Chronic anal fissure, TTC and GTN

[gloveson]

Hi all,

According to coleorectal specialist I have developed a chronic anal fissure that has an associated sentinel pile. Got it from bad constipation at end of last year when pregnant. I went on to MC at 8 weeks on New Year's Day and now have this issue. What a start to 2021.

I'm being prescribed GTN for 8 weeks which obviously puts TTC on hold which at 36 yo I am devastated about.

Pain going to loo is pretty bad but can be up and down. Not as bad as some of the descriptions in here but now have this horrible sentinel pile. I actually think I've suffered on and off from this in past but misdiagnosed with regular piles.

Please someone tell me it gets better? I want to get back to TTC but at same time I need to be better!

Botox never worked for me long-term. But Google Anal Advancement Flap, I had that 13 months ago and it healed me after 7+ yeara of agony.

@Dreamer1989 how long did botox last for u before it came again?

@Cremebroule about 2 months each time

@Cremebroule hey i know this thread hasnt beem active but just in case you do see this can i ask if you are still healed . I am looking to go down the botox route after suffering from this fissure for 16 months - joys of childbirth

@mumof2bambinos sorry about the pain ur going through. It’s definitely worse than childbirth itself. And Yes I am still fully healed :) it worked perfectly for me. Hopefully you will be the same. I know how disruptive it can be to life.

@Cremebroule thank you so much for replying! And so chuffed to hear its still healed. Its given me hope. Are you still taking laxatives or just eating a normal diet

@mumof2bambinos after the procedure, I took laxatives for around 1 month just because I was still paranoid. My dr told me after my 2 week check up that I was fully healed and can stop. But I was still so scared it would come back and that horrendous pain will start again. After I started feeling normal again I stopped and life was back to normal and has been since. I had 2 fissures opposite each other. It’s been over 2 years now pain and fissure free. I had a specialist with over 20 years in anal fissure do the procedure.

@Cremebroule thank you for taking the time to share your experience. I cant wait to start feeling back to normal. Fingers crossed the botox works well for me too. Xx

@mumof2bambinos no problem:) wishing you pain free days soon!!

Hi, another one here reviving the thread!

The updates are really helpful @Cremebroule and I'm so glad the Botox worked for you!

@mumof2bambinos how are you? Did you end up having Botox and if so how was it?

I had an EMCS in September 23 and the bastard dihydracodeine gave me horrendous constipation which lead to a fissure. Worst pain I've ever been in. I had a small external haemorrhoid in my last trimester but didn't cause me any gyip. I've been to drs who confirmed a small external haemorrhoid or skin tag? She couldn't feel any internal haemorrhoids or see any fissure but I'm definitely sure I have on somewhere inside.

She prescribed me Laxido twice a day for 2/3 weeks and Scheriproct for 10 days. Stool is soft and easy to pass with minimal pain but there is still a little pain. And it's feel so uncomfortable for hours after a BM.

In due to go back to GP next week and anxious as to what she'll suggest..

I hope there is another cream or ointment I can try but I am limited as I am still breastfeeding. Also I feel it needs to go inside not on the outside.. I have a needle phobia so HATE the sound of Botox up the bum but as least it appears they do it under general. Still, doing all of this with a small baby 😩.

Anyway, just wondering if you're both okay and healed?

@scoobysnaxx hey hope your well
I had the botox procedure done..not sure if i have fully healed yet as my stools are still very soft. My issue is when the stools are formed they tend to retear the fissure even when its soft

Have you tried rectogesic/gtn cream althought am not sure if you can use that as your bf

@mumof2bambinos hey thanks for replying! I really hope the Botox heals it for you, but I can imagine the anxiety thinking about stopping the stool softeners.. re-tearing must be awful.

I went back to the dr (a different one) and she examined me and said she couldn't feel a fissure. She could only see and feel a small hemmorhoid that was partially inside and out. The other dr that examined me also couldn't feel a fissure. I felt for sure there was one and it really felt like a cut!

Anyway, she prescribed me the scheriproct suppositories and they are helping a lot more. Continuing with Laxido for next few months.

If I don't have a fissure which apparently I don't, I can only imagine the pain. The impaction I had after childbirth and the sheer pain when going and after, was the worst thing I've ever felt!

@scoobysnaxx fingers crossed you dont have a fissure. Ive never known pain like it. However i had multiple finger exams and they said theres no fissure. Then i had a finger exam by a crs and she said no fissure. Had a sigmoidoiscopy and they said they cant see a fissure. I was adamant i had a fissure. The symtptoms were that of a fissure. Finally i went for EUA and they confirmed i did have a fissure. Sorry to share this with you. I suppose my point is if you still feel like its fissure pain get an EUA xx

@mumof2bambinos oh god that's awful! That must've been disappointing to hear but also a relief in a way as you knew that's what it was!

I'm really feel much better atm with no pain when going and no discomfort after, but I will be continuing with Laxido and tapering off this very very slowly.

I really hope the end is in sight for the both of us!

@scoobysnaxx hey just checking in how you are doing xx

@mumof2bambinos hey thanks for thinking of me!

I finished the scheriproct suppositories and they helped while taking them. The last few days felt back to normal. A few days later I'm sure the pile became slightly inflamed again and was sore for a few days. Again some discomfort when going and for hours after. Still taking laxido.

I've bought some germoloid cream and trying to use that daily, just to see if it helps, along with more time.

I'll def go back to the GP in a few weeks tho and get examined again. Really hope it isn't a fissure!

@scoobysnaxx hey how are you doing xx

@mumof2bambinos hey thanks for messaging. Hope you're well!

The arse saga continues unfortunately 😔

After finishing the suppositories I continued for a while with Laxido twice a day and and some germoloid cream (as I felt the anaesthetic in it help numb it a little).

Mid February I had 2 straight weeks with NO pain. No pain during movements and none of that burning pain for hours on end afterwards. I literally felt back to normal.

Then I had a movement and felt that pain again. It's not major pain, but you can tell. It feels like a cut that's being reopened. Then the hours of after pain returned.

I spent 20 mins on the phone with my GP early March (well it was a paramedic doing an urgent telephone consultation) as I'd had enough. I told him I am convinced I have a fissure. He asked if I thought if I would benefit from another exam and I said no. It's uncomfortable and 2 different Drs have identified 1 pile that's internal/external and no fissures.

He asked me what I wanted and I said I want to treat this as if it's a fissure. What would you prescribe? I mentioned GTN ointment and calcium channel blocked.

He looked up the treatment for fissures. And none of the above are advised for use in pregnant or breastfeeding women.

He asked me when I was planning to stop breastfeeding and I said I'd start weaning at 6 months (in a few weeks) but had planned to continued breastfeeding until ready to stop.

So we agreed I'd continue with laxido twice a day (I've upped it to 3) and he advised I used the scheriproct ointment again (this time using the internal applicator - I didn't use this last time as I was too scared of making the fissure worse!).

I've just finished the course of scheriproct- no difference.

In fact today has been a particularly bad day. I didn't go to a baby class as I couldn't face sitting on the hard floor. My gait is even affected!

I'm sitting here getting my baby to sleep in my arms and I'm so uncomfortable.

I can't done on like this much longer. It feels like I'll never be normal again. I am upset and angry at the fact that I might have to stop breastfeeding earlier than I want to because I need to get my arse sorted.

How are you doing??

Also - did you get put to sleep for the sigmoidecromy, the EUA and the Botox? General or local?

I have a bit of a thing about pain/procedures and would rather get knocked out if it comes to it! Xx

Hey @scoobysnaxx ..just jumping on here to add that I know what you’re going through and it sounds like a fissure. Horrible that you can’t take anything while breastfeeding. When I did Botox, I was completely knocked out. I had pumped before so baby had enough milk till I woke up.
I pumped after surgery and got rid of the first batch but resumed BF normally after as instructed.
I hope you can get through this asap xx

Hey all,

Sorry some of you are still struggling, it really is so so awful. I felt like mine controlled my life for years and my mental health really suffered. Last time I posted I was thinking about baby no.2 but scared of coping with a pregnancy and birth. Well, after GTN had my pain easing off a bit for a couple of months I fell pregnant and was so relieved to say that whilst I still had piles, I stopped having fissure issues during pregnancy!?! It was still a bit sensitive but nothing on life pooping glass on a daily basis!!! The weird thing is, my fissure eased off during my first pregnancy too, I wonder if it's the additional blood flow that helps things to heal. Anyway, I was still a bit petrified about the birth reopening them but to my shock I naturally birthed a huge 9lb 12oz baby and haven't had a problem since!! That was over a year ago now and somehow everything has stayed healed!? I spent 6 years in agony only for it all to be over just like that! I do wonder if birthing such a large baby moved things down below to a degree where the vulnerable and scarred skin has now moved away from the rectal muscle and that could be why? Whatever happened I never imagined this would be the outcome, I was 100% sure I would be facing surgery once I'd finished having children so I feel incredibly lucky. I'm sorry if this isn't very helpful right now but I just wanted to offer my story for a bit of hope because I never expected that they would simply go away without significant treatment! It seems a significantly sized baby did the trick!?! After 6 years of hell!!

@scoobysnaxx With regards to GTN whilst breastfeeding, I suffered greatly until I stopped feeding my first at 15 months and the gtn cream helped significantly! It didn't fully heal them but gave me periods of time where I was much more able to cope and pain very much reduced. If you want to keep your feeding journey going, would it be possible to pump enough milk to see you through a short stint of GTN and then pick it back up again after a few weeks of treatment? Maybe keep pumping during to keep supply going? It sounds like an enormous effort and I'm aware it's not always as easy as that - mine never even took a bottle! But just a thought that might help. X

@scoobysnaxx heyy i had botox under GA and didnt feel a thing! However i still dont think its healed me. How does a cut cause so much pain! Hope ur duin somewhat better

@Bessiebum hey just readibg your post and so glad your fissure healed. Im at that point now where i want another baby but i cant heal my current fissure. I have had botox too