Anal Fissure - Extreme Pain 10/10 - Any advice please (18+)

[TheHotsummer]

Hi,

I experienced the worse pain of my life when attempting to relieve myself (stools).

It was like a knife was being used at the same time ...causing the most painful experience I've ever had to endure. I felt like my bottom was about to fall out.

It's been 5 days now...my GP believes it is Anal Fissure and has prescribed Glyceryl trinitrate.

Glyceryl trinitrate causes a painful headache which can last over 30mins.

I don't know if it has helped so far....as the painful experience is still there...perhaps reduced by 10%.

I have used laxatives, Bio Kult to try and soften the stools.
Also using Germolids which is meant to help reduce some of the pain.

The pain has reduced but still extremely painful.

I've now purchased Anusol, our local Chemist suggests this is stronger than Germolids and I've also read on this forum Magnesium can help.

I'm taking laxatives with meal.
Stopped eating for the first few days and now re-introduced food (pprridge for breakfast and boiled veg. + Grilled chicken for lunch or dinner) with lots of water.

I don't know what else I can do...I'm thinking of stopping eating as pain is just unbearable.

I'm taking painkillers (paracetamol along with Ibuprofen) but they don't seem to help.

I'm sleeping on the sides when I can.

I have tried different positions when visiting bathroom....raising legs on stool, standing slightly over the toilet to try and minimise some of the pain.

It's now day 5....pain is 9/10....I've spoken to GP since and his advice was to continue taking Glyceryl trinitrate.

Any advice or tips from anyone here who may have gone through this dreaded awful experience.

Thank you.

Sorry, my post isn't that clear. I had the splitting headaches, same as you.

The medicine in the photo was the new one that helped without side effects.

Can only help with constipation but:
Fibogel (buy off shelf in chemist, no prescription)
Prune juice
Every day without fail

Suppositories meant to be good too (glycerin from memory?)

So sorry. It's awful.

Ah you poor thing, they are horrific. I also suffered post pregnancy. The pain is like nothing else. Retrogesic ointment from the GP did clear mine up, so I would try that for sure. I also found a cap full of milk of magnesia at bedtime worked best by far, just enough to soften everything while the retrogesic heals it and then keep using it until you’re back to normal. Good luck

Rectogesic and lots of salt baths helped me. I'd run the water really hot, stick loads of salt in and just sit there in sweet relief. It will get better OP but as others have said it's about trying not to re-tear when you go to the loo. I also learned that if you put you feet flat on a stool in front you when you go it brings your knees up which makes it easier to pass stools (the other kind). You end up in a squat position but on the loo. Good luck

I'm not sure if a GP can prescribe it (mine was prescribed by a Colorectal surgeon) but I found Diltiazem helped mine to heal, along with hydrocortisone suppositories and putting Vaseline up my bum before a poo (sorry for the TMI!)

Stool softener rather than laxatives, dulcolax capsules which you can buy at the chemist. Does take ages to heal when it keeps re-opening. 😬 You have my sympathies, pain is worse than childbirth!

After you’ve gone as it were and you’ve done the dreaded dry wipe, use wet wipes to finish cleaning up before you put your cream on.
Sweet potato have always had the best stool softening effect for me. Prunes are good too, but lots of tooting round Sainsbury’s later in the day!
I feel for you, it is so brutal.

Sorry you are suffering OP. My DH had a fissure that took ages to heal. He tried everything. The stool softener type laxatives worked best. He also sat in a salt/epsom salt bath.

I am not telling you this to discourage you, but given how long DH suffered, you might want to be as aggressive as you can from the beginning. Maybe looking at adding a bidet seat to your toilet so you can clean yourself with water rather than wiping would be a good idea. It might calm the stinging.

DH found that creams with lidocaine helped a bit.

Fissures really are miserable. DH now is extremely vigilant about his diet containing tons of fibre so it never happens again.

My deepest sympathies OP, I’ve suffered in my time with a few anal fissures and they’re utterly miserable! 😣

The worst bit for me was the throbbing pain for about 12 hours after a bowel movement! 😣

Anyway, my tips are;

*Laxido, 2 sachets a day minimum. This will help keep things nice and soft.
*Drink plenty of water- I now drink 3 litres a day, everyday without fail.
*Sitz bath for 10 to 15 minutes after every bowel movement. I used to put coconut oil in the water, very soothing.
*Prevent your skin from drying out and cracking further by using a moisturising body wash on the area, like E45.

• Under no circumstances strain/push during BM’s (and that goes for when it’s healed, too). Just let gravity take effect.
• If you are suffering with prolonged pain after a BM like I did, try and train yourself to go just before bed so you can sleep through the pain (might be easier said than done if you’re a regular morning person, I’m not).
• I found applying Sudocrem after a BM helped.

I find doing all these things generally takes the pain away after about 10 days as it’s all about preventing the tear from opening again. I hope you get some relief soon!

Lactulose and glycerine suppositories x

If all else fails Hot bath. Go to the loo in the bath
Ricola sweets are better than lactulose etc

Xh used to swear by preparationH. It comes in a tube with a nozzle so you can squirt it inside. Think there are suppositories, too. It contains shark oil.
There's inulin, a laxative from slim and save in various flavours. It's also in Jerusalem artichokes.
In France there's microlax, which hurts, but empties your bowel. It's a little bottle of detergent that you squirt up and it washes the blockage out, but as it has detergent you'd need vaseline etc.
Put your suppositories in the fridge. Having them really cold helps.

Veteran of vlcd diets and almost dead thyroid gland causing extreme constipation helps.

Another thing, could you get painkillers in the form of suppositories from your GP? Think they're available for babies etc.

Proctosedyl ointment has a local anaesthetic in.

Once you’ve used Movical for a while you can introduce psyllium husk into your diet. It’s an insoluble fibre, take it with lots of water - staying well hydrated is really important.

Massive sympathy from me, I’ve been there and it is miserable, fear of going to the loo, almost crying with pain, throbbing for hours afterwards while you try to smile and get on with family life, it’s awful.

At the moment I’m fine though but I have to keep on top of it and remind myself to take the psyllium husk, otherwise I’m sure it will come back.

Good luck.

Hi all

I wanted to say THANK YOU to all of you.

You've all helped me with your kind words and advice, I'm for ever grateful.

The pain has certainly reduced but has not disappeared.

Even when I'm trying to sit (sitting on a thick pillow on top of a super ultra soft sofa) the pain comes on intermittently, so I'm forced to either lay down to walk/stand.

When going to the bathroom the pain has varied from 08/10 to 06/10 (10 being the most painful).

So, I'm still in pain but the advice you guys have given have provided me with a lot of relief.

I'm going to include below tips/items that have helped me...incase they help anyone else in future.

This is in no particular order:

1. Take pain relief. Combination of paracetamol and ibuprofen is what I took for the first few days but I don't feel it was strong enough. GP prescribed Co-Codamol but I was fearful of its side effects so have not taken it...but I parallel I began taking Germoloids (purchase from Chemist) which helped with pain relief.

1. You need to use a cream / ointment for your bottom - this is a MUST and was the big difference for me.. disappointed GP did not suggest this when I first spoke with him. (He suggested it 2nd time)

There are 2 creams I tried Germoloids and few days later I purchased Anusol. I found Anusol to be more effective.

Apply the cream as advertised BUT...and this was a game changer ....apply it just before you need to go to the bathroom.

1. The moment you feel like you need to visit the bathroom, apply the cream/ointment and take a painkiller. Try to time it if you can...about 5 mins or so before you need to go.

1. Breathing technique is important. Make lips like a horse and breath like your about to give birth...sounds funny and strange but it helps.

1. Squatting on toilet made it worse for me. Sounds awful but standing over toilet (not sitting) helped reduce the pain. Just standing slightly over.

1. Don't force it....let it naturally flow...forcing will make it even more painful.

1. Drink lots of water....lots of it.

1. Stop eating. Just stop. First couple of days....reduce your food intake to the absolute minimum. Banana and water if you can.

1. If you're reintroducing food, eat bland food...small portions with lots of water.

10. GP prescribed me RECTOGESIC which helps with the tear (Anal Fissure). It can cause headaches but is meant to help with healing. There other creams available which don't cause the headache but do the same sort of thing. I've not tried them but was informed by the amazing posters in this forum.

11. You must be patient. This can take a while (has been 6+ days so far). I was debilitated for the 1st couple. Day 6 and I've gone out for the first time..still very painful and I'm conscious of needing to go to the loo.

12. Don't wipe your bottom with tissue. Use warm water.

13. Avoid cold water on your bottom. Warm water does help a little.

14. Pray it heals and you get better.

15. Sleep on your sides. Don't sleep on your bottom.

16. Apply the creams and ointments before you go sleep.

17. Keep wipes close by.

18. Wear lose clothing

That's all I can think of so far.
This is what has helped me so far....so just posting in one place.
I'll add anything else as I can.

Thanks all again.
I'll post again soon.

Get some lidocaine prescribed as it will numb the area - you can apply it 20mins before you need to go and it will numb the area.

Other lifesaver for me was a bottom bath. It sits in the loo seat and you fill with Epsom salts and warm water. I just go in it abs clean it after. Makes it much quicker and more gentle. Also helps to heal the area so use it to soak after too.

@TheHotsummer

Hi all

I wanted to say THANK YOU to all of you.

You've all helped me with your kind words and advice, I'm for ever grateful.

The pain has certainly reduced but has not disappeared.

Even when I'm trying to sit (sitting on a thick pillow on top of a super ultra soft sofa) the pain comes on intermittently, so I'm forced to either lay down to walk/stand.

When going to the bathroom the pain has varied from 08/10 to 06/10 (10 being the most painful).

So, I'm still in pain but the advice you guys have given have provided me with a lot of relief.

I'm going to include below tips/items that have helped me...incase they help anyone else in future.

This is in no particular order:

1. Take pain relief. Combination of paracetamol and ibuprofen is what I took for the first few days but I don't feel it was strong enough. GP prescribed Co-Codamol but I was fearful of its side effects so have not taken it...but I parallel I began taking Germoloids (purchase from Chemist) which helped with pain relief.

1. You need to use a cream / ointment for your bottom - this is a MUST and was the big difference for me.. disappointed GP did not suggest this when I first spoke with him. (He suggested it 2nd time)

There are 2 creams I tried Germoloids and few days later I purchased Anusol. I found Anusol to be more effective.

Apply the cream as advertised BUT...and this was a game changer ....apply it just before you need to go to the bathroom.

1. The moment you feel like you need to visit the bathroom, apply the cream/ointment and take a painkiller. Try to time it if you can...about 5 mins or so before you need to go.

1. Breathing technique is important. Make lips like a horse and breath like your about to give birth...sounds funny and strange but it helps.

1. Squatting on toilet made it worse for me. Sounds awful but standing over toilet (not sitting) helped reduce the pain. Just standing slightly over.

1. Don't force it....let it naturally flow...forcing will make it even more painful.

1. Drink lots of water....lots of it.

1. Stop eating. Just stop. First couple of days....reduce your food intake to the absolute minimum. Banana and water if you can.

1. If you're reintroducing food, eat bland food...small portions with lots of water.

10. GP prescribed me RECTOGESIC which helps with the tear (Anal Fissure). It can cause headaches but is meant to help with healing. There other creams available which don't cause the headache but do the same sort of thing. I've not tried them but was informed by the amazing posters in this forum.

11. You must be patient. This can take a while (has been 6+ days so far). I was debilitated for the 1st couple. Day 6 and I've gone out for the first time..still very painful and I'm conscious of needing to go to the loo.

12. Don't wipe your bottom with tissue. Use warm water.

13. Avoid cold water on your bottom. Warm water does help a little.

14. Pray it heals and you get better.

15. Sleep on your sides. Don't sleep on your bottom.

16. Apply the creams and ointments before you go sleep.

17. Keep wipes close by.

18. Wear lose clothing

That's all I can think of so far.
This is what has helped me so far....so just posting in one place.
I'll add anything else as I can.

Thanks all again.
I'll post again soon.

I couldn't edit the previous post but here are others

19. Magnesium (I had the tablet form from our chemist
20. Laxatives also helped me
21. I also used Bio Kult for the first few days which helped soften the bowls.

More to follow

Gt is well known for giving headaches. Its unpleasant but not remotely harmful. So it's not good advice from pp to stop the med because it causes headaches.

I've had this you need to give it time to work. Stopping eating won't really help as it can cause constipation. I used to take painkillers to help with the headaches. Cocodamol is stronger. But can cause constipation so do use a laxatives or stool softener too.

@Neonplant

Gt is well known for giving headaches. Its unpleasant but not remotely harmful. So it's not good advice from pp to stop the med because it causes headaches.

I've had this you need to give it time to work. Stopping eating won't really help as it can cause constipation. I used to take painkillers to help with the headaches. Cocodamol is stronger. But can cause constipation so do use a laxatives or stool softener too.

Well, my GP told me to stop it due to the headaches.

I couldn't use the GT cream. I'm a working lone parent who doesn't get to rest and paracetamol didn't stop the pain.

Are they sure it's a fissure? One time I had a blister inside my anus that burst and become an ulcer and got infected and it was really fecking painful. It was initially misdiagnosed as a fissure. It required some sort of ointment from what I recall that had an antibiotic and a steroid in it.

I was coming in here to recommend scheriproct (spelling). On prescription, keep it in the fridge.
After I had my kids I had piles and fissures - like pooping glass 😭😭.

Next baby I started on the water, prunes etc before Labour just in case!

Couple of things to add which may also benefit.

A few weeks back I was prescribed set of strong antibiotics to clear up an infection.

The antibiotics killed both the good bacteria and bad, causing stomach issues and which led to the anal fissure.

Perhaps GPS need to consider suggesting increase of fibre during the course of Antibiotics.

That's what started my pain of issues.

Agh, it's horrible OP. I've had a fissure before, but the one I had just recently after giving birth was the worst, I was literally crying every time I had to go. I'll just add 2 things that helped me.

Ground flax seeds for fibre - mix them into anything, they don't really have a taste.

A cream called Neofitoroid. I'm in Spain, but I think you can get it on Amazon in the UK. It's plant extracts, so shouldn't interfere with other things, although it's always best to check with a pharmacist. I was skeptical as I wanted something with lidocaine for the pain (they wouldn't give me anything due to breastfeeding) but this stuff helped a lot. You apply it just before going to the toilet, and it reduces the pain hugely.

Please don't stop eating, it'll just make things worse!

Good luck, I hope you get some relief soon.

Random tip here but I’ve discovered accidentally that apple cider vinegar daily helps with chronic constipation. I take a supplement of it to help with the Keto diet, and I’ve not had any trouble going since. I stopped for a week as ran out and was straight back to constipated