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Anal fissure

Anyone have any experience with this? I have been dealing with this for over two months now. Horrible pain and pressure in my rectum! There is no bleeding with it but I am passing mucus. My Dr. put me on Anucort suppositories, which only helped a little and now the pressure is coming back. The pain when I have a bowel movement is unbearable.
 
I had an abscess between my butt check and my anal canal the size of my fist before I was diagnosed with Crohns and UC. I could feel it - it was very hard and tight and the skin was hot and tender. By the time I saw a doctor it was to late for antibiotics so I sat on a hot water bottle to ease the pain and draw out the infection until it was ready for surgery.

After diagnosis, I got a number of fistula's around the same area. My Specialist at the time was not very good and didn't believe there was a problem. I had an MRI and I could see the infection (it was white on the scan) however she said everything was normal. I finally got an appointment on a day when is was really flaring and a bit pusy. She realised something was wrong and I was sent to a surgeon. Unfortunately leaving it this long meant that there was some damage and I was lucky I didn't lose the inner rectal muscles that control bowel leakage. Even though the initial fistula was fixed I kept getting more fistula's around the same area. I started with a new Specialist and he put me on 6MP - I haven't had any problems since (touch wood).

So, to cut a long story short (or shorter lol), I would recommend you get this seen to very quickly and don't take an answer you know is not right (you know your body better than anyone). Don't be in the same situation as me where I had about 6 or 7 surgeries because my initial fistula was not diagnosed correctly and I was to scared to counteract the doctor. The scar tissue from these surgeries causes some minor leakage and a sore butt when the Crohns flares and I have to wipe a lot. Secondly if this is a reoccurring problem it may be worthwhile talking to your doc about 6MP. This has been a lifesaver for me (even though I have had some side effects that are yuk)! I also found that nuts and grains tended to aggravate the area and trigger the fistula's (may be just me) so I avoid them now. Lastly I found the hot water bottle was my butts best friend when I had fistula's - the heat seems to help!

I really hope you get better soon and good luck!
 
Thanks for the info. My Dr. has looked down there twice and said it is a fissure both times so I don't know. I left the Dr. yesterday really frustrated because I feel like he rushes. It's like it is an assembly line in that place. I really don't think he listens when I tell him the pain I am in. I am having horrible leg and arm pain and he didn't even address that.
 
I left the Dr. yesterday really frustrated because I feel like he rushes. It's like it is an assembly line in that place. I really don't think he listens when I tell him the pain I am in. I am having horrible leg and arm pain and he didn't even address that.
I know that feeling. One thing I have learned is to make my appointments as early in the morning as possible. I have noticed a definite difference in the amount of time he spends with me vs. late in the afternoon. I always feel that in the afternoon he is rushing around because he is behind schedule and trying to fit in all of his appointments. I never feel that way in the morning. If you see your doc in the AM and he is very rushed like that, you might want to consider a different doc?
 
A month ago I went to see my GI because I was sure I had a fissure. He had a look and confirmed that it was a fissure. I found it really painful to move around and going to the bathroom was a small nightmare. He prescribed Diltiazem 2% ointment which I rubbed all around my anus and cheeks.

Two days after I started putting the cream on (at least twice a day or after every BM), something "burst" from inside my anus. It was FOUL smelling chalky like substance (sorry for the graphic description!) that poured out. But what a relief after this 'explosion.' The pain I had been experiencing diminished significantly and the fissure that was just outside my anus cleared up after about another four to five days.

I suspect that along with the fissure that my GI had seen in the perianal area, there was an abscess either inside my anus or just around my anus/rectum area that had 'burst.' Since my GI had not done an exam of my anus or rectum, he would not have seen it. However, I think that the Diltiazem relaxed my anus enough to allow the abscess to pop. The Diltiazem also allows for a lot of relief from the pain.

Good luck, and if you're not feeling that you have of a positive response, then I'm with Cookie and would suggest that you get a referral to a new GI?
 

Astra

Moderator
I've been doing some research into Botox for head and neck pain, migraines and headaches.
Apparantly it helps with muscle spasms, asthma, movement control and spasticity etc.
And then I read that scientists had injected this botulinim toxin into the anal sphincter (of someone!) to relax the sphincter and promote fissure healing!!
 
The Diltiazem cream is what he prescribed for me yesterday when I went in because there was no releif with the Anucort and putting it in was just causing more pain. I am glad to hear that this new cream I am starting today has had positive results with someone. I sure hope it works for me.
 
I've had anal fissures before and they still become painful when i have nonstop diarrhea. i know how you are feeling. Well, my doc advised me to use lidocaine, a local anesthetic cream and ordered me to use it every time i have a bowel movement before and after. he mentioned that there is no problem of using many of it. It's not harrmful. Another treatment was a chemical mixture of hydrocortisone and a local anesthetic as well. This ointment has to be applied only until pain diminishes and I can repeat it whenever i have painful fissures. I'm not a US redident, so I don't know whether you have this med i or not but ask your doc about it. Hope you feel better soon.
 
I have battled with fissures non-stop since 2005. The Diltiazem cream hopefully will be effective in relaxing the muscle - the goal. I have read many people having success with this. I have used both nitro and Nefidipine in the past. The Nefidipine is also a calcium channel blocker like the Diltiazem.

It seems like a lot of doctor's like to prescribe topical steroids for any anal issue. For a fissure it does nothing other than thin the skin after long term use. Remember to do sitz baths as much as possible.
 
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Anyone have any experience with this? I have been dealing with this for over two months now. Horrible pain and pressure in my rectum! There is no bleeding with it but I am passing mucus. My Dr. put me on Anucort suppositories, which only helped a little and now the pressure is coming back. The pain when I have a bowel movement is unbearable.

Yes. After I had my j-pouch that was one of my problems as well. I ultimately needed a temorary ileostomy to allow things to heal (there were other issues going on).
 
I've been doing some research into Botox for head and neck pain, migraines and headaches.
Apparantly it helps with muscle spasms, asthma, movement control and spasticity etc.
And then I read that scientists had injected this botulinim toxin into the anal sphincter (of someone!) to relax the sphincter and promote fissure healing!!
Yes this is true! I was supposed to have botox when I went in for my fissure operation in January 2011, but when the surgeon saw how bad my butt was he didn't use it.

Maybe it ended up in a woman's face somewhere.
 
I've been doing some research into Botox for head and neck pain, migraines and headaches.
Apparantly it helps with muscle spasms, asthma, movement control and spasticity etc.
And then I read that scientists had injected this botulinim toxin into the anal sphincter (of someone!) to relax the sphincter and promote fissure healing!!
Hi I've had the Botox treatment ask your doctor about it, I was glad to have been given it as it helped me.
 
I'm using that cream as well, have been using it for about three weeks now since my surgery, where they removed a fissure and opened a fistula. I'm not really sure how much it is working for me because I am still healing from the surgery I think it will be a while until I know for sure if it has been a total success.

do you put the cream in the rectum or around it?
I just put it around it at the moment, because of having surgery I don't want to put it in it, but it does say in the leaflet to put it in it and around it.
 
Hi i have just come out if hospital from a flare of my uc and i now have a fussure which has been causing me sooooo much pain they have given me laxidose and senacot to make going to the toolet more comfortable while i heal the fissure with a cream but even using laxis it is painful it burns inside and makes me feel incredibley sick then i have to lie down for half an hour t let my body recover from th trauma and pain of it . Has anyone else had these symptoms i feek so alone an scared im never going to get better :( and im still feeling weak and im nt sure if this is just me recovering from my flare or if theres something wrong ! Help
 
I have had reoccurring anal abscess for 4 years they are super painful but make sure you get it looked at my last one ate away at the muscle and if it wasn't drained and cleaned out would of lost control of my bowels eventually
 
Went to the colo-rectal surgeon today due to my ongoing anal fissure.It appeared after 3 years of perianal crohns, it is about 1/4 inch long and it is not infected. I have been reading extensively on patient case studies and how unsuccessful they have been over the years in treating it. I have been specially puzzled as to how surgery has not fixed the problem, in some cases it has made the problem worse by cutting into the sphincter and creating severe incontinence.

So I asked the surgeon Why is surgery so ineffective in the anal area ? After 30 years of his experience doing thousands of surgeries, he replied: the anal tissue with Crohns is prone to not heal, it just remains raw, bleeding sometime, getting infected at other times. The main hope are a biological that will work. I was on Humira for 4 years (worked wonderfully for 2 years, then it stopped) then Entyvio for 7 infusions (did not work at all). Now it was recommended that I will go on combo therapy with Remicade and Imuran.

The surgeon recommended that I do not use cortiosteroids (made it worse for me), just keep the area clean with a gentle wipe. He recommended that I take a small ball of cotton, strip it longer to about 2 inches and stick it in the inside to prevent moisture from coming out. He said to stay with Calmoseptine for the itching and protect the area. I also use Prax which contains Pramoxine anasthetic, they can be both be ordered by the pharmacy without a prescription.
 
Unfortunately it has not healed going on 5 years now.

Started on Remicade and Imuran at 5mg per kilo, was not working so it was upped to 10mg and it works, although I will give it a "C" grade. The best it has done for me is to reduce my bowel movements to 3 a day. This has tremendously improved the rawness of the anal area because of the less irritation when I go to the bathroom.

After every bowel movement I cleanse it with Balneol which is wonderful. Still using the Calmoseptine mostly at night were the itching is worse. Still using the butt plugs but if I have a bowel movement in the middle of the night it goes away.

The fissure is still 1/4 inch, had it checked 4 months ago, has not grown and more importantly no new ones have emerged.

My biggest problem now is a partial obstruction that causes major problems about twice a year. The Remicade has helped somewhat but I know that I will eventually need a bowel resection in the future.
 
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