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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Can a chronic fissure heal



11-10-2011, 05:45 PM   #1
matty
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can a chronic fissure heal

hi everyone. Had my fissure 8 weeks now so i quess its chronic,it had a skin tag at 3 weeks. The last 3 nights it was burning pretty bad. I use vasoline and sitz baths andmetamucil. Do chronic ones ever heal without surgery. The dr. finally gave me the dilizam cream2% spelling off. Haven't tried it yet as i have my monthlys. I ocassionaly felt pain on right buttock now its on right side going down leg. My cut is towards spine. any advice please.
11-12-2011, 02:14 AM   #2
Rivers
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Yes there is treatment for chronic fissures.

You can choose one of a few methods.

1) medication such as Nifedipine/lidocaine ointment which is applied to the fissure 3x a day and after a bowel movement. it works by dilating the skin around the fissure and allowing it to heal over time.

2) Botox injections- these can work really well. You have them done in the doctors office under local or semi-general anesthesia. It lasts for about 4 months, relaxing the muscle around the fissure.


3) surgery to remove the fissure. This involves cutting part of the sphincter muscle so its usually the last choice.


I've used Nifedipine and it works great. I still have the skin tag there but the fissure is healed. You have to get the Nifedipine compounded. it works great though. I also did the botox and it worked great for 4 months and then the fissure re-opened after a hard bm and I opted for the Nifedipine.

Hope that helps you some
11-12-2011, 08:49 AM   #3
Crohn's 35
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The only other suggestion is Remicade? but as Rivers ideas have come to light I would seek that out. Hope you feel better soon!
11-12-2011, 11:12 AM   #4
hannah-rose
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hi everyone. Had my fissure 8 weeks now so i quess its chronic,it had a skin tag at 3 weeks. The last 3 nights it was burning pretty bad. I use vasoline and sitz baths andmetamucil. Do chronic ones ever heal without surgery. The dr. finally gave me the dilizam cream2% spelling off. Haven't tried it yet as i have my monthlys. I ocassionaly felt pain on right buttock now its on right side going down leg. My cut is towards spine. any advice please.
Hi Matty,

I had fissures all my life (look down at my signature).

If a fissure doesn't heal with sitz baths and topical creams etc the next step would be GTN ointment which relaxes the anal sphincter to encourage healing.

If that doesn't work, then botox injections into the sphincter do the same thing and last for about 3 months at a time.

If that doesn't work then an LIS is the last remaining option and is surgical.

Some people have a fissurectomy too which basically cuts away at the fissure to produce a fresh wound which should heal, although without treating the underlying cause of the fissure - anal sphincter spasms - this is unlikely to work.

This however is all assuming the fissure is not related to Crohn's. If your fissure is related to Crohn's then Remicade is a very effective Crohn's treatment for perianal disease.

I have a history of perianal disease stretching back to when I was eight years old and I'm currently have Remicade treatment which seems to be healing my perianal ulcer (which was a chronic fissure which became infected and turned into an anal ulcer).

Hope this is helpful

Hannah
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11-12-2011, 09:56 PM   #5
matty
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thanks for replies. Regarding the cream i got 2% dilizam cream(spelling off) Is it a good cream or should i go back and ask for the nifedipin cream. hannah so sorry you've been through so many of these, my first one and i want it gone. I know i got mine from using my finger 2 dayls ina row, i was badly constipated. I'll never use my finger again.
11-13-2011, 03:33 AM   #6
hannah-rose
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Hey Matty, don't beat yourself up about having to help yourself out when you've been really constipated. It's happened to me on more than one occasion and sometimes it's just the only option, it's just a miserable experience for those of us that suffer from constipation.

Are you taking stool softeners or laxatives at the moment? Osmotic laxatives They are good at softening the stool so you don't get constipated.

The cream you're using should work well to relax the sphincter muscle and help your fissure to heal. Just make sure you are using it correctly and are putting it inside the anus, not on the outside.

There's every chance your fissure will heal with a combination of a high fibre diet and a stool softener to ensure soft bowel movements daily, the diltiazem cream, vaseline to protect the delicate skin and to lubricate prior to a bowel movement, and daily sitz baths.

If you can do all of this then at least you're giving your body the best chance of healing.

Hope you feel better soon
11-15-2011, 02:00 PM   #7
matty
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thanks hannah. I take metamucil and scared to try anything else. So far haven't had to push for a 1 month. Yesterday i saw a dr. i was considering changing to and he didn't even check my fissure right he said he couldn't see it, allhe saw was a skin tag. He didn't even put gloves on to check me. He said if you can't see it, then its healing but if it still hurts its not completely healed. My family dr. is trying to make me see the general surgeon after 6 months to do the surgery if needed. I'm not complaining about the wait cause im terriefied of surgery but i want him to refer me to a crs which i did mention to him and said a fissure is no big deal. Some dr. are sickening.
11-15-2011, 07:11 PM   #8
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Has anyone ever treated fissures with polysporin (an OTC antiboitic ointment)?
11-16-2011, 02:23 AM   #9
matty
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i've never heard of it, i've real lots on fissures and never heard that. I'm also on a support group and its never mentioned but i quess you never know until you try it.
11-16-2011, 02:36 PM   #10
hannah-rose
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An antibiotic ointment wouldn't heal a fissure. Fissures are tiny splits in the skin around the anal opening, usually caused by constipation, and non-healing fissures are often caused by anal sphincter spasm.

If a fissure was infected, an antibiotic would kill off any infection, but it wouldn't necessarily heal the fissure - a fissure is a wound like any other.
11-25-2011, 12:35 AM   #11
matty
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i saw my gp yesteday for my refils and asked him to look at fissure.My partner looked at it and looked under all the skin tags and cant find it. dr. looked but not under skin tags and said its healed. How does it look when its healed. I still have burning sometimes but i was having a burning bum before fissure
11-25-2011, 11:49 AM   #12
CyCrohn'sGuy
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I'm confused. My GI tells me I have a fissure that requires surgery (anal stretch) as it is not healing. But everything I read regarding fissures mentions pain and constipation. I have neither. I bleed sometimes after a BM but its not due to constipation. On the contrary, my BM's are always very loose and the fissure is not painful. I do get very itchy around the area though. Could this be something else?

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11-25-2011, 07:52 PM   #13
matty
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maybe a hemorroid, but gi said a fissure. I also have no pain with bm's. I do get occasional burning and sometimes a sharp pain for a few seconds and its gone. Have you checked yourself, i can't as i'm far sighted. My partner checks and can't find it now, but did see it at the beginning before the skin tag. Do you have to push for bm's. Usually if you push you can retear it. Maybe you have a very small cut as you have no pain. Sorry i can't be of much help as i'm learning myself of this. I've had it about 9 weeks. I'm also on a fissure support group and some have there's for 5, 10 years.
11-25-2011, 08:39 PM   #14
Rivers
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I would never do the anal stretch procedure, its outdated and barbaric! Try the Nifedipine cream, botox or a proper surgery.
12-05-2011, 01:29 PM   #15
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I had a terrible fissure a few years ago that I had for 3 months. It was horrible and no pain pill worked for it. It was absolute Hell when I had a BM. It would feel better sometimes till I had a BM and then it would be "torn up" and killing me again, bleeding. I decided to try the BM's while taking a sitz bath. THAT is when it began to heal and quickly went away! I know it sounds gross, but it worked a miracle for me. Bree
12-07-2011, 11:32 AM   #16
matty
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thanks bustersmom, i don't know if i coulddo that,i quess if i really try but i don't know if my bm will come in the sitz bath.
12-07-2011, 12:03 PM   #17
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I don't know how long the pain and bleeding would have continued. It may be too much for some people, but the extreme pain was too much for me. I'm not sure how much longer I could have taken it. It worked, the fissure was much less painful after a few days. It totally relaxes the muscles when you "go" . It Works. Extreme measure? Yes. Healed fissure? Yep.
12-07-2011, 01:34 PM   #18
CyCrohn'sGuy
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Good for you Bustersmom !!!
12-31-2012, 02:03 PM   #19
dibakar_1986
 
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Hi
im having anal fissure for last few years but i discovered it recently when i felt severe discomfort which is keep coming back. I have had a skin tag and used to feel pain and then i forgot about that. Recently a my gp told i'm having a chronic anal fissure with sentinel skin tag. I take sitz bath and using Diltiazem Hydrochloride 2% twice daily. I have constipation. I still face sometime light pain and sometime light bleeding from that skin tag. I recently have consulted a surgeon and he said its can only be removed using a surgery otherwise it will keep coming. I'm afraid of having a surgery. Can anyone guide me is it really a chronic anal fissure or do i need a surgery to heal it. Any suggestion and alternatives will be highly appreciated.

Dibakar
12-31-2012, 02:15 PM   #20
matty
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hi dibakar. I too still feel like my fissure acts up from time to time but like you i am scared to have surgery. I think if it gets worse i will consider it. Right now i just do the sitz bath after a bm. If i feel its acting up i do another sitz. Sorry, myself i don't know much of them on healing but i know you have to take something for the constipation like metamucil but that one made my bm's bulky so i quite it and don't take anything now. Daily sitz baths helps and as for creams, i never used any, just vasoline before a bm. Sorry that's all i can tell you, hope you feel better soon.
12-31-2012, 02:23 PM   #21
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Hi Matty
Thanks for your suggestion. Im really perplexed about this and scared of having a surgery and to turn it to another fatal disease like cancer... hope to get more suggestion on this.

Thanks in advance

Dibakar

hi dibakar. I too still feel like my fissure acts up from time to time but like you i am scared to have surgery. I think if it gets worse i will consider it. Right now i just do the sitz bath after a bm. If i feel its acting up i do another sitz. Sorry, myself i don't know much of them on healing but i know you have to take something for the constipation like metamucil but that one made my bm's bulky so i quite it and don't take anything now. Daily sitz baths helps and as for creams, i never used any, just vasoline before a bm. Sorry that's all i can tell you, hope you feel better soon.
09-25-2013, 12:01 PM   #22
igrik1986
 
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Hello,

Just would like to express my frustration on terrible condition I suffered for already 8 months, after hemmie excision. Tremendous help and support I found on board anal-fissure.org

I have shared my story there, and there are many related and helpful.

Probably this is something for you to check....
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07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story

Last edited by igrik1986; 10-19-2013 at 02:15 PM.
09-26-2013, 08:40 PM   #23
annawato
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Here is an article that explains what causes fissures and how they can be treated. Hope it helps.

http://www.fascrs.org/patients/conditions/anal_fissure/
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