Anybody Have Any Advice for a Anal Fissure (Tear of the Rectum Muscle)

You poor thing! When I went through this, I drank a glass of Aloe Vera Juice everyday for healing (get the good stuff at a health food store) and a shot of mineral oil to "slick" things up. Gross but effective.
Good luck! Hope you feel better soon!

Oh they're the worst! Anyway, this is what works for me. Inserting vaseline prior to a bowel movement. No excessive pushing, Wiping VERY carefully. Blow drying the area with a warm hair dryer. I haven't had one in a long time, but these are the things I remember doing. Oh, and baths...lots of warm baths.

Good luck, I wouldn't wish one on anyone.

I did have this same experience a few years ago. At first I thought it was a bad case of hemorhoids but after continued pain and bleeding I finally went to the doctor and they identified it as an anal fissure. I had been doing all the things like stool softeners and high fiber diet and soaking in the bath tub and nothing had worked. They decided to go the botox route and it fortunately did work for me. I continued all the oterh stuff. Soaking in a bath was the thing that made it feel better. If you don't have a decent bath tub a Sitzbath that can be used to soak on your toilet is a good alternative. I do have to warn you that the botox shot was one of the most painful things I have EVER felt! It was only momentary but I screamed like a baby. I had certainly never thought that at forty something my first botox shot would be in my ASS!

BEst of luck to you

Some of the folks responding are confusing anal fissure and anal fistula. They are two different things, treated differently.

Anal fissure is indeed a tear in the lining at the anoderm, which becomes chronically inflamed and nonhealing. There is stinging and burning with bowel movements of course (any cut would burn if you rubbed poo in it, right?).

The very severe pain that you are experiencing is something different, however. It occurs when the anal sphincter - a ring of powerful muscle - goes into a spasm. You know those leg cramps that we've all experienced at night, where you wake up and your calf or foot is locked into a cramp? It's excruciating. You jump out of bed, hop around, scream, cry, massage it, and pray for it to pass. Well, that's what is happening to your butt when you have those very severe pains. Your anal sphincter is locked into a cramp that won't break.

That's the idea behind the topical nitroglycerin, or the botox injection. It causes muscle relaxation. Once the muscle spasms stop occurring, the tear will heal. We don't know why exactly, but we know that it's true.

If conservative care fails, the surgery to treat chronic anal fissure is called a lateral internal sphincterotomy. It involves cutting the muscle part way through so that the spincter cannot lock into spasm. It works very well, but you can accomplish the same thing with a botox injection. If you see a colorectal surgeon s/he will be well versed on all of the options to treat chronic anal fissure.

Good luck.

Don't be embarrassed, hon. It's a really awful thing to have to deal with. If I were you I'd call the doctor and tell him you are still in pain, and the medication isn't working, and you can't go on a high fiber diet until the pain is resolved. If he doesn't resolve it with either botox or surgery, or with some kind of pain reliever, get another doctor, or at least a second opinion.

Try miralax with lots of water.
If not better in 2 weeks, just
do the surgery to break the cycle.
You should always be "preventing"
hard stools, both before and after...
Good Luck...

Hi!
My husband had one, and he hid it from me for a year. It finally got so bad he had to tell me. We went to the doctor,(Kaiser) and they just scheduled him for surgery. It really was no big deal, they went in and cut the fissure open all the way, drained it, and left it. I had to help him keep it clean,but it really was no big deal. I will bet that you have an infection in there that is causing you the pain. Go get a second opinion... My husband is a big baby when it cimes to doctors and even he had to say it really wasn't a big deal.
I hope this helps you !
Good luck!

My mother had surgery and it's really not that bad. It does seem to be the only permanent fix. Because eventually, another bm is going to reinjure it. Sorry to sound so negative, but my mother had multiple fissures and is so glad she had the surgery.

An anal fissure is incredibly painful. My doctor told me to take sitz baths in warm water about 4 times a day and to use the nitroglycerin gel, however, I wasn't noticing any improvement either. Once school started (I teach), I couldn't do as many sitz baths. I noticed that the fewer sitz baths I took, the less pain I was experiencing. When I tried to explain this to the doctor, he thought I had totally lost my mind...he wanted me to go back to the sitz baths. The day I did, the fissure began to re-open and the pain got worse. It seemed the frequent soaking was keeping the fissure from healing. I finally followed my own instincts and stopped the sitz baths. The fissure healed and the pain disappeared. I haven't had any problem since. I'm not saying this will work for everyone, but it sure worked for me. Also, if you are one of those people who do not respond well to fiber (I don't), try an herbal tea with Senna in it (I use "Smooth Move" by Traditional Medicinals - you can find it at GNC or Whole Foods)...it's extremely gentle, but effective, and it has a pleasant taste...you won't even need to add sugar. I wish you all the best on this...I know how awful and embarrassing it is to have to keep going to the doctor for something like this. When I hopped off the table after my last appointment, I swore I'd do whatever it took to never have to go through it again! Please let me know what happens - I'll be praying for you.

have surgery!! i had a complete rectal prolapse(huge hemmorrhoids) for years that i tried everything for. i finally had surgery and i was a new woman no longer in pain!!!! do they say the surgery is effective for the pain? if so, just do it! iam very happy i did! V.

I to have an anal fissure and got it after I gave birth to our first child. I became constipated and instead of using something to help, I just pushed. What a mistake! I know exactly what you are going through. It is HORRIBLE pain. I bled alot when having a bm and I ended up having a flexible sigmoidoscopy because my doc was afraid I had colon cancer but I just had the anal fissure. Anyway, my uncle (an ob/gyn) prescribed me PROCTOFOAM and it worked wonders. It takes about 2 vials to heal completely but it really works. Get at least 3 refills so you have enough. Its a steroidal foam you put in your bum 2-3 times a day but it really works. It took about 2 months but I finally healed after a year of having this stupid tear. I did tear again after having our 2nd child but I tore at the scar tissue so I didn't have much pain at all but alot of bleeding. I did eventually heal with this one with the use of the foam or without - I'm not sure. If you have Kaiser, the RX was $20 a vial - if not, Walmart sold it for $60 a vial so it's not cheap. Tell your doctor you want to use this medication. It really does work, especially for the pain. The healing takes time but it will heal. Good luck and again, I feel for you because I know what you're going through.
G. A.

I have had an experience with these lovely fissures. My doctor put me on a steroid suppository and high fiber, high fluid diet. The combination of the two resolved the fissure after a month. My father did have to have his surgically repaired, but it is a minor procedure that completely relieves the issue.
Just remember this is a sphincter muscle that opens and closes which will reopen the fissure if you strain just a little bit to pass a bowel movement. Good luck to you and hopefully your pain diminishes.

I have one as well. It is extremely painful. The essential thing for me is to keep the area clean. I buy Pamper all natural with aloe vera baby wipes (teal green package). The are the ONLY ones that do not hurt. I've tried every brand.

I found the pain comes worse when the area is inflamed or infected. I also use a hemoroid cream or suppository to help reduce the hemoroids which caused the fissure.

I try to keep the area dry too. After using wipes, I pat dry with a toilet paper that doesn't leave much lint, like Scott, or a hand towel.

I used to have a prescription for topical lydocaine for the pain when infected, but I don't have a doc in this state who will give it to me.

I also added Miralax and Benefiber to my diet to help make bowel movements consistent and easier.

Stephanie

Hi S.,

First of all, I am so sorry you are going through this. And as one who wakes up in the middle of the night and now often goes through the same thing even in the daytime, I so sympathize with you.

I did not know what to call this problem, but thanks to Meredith, now I do. I only called this "spasm's" and knew they were extremely painful. Painful enough to wake me from a dead sleep.

As for me, my remedy to stop the pain was, and is, to get a wash cloth, run it under the tap with hot water, as hot as I can stand it, place it in the area of pain, and lay down on a towell, (as to not wet the bedding), and usually find the pain is gone within a minute or two. Otherwise I use a heating pad on the highest setting. But I find that this is less effective and takes much longer to find relief.

I saw that you have tried heat and it did not work, but I don't know what kind. And since I suffer from the same thing, I can only share what worked for me. I know so well how painful this is and pray that you find relief soon for this problem. I also hope that in some of these helpful suggestions you find something that will work for you.

God Bless you,

B.
Yuba City, CA

I'm very sorry to hear about your troubles. When my daughter was born I had a huge episiotomy that tore and then surgery to repair, with various continuing complications. A good fiber to try is Acacia fiber. It is a soluble rather than insoluble fiber so is gentle to digestion and during elimination. You can order acacia here: http://www.helpforibs.com or can probably find it at stores featuring organic foods. Hope you feel better soon.

I had this problem after the birth of my first son. It is so painful. I had a doctor do a colonoscopy to make sure there were no other issues since it would not heal on its own. There were not thankfully but he did put my on colace (Sp?) for a long time and it finally healed on its own. Good luck!

Hi S.-
O that is just terrible. Here's my embararsing moment- I was channel surfing the radio when I heard a lady talking about an anal fissure that she had. Her doctor actually performed surgery on her to "stitch" it back up. She said it was really small, but really painful. After the surgery, she was all better. Maybe, if you can, start looking into specialists and see if one of them can either reccommend a more suitable course of action or a helpful surgery. I say a specialist because this would be the one part of the body they know better than anything else. Maybe look into UCLA or contact someone down south. Here are a couple of links: the first one is for other treatments to talk to your doctor about since what you are doing is not working.
http://www.healthline.com/adamcontent/anal-fissure#callin...

This link is to help you find a specialist/proctologist in your area- or closest to you.
http://www.revolutionhealth.com/browse-doctors/proctologi...

I hope that was helpful. Good luck.
-E. Mc.

I'm not completely informed about this, but, having had what I thought was an anal fissure, I would not call that a tear of the rectum muscle. As far as I know, an anal fissure is just a tear of the tissue right at the anus, if you look closely you can see a raw crack. It keeps re-opening every time you poop.

Make sure your dr. knows what he/she's talking about -- they don't all know, as I have discovered.

So I assume the pain is when you go? If it's the kind of anal fissure I know about, you need to keep the skin moisturized so it doesn't keep ripping, probably Prep. H would be the best.

I had surgery a couple of times, supposedly for hemmhorroids (I'm not even going to bother to waste time on the correct spelling), and you want to talk about pain!! It took months after the surgery to be able to go without excruciating pain.

I would research your condition more.

I get these from time to time and they take a long time to heal, but wiping can make it worse so I use the prep H wipes every time after I go and it really helps keep the irritation and pain away. The cottonelle wipes are irritating to a fissure. keep a box of the prep H flushable wipes near your toilet and definitely keep your stools soft with lots of high fiber whole grains, salad, etc and fluids.

Hi S.,

I'm sorry to hear about the pain you're in- I do understand as I've had fissures from time to time. It sounds like you're dealing with something on another level though and you have my sympathy. I think it's important to put something on there that will help it heal, which as you know is challenging since the area in question deals with the same stress every day (one paradoxically hopes!) I eat tons of fiber, and that has helped me reduce the frequency of getting them, but in the mean time you need to help the tissue heal too. I would recommend a good herbal salve. They PROMOTE healing, as opposed to antibiotic ointment which just keeps bacteria down. Useful, but an herbal salve will do that and much more. I've relied on them for years and they really work (if you get a good one.) I don't know where you live, but you should be able to find a good natural food store, whether it be Whole Foods, Good Earth, or a co-op. Ask in the Health and Beauty Dept. for some help choosing a salve, and you don't have to get too specific about what it's for if you don't want to, but do mention that it's for a mucous membrane, it might matter with some ingredients.

All the best. -K.

S.
It wasn't me but my 45 year old sister. She had pain for years. Finally saw 2 different Dr's and both said the same. She had an anal fissure. She did the liquid, fiber and not eating (her idea - no food on poop) and nothing worked. She did everything she was told and could think of on her own. She finally decided to have the surgery. The Dr warned this could be the most painful thing she has ever done. It was another month pain. That was September 2008, and she said if she had to do over and know the out come she would be the 1st in line. The surgery was painful and the recovery was painful (good meds helped however). She is now eating better with a high fiber diet and no pain. We joked on the way to the hospital - 'Everyone has a cracked Butt, but you broke your Butt!' Hope this helps let you know there ARE others with the same problem. Keep smiling and know you are not alone and you will make the right decision.

I had a lot of little tears after every BM (soft or not) after my daughter was born. My doc gave me a medicine called analpram (nice name, huh?) which I used for 1-2 weeks. It helped me heal fast. I think it is a steroid. Maybe you can ask your doc about using the same drug?

Hi S.,

I can share some info that could be very helpful to you.

Aloe vera juice is very good for healing tissues all throughout the digestive system --from the top to bottom. You could take that several times a day and it can be taken along with anything else that your doctor may suggest.

For pain, you can take omega III fatty acids, calcium and another herbal product that calms the nervous system called Tranquility. I can share more with you about it if you want to call me. This combination for pain can be taken as often as needed.

Victorious healing awaits you,
D. Hendon
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