I’ve just been back to see my GP to get the prescription for the Anoheal (diltiazem). He said further to my call yesterday, the pharmacy had been trying to get hold of some and couldn’t get any locally so they had to do a special order direct from the suppliers which could take a while to be delivered. He said they don’t normally prescribe this because it is more expensive than GTN (nitro) but are willing to in my case because of my small children etc etc. Has anyone else been told it is more expensive? how does the diltiazem work in comparison to the GTN?

A:
Diltiazem is a calcium channel blocker, Nitro is a vasodilator. I would call around and compare prices- availability and not rely on the doctor or pharmacy especially if you need it now.

I had LIS in october and my fissure finally healed but the area still can be tender at times.
I tried the diltiazem and I find it burns and irritates the most. I’ve used nirto and nifedipine and I think the nifedipine is the least irritating and works the best but that’s just my opinion.
I had other issues besides the fissure, scar tissue from an old hemorrhoid surgery and ibs and some pelvic floor problems so I think the area where the fissure was and some of the old skin tags stay tender for quite a while. The only thing that seems to help me when things do get tender are sitz baths. Of course eating more fiber and keeping bms strain free are a must. If the diltiazem is irritating you tell your doctor and see if you can try something else.
If you have a health food store close by try pure aloe vera, you have to store it in the fridge but that’s even better. It feels cool and soothes the irritated skin.

I’ve been dealing with this ass demon for almost 2 yrs and I also noticed that my intimacy has been subpar at best. Sometimes I felt like I had ED, but I thought the cause was due to aging (40yr old). I didn’t have ED before AF. Now my questions to you anal sufferers are as follows: Do you have the same condition as mine? Would taking the blue pills promote healing of the anal fissure?

A:
The pain and discomfort from my butt problems has certainly affected the libido and has from time to time seen ED rearing its ugly head!

However, many health problems have the potential to affect the little fellow’s ability and performance . You should speak with a doctor to ensure there isn’t any other health problem that could be the root cause of the erectile dysfunction e.g. kidney, heart problems, vascular disease, etc.

It is important to be checked out by a doctor to ensure the blue pill isn’t going to cause you any problems.

The doctor has seen this all before and should be reassuring that a normal life can be resumed! Don’t allow any embarassment put you off going along to one. Goodness, if you’ve been along with the AF to a doctor then you should hopefully be through the embarassment stage with any doctor and “down there” problems.

I have now been dealing with this fissure issue since September 08.
Although I think that I have healed(to be confirmed with my sigmoidoscopy coming up)it still gets sore at the site when I sit for extended periods of time and I still get tailbone spasms from time to time but this is usually later on in the day, again if I have been sitting for long periods of time.
How long before these residual annoyances subside and I can feel normal again(relatively speaking)?

A:
I had my fissure for about a year.
I too thought I was healing and almost canceled my LIS surgery twice but thank god I didn’t back out. I had the surgery and when I woke up the CRS told me my fissure was very big and deep, it was highly unlikely it would have healed on it’s own.
The reason I was experiencing less pain was because I kept my stools relatively soft and easy to move. I can’t tell you how many things go through your mind when you decide to have surgery.
First and foremost the incontinence issue sticks in your mind. I had tried everything else first though, I did all the ointments, I had the colonoscopy and that tore the fissure a little more (but they told me up front that might happen).
My doctor didn’t recommend botox for me because it was only temporary and because I’ve had spasms for a long time and the sphincter was very tight.
The chance of retearing was greater. As for the sensitivity of the area, it remains.
I don’t have the terrible pain of the fissure but if I have too many bms in a row the area where the fissure was gets a little irritated. If you don’t clean thoroughly after a bm (because of the skin tags) that can irritate it too.
I can tell you the one thing that sticks with you after an experience with a fissure is the thought that it could happen again. That fear remains. I’m hoping in time it will go away, but it’s hard to forget being in pain for almost a year.

I’ve been dealing with a fissure for almost 11 months now. i just had some suergery to remove a skin tag that formed above a fissure. my dr. cleaned my fissure out and stiched it together to help it heal. don’t know if that’ll work but he’s been suggesting LIS since I’ve had it for so long. my biggest concern is the incontinence that occurs after the procedure. has anyone had the LIS procedure done and has had a major problem with incontinence?? He’s also suggested alternative treatments like botox but seems like people who’ve had botox treatments on this board had it come back. this thing has taken over my life and just want it to go away. words of experience after LIS will be be appreciated.

A:
Most LIS procedures today will not cause incontinence. In the “olde days” they cut the entire length of the muscle so you would be incontinent. They now only cut a portion so you still have some muscle to hold the poopies.

Botox has worked for some. It is always worth a try, but it only works for a few months, then you need another shot if you haven’t healed.

Have you tried any ofo the topicals? Talk to your doc about getting Nifedipine that may help you too.

I’m surprised your doctor removed your skin tag with an active fissure. The tag is formed by the fissure to protect it. My doctor said he wouldn’t remove a skin tag unless the fissure was healed because the chance it will grow back is pretty good.

I had LIS and an injection of some kind of steroid into the fissure and it healed in about 8 weeks.
The LIS relaxes the sphincter muscle so things can heal down there. It doesn’t treat any other bowel problem though. I was very afraid of incontinence but my CRS told me the chance of that was very low.
Sometimes people experience a little loss of control when they have gas and that usually goes away in a few weeks. I had my fissure for about a year and just couldn’t stand the pain anymore so I chose the surgery. The area remains tender for a long time but it’s nothing like the pain of a fissure. I wish I hadn’t been so afraid to begin with and had the surgery sooner but it’s a scary decision to make. Just remember even after the surgery it’s important to keep your stools soft and strain free. We all have our own methods for doing that, some take benefiber or MOM or miralax and eat higher fiber diets. If you need some
suggestions just ask.

I have had my fissure for 24 yrs. The pain and discomfort is ridiculous but I am under specialist care at the hospital.
I recently had a bad flare up with extreme pain, bleeding and spasm. I was so desperate for relief I would have tried anything. I used a calendula officinalis poultice (marigold flowerpetals) externally and managed to get some sleep. I found it really worked for me, it brought down the inflammation and relieved the pain. I have also been using the infusion to clean myself after a bm and it is really making a difference, its still sore but its vastly improved and its early days. I recommend trying this (it doesnt interfere with any meds)

 I’ve been dealing with reoccuring rectal rashes and I mentioned this to my doctor. She thought it might be from using moist wipes or dampened toilet paper. Now I’m not sure what to use because dry TP is too harsh on my skin. Did you have experience with moist wipes causing rashes and, if so, what do you use instead?

A:

Have you tried different brands of wipes? Or of TP? (I only use Charmin soft)
Are you using ones that don’t have alcolhol in them?
Do you pat dry or use hair dryer to dry off after wipes or wet TP?
Do you apply anything after wiping? Like lanolin or vaseline? Are you using any prescription creams?
Did you discuss possible causes such as yeast issues?
Try sticking to one brand of tp and wet it for a month and see if anything changes.
If no changes, try wipes – the same brand- for a month.

I used to use wipes a few years ago, but I didn’t like using chemicals.
So I use a spray bottle to moisten TP with water now. I use Charmin soft TP. I occasionally use zinc oxide or yeast creams after, but that’s when I feel the rash flare up. It occurs after BMs and after sitting.

The problem can be even not related to the wipes themselves – it’s just that you need to dry the area after you use them. I just use a hair dryer set on low. It’s fast, easy and dries the area really good.

Benefiber/Metamucil thickening digestive tract?

I spoke with a nutritionist and he mentioned that taking psyllium products consistently such as Benefiber/Metamucil can cause your digestive tract to thicken. He said the best way to avoid this problem is to take psyllium every other 2 week.
I googled to verify this information but got no results.
Anyone have any idea?

Metamucil

A:

The difference between Benefiber & Metamucil

Fiber acts kind of like a colon cleanser. It moves the food you eat through your digestive tract quicker and the bulk of it is what pushes against the wall of the colon on it’s way out to clean it out. It doesn’t thicken anything but your stool. I don’t understand what your nutritionist means by thickens your digestive tract. The main ingredient there is wheat dextrin.
I think Metamucil is more of a bulking fiber than Benefiber. Too much bulking up of your stool like you get with metamucil isn’t really helpful to a person that suffers from anal fissures because your back side has to stretch too much to pass it, that’s why a lot of us like Benefiber. When you have fissures you need a consistently soft, strain free stool so if you only took it every 2nd week how would that help you in the first week.

I am a HUGE proponent of Benefiber as it really softens things better than any other product I’ve tried. This (on top of Miralax & lots of water) was the only thing that finally helped me heal my fissure after 7 months of debilitating pain & after trying so many different things including botox, LIS, aloe vera, wheatgrass cream, Metamucil, Nifedipine, Nitroglcerin ointment, etc.

I literally felt the tear (glass-passing sensation) every single BM (even 3 months after LIS) until I added Benefiber to my regiment.

How I use Benefiber & Miralax

I take 3 Tablespoons of Benefiber throughout the day & Miralax at night. I make sure to drink 64 oz of water a day. When I get to work, I put 2 Tablespoons of Benefiber into 32 oz of water & sip on it all day. Then, with dinner I have 1 Tablespoon of Benefiber with 16 oz of water. Then, before bed, I take a quarter dose (17 gms is regular dose) of Miralax with 16 more oz of water. I was taking 1-1.5 x a full dose plus the 3 Tablespoons of Benefiber when my fissure was at it’s worst & finally began to heal.
I’ve found it’s easier to use a 32 oz water bottle to make sure I get the 64 oz of water & stick to my schedule.
I can pretty much eat what I want, but I do tend to have a spinach salad & fruit everyday. I usually add peas or chickpeas to my salad for a little more fiber but not always. I think I have a more constipated system than most so don’t know if others would need both Benefiber & Miralax.

At any rate, I wanted to relay my story again & what worked in hopes that it may help someone else. I cannot stress enough about stool consistency! I did not get this & no one stressed to me. I thought things were soft enough for the longest time as it was so much easier to go than what I was used to before the fissure. However, things were not nearly soft enough . . .
need to be the consistency of pudding/soft-serve ice cream in order to heal those suckers! I do recommend shortly after you’ve healed (maybe month) firming things back up though b/c I did experience burning for a while after healing & none of the docs nor I could figure out why since fissure was healed. I am a lifer on the Benefiber & maybe Miralax too

If you have a fissure, just get these products here: Benefiber - Miralax - Metamucil

A fistula generally starts as an abcess and it tunnels to the outside to release the pus. It can tunnel from inside the bowel to the vagina, to another section of bowel or to the outside beside the anus or other areas. You can have one and not know it but they do eventually become very painful. They are usually treated with anti-biotics first and if that doesn’t heal it, surgery is next.

A pocket of infection that tunnels its way to the outside. I had one and we think that it came from one of the Botox injections. It was in the anal canal and tunneled over into my buttock and then continued on to the outside. There was a tiny hole next to my anus about 1/2 inch over, beside it and it drained yellow pus. It had a foul odor. I never ran any fever or felt bad. It was just annoying and smelled. My CRS tried Cipro and Flagyll. Neither worked and I had
to have it surgically fixed. Any drainage should be investigated to see where it is coming from. Also once you have a fistula, they can spread and make more and then you really have a mess.

I  had surgery on the first fistula that I had. A fistulotomy (I think that is what they called it) and when she was in there she cut into the rectum muscle a tiny bit to try to relieve the pressure on the fissure. It worked ……both for the fistula and the fissure (no fissure pain since 2004). About a year after the surgery I got another abscess and that developed into another fistula. My surgeon suggested that if I thought I could live with the fistula then I might want to consider that instead of more surgery. Because the surgeries are so invasive I chose to keep my fistula for the time being. Since the fissure was not bothering me anymore I was inclined to leave well enough alone!!!!!

The problem with the existing fistula is that it has a pocket in it and over time (about twice a year lately) the pocket seems to fill up with fluid and then needs to drain. Everytime this happens I get an abcess and then I go through that whole process (daily trips to the hospital to change packing), it then heals and eventually the fistula stops draining
and then about six months later I get another abscess.

I saw a new colo rectal guy in Feb and he told me I had to come back when I have an abscess so next time I get an abscess I will go and see him to see if he has any new ideas.

All of this seemed minor to my fissure and because it hadn’t bothered me since my surgery (2004) I was ok to just leave everything be, but my fissure has come back to life since my visit to the colo rectal guy in Feb so right now I am trying really hard not to aggrivate the fissure if at all possible. I have actually been off work for the last two weeks
as a result of the abscess and then the awakening of the fissure.

 In my case I have had a history of irritable stomach and then irritable bowel with constipation most of my life. I guess I am a little bit anal in that I want to have a BM every day and can’t stand the feeling of fullness from not going- so I sit on the pot and read or do soduko until I feel significantly empty. This has led me into hemorrhoids and then fissures. I have them on and off, like it’s a vulnerable area that weakens and breaks down. I had surgery in 2005 and have been pretty pain free, but I have to have a daily routine of high fiber plant based food, lots of water, and I take Metamucil and oils.
I was taking Metamucil and mineral oil, which keeps things flowing and smooth, however I began to be concerned about ingesting the petroleum every day. I found the alternative for me that works, after experimenting with different oils is a triple omega oil product of capsules made up of flaxseed, fish, and borage oil. I take the Metamucil mixed in a large glass of water followed by a large glass of water followed by another glass of water and three oil apsules twice a day.
All has been okay, except at times of stress or sitting at the computer too much-then I do get some spasms and bleeding, which I do have right now. There is no bad pain like the excruciating tears I once experienced. I simply keep things flowing, use our bidet toilet seat to wash the area after a BM and take baths.

I found it interesting the info having to do with Chinese medicine. There is no doubt that Eastern medicine, Ayurveda, and herbal remedies can help, but I would not go so far as to judge those of us that have this chronic condition. It is something many of us deal with regularly and not from choice. I am going to be seeing a Chinese MD as a health consultant for various things. One of which is a zinc deficiency that I experienced recently. I am wondering if it has anything to do with the oils.

I had the misfortune of having repeted tears after fissurectomy.
Then, I consulted reputed gastro surgeon – he did a digital exmanination of my anus. He suggested me to udnergo surgery again.
 
I took the decision not to undergo surgery and to make life style modifications like walking, taking more vegetables/greens, timely food, regular sitz bath….etc
 
Now I am free from retears / burning senssation in anus.
 
From my experience, I strongly feel that a holistic approach by the sufferer can tackle fissures.
 
You can take cue from my experience and avoid the mistakes I comitted.

Just wanted to write a quick note regarding my recent LIS surgery I had last month. figured it would help anyone considering it. when i 1st was diagnosed with an AF over a year ago, i refused to have the procedure because i was terrified of becoming incontenent. I regret not having it much sooner. it’s been about a week and a half since i’ve had LIS and I haven’t felt this “normal” in alomost a year. the recovery has been great, i took pain killers once and was up and about in 5 days. I’m still a bit sore after a BM but there’s almost no discomfort and no bleeding. the bleeding seemed to have stopped 3 days after the surgery. it was incredible. although there’s always risks with surgery and LIS  is not for everyone, if your dr. says you’re a candidate for LIS, I say go for it. best decision I made.