiday food etc. I was sticking to boring fibre meals. Can i ask did you have any more kids during the time you had your fissure and was on laxido. I want to have another one but i am too scared. Esp giving natural birth

Hiya again.
@mumof2bambinos so so happy for you. It feels like a new life when all is well down there.
I missed one dose of having Dulcoease and I am back on having internal haemorrhoids again. So annoying!!
Can I ask is Laxido the same as Movicol?
x

And does it make you go more than once a day?
and you are right about bulking up stool, I didn’t realise I don’t need to do that. Once I did I stopped taking Fybogel and I felt better.

@mumof2bambinos Yep - I was also petrified of having another pregnancy and birth, but yes we did have another. I fell pregnant when my first had just turned 4. I kept on laxido throughout pregnancy (increased dose a bit in first trimester to combat any constipation from hormones) and I also had an ELCS as the thought of pushing a baby out filled me with fear (NHS wouldnt agree my fissure history indicated a medical need for ELCS, but I pushed for one and NICE guidelines allow the mother to choose anyway so they had to agree)! My ELCS was wonderful, and as I knew when it was happening I ensured I continued to take Laxido and again, increased dose a little in days afterwards to combat any constipation from the spinal/epidural and morphine. No issues whatsoever during pregnancy or after the birth. My youngest is now 2.

@Emeralds65 Yes, Laxido Movicol and Cosmocol are brand names for the same medicine. It's literally all the same. It's very gentle on stomach and it has no stimulant laxative effect so thats why is considered safe long-term - all it does is bring water into the colon and bowels to keep the BM soft. I go once per day taking between 1-2 sachets each day - its also incredibly predicatble which is nice. I take both sachets together in a pint of water at night along with the magnesium pills and wake up around 7am and go to the loo straight away and that's me done for the day!

When my fissure relapsed in June/July I upped dose of laxido to 3 sachets each day (from my maintenance dose of 1/2 sachet) and it did make me go multiple times and that wasn't great tbh. I should have increased a bit slower in hindsight!

@Emeralds65 hi yes laxido is same as movicol. In the uk its movicol and in us its mirilax. But all the same thing. No it doesnt make you go more than one. When i was taking a daily sachet i was only going once. And it was such relief. I stupidly decided to have fybogel and psyllium husk to bulk it up. And now realise i didnt need to. So im hoping i heal and get back to where i was

@catsandkid thank you so much for sharing your experience. Its so reassuring to me. I had an emergency c section with my first and a vbac with my second. So im assuming opting for a c section should be ok for me since i already had one. I just wish there was more info from midwives about postpartum constipation as this is what caused my fissure. That constipation after birth is something else!