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.

@TheHotsummer

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.

And maybe pro/pre biotics.

Hi all

Just a quick update

I've tried to eat as regular as I can but in moderate portions.

Breakfast is shredded wheat with warm milk and honey

Lunch/ dinner is either grilled fish or chicken with brocoli & mash (or boiled potatoe).

Occasional tea or coffee

Fruit + water

The pain has reduced when visiting the bathroom, however it's still painful. And occasionally bleeding.

I'm using the ointments mentioned above.

I did think I'd be OK by now....so a little upset it's not recovering as fast as I hoped.

I have had to stop training & running as I'm anxious of causing any further tear or harm.

I'm extremely worried each time I visit the bathroom.

Standing slightly over the toilet is definitely helpful...sitting makes it more painful.

I'm not sure what else to do...I'm anxious about being examined if I visit the GP.

I'm also worried this may never recover and I could be looking at a long term issue.

Limiting food at the beginning did help me.

Do drink lots of water and eat fruits like grapes + banana.

Haven't been able to enjoy any physical time with my partner.

This is border line hitting towards a small depression I think.

Have you tried Movicol yet?

I don't think running etc would make it worse. Have you been advised otherwise? Exercise is important to keep your gut moving and prevent constipation.

Please don't stress about getting examined, the Dr won't bat an eyelid and may want to rule out an underlying cause. I had mine looked at once, and the second time (years later, different Dr), he didn't look, just referred me to a bowel specialist, who found nothing (didn't think internal exam was necessary) and referred me to a dermatologist who found nothing either. Bit of a faff, but the doctors were very professional, understanding and reassuring.

Please don’t stress about seeing GP. I saw mine last Friday, had painful lump, didn’t think it was piles as no bleeding, and had piles 4 months ago, but GP said it was piles, examination - she looked at area 10 seconds, then did internal (with cream) which lasted less than 10 seconds. I was offered cream and suppositories, took both. I also take laxido which really helps soften poo. Also I don’t use soap, but use an aqueous cream.

Generally exercise is beneficial for a fissure as it increases blood flow to the area which promotes healing. The only time I didn't find it (running) to be was when pregnant. I'd probably avoiding heavy weightlifting etc though. And of course see how you feel when you do it and afterwards.
It's so tough being where you are now but you will get through it and get better.
I'd recommend upping your fruit and veg a lot. Bananas and grapes aren't the fruits I'd prioritize but you know how your body responds to specific foods. I think the best fruits for digestion (or the kind of digestion we are after in this situation!) are kiwis, plums, prunes, figs, cherries, pears, all berries. Vegetables: spinach, beetroot, onion (contains soluble and insoluble fibre,) aubergine, kale, brocolli and other green veg. I'm vegetarian so I suppose I'm biased towards plant foods but it sounds like it would be beneficial for you to eat a bit more of them at the moment.
Best wishes to you!

@Spidersinmyhair

Have you tried Movicol yet?

No I haven't yet tried Movicol but I'm taking Fybogel...is Movicol better ?

I'm finding that it's most painful before anything is released.

I was bleeding this morning (most it's been)...it was like a nose bleed...lots of blood. It stopped once I had finished.

These are the medications I'm currently taking

Rectogesic (Prescribed by GP)
Anusol (Chemist) was taking Germoloids before
Fybogel (Chemist)
During the night I'm using Anusol Suppositories (it's like a capsule you insert).

I've limited use of pain killers as I didn't want to get used to them.

I'll increase my veg and fruit intake.

Excercises....I am walking but just anxious of tearing again.

And this morning I was bleeding a fair amount.... :-(

Are you applying the creams just as you go to the toilet so they act as lubricant? I hadn't realised at first that that was what you were supposed to do, and just applied twice a day!

@LaMadrilena

Are you applying the creams just as you go to the toilet so they act as lubricant? I hadn't realised at first that that was what you were supposed to do, and just applied twice a day!

I'm applying them twice a day and also just before I need to go too.

I wonder if a very carefully inserted with Vaseline, boiled, cooled to warm water enema would be helpful in reducing the poo to liquid and thus allowing its passage without opening up the bleeding area?

I've had this twice and never want it again!

I found they took at least a month or two before those horrible painful spasms eased off and would soak in a sitz bath with epsom salt and hot water to soothe when unbearable (not for too long though 5 mins or so).

Very hot water seemed the best for me and I would also aim the hot water from the shower head at it after a BM which was really helpful at reducing those spams.

Things I still do now to prevent another are:

Full fat greek yoghurt and a few tinned prunes for breakfast.
A spray bottle of water on soft loo roll to gently dab (not wipe) after BM.
Jump in shower after a BM and wash with hot shower head.
Use a Squattie potty step.
Try and eat at least 5 fruit/veg a day and increase things like dried apricots if I ever get a hint of things not going smoothly!!

Hope you get some relief soon.

How long did it take your fissure to heal please

Has your GP actually seen this, or is this all being done over the phone?

One of the rules in these situations is to "keep the traffic friendly" - inevitably having a shit will be painful, but will be less so if the stools are soft. So Movicol or Laxido are your friends.