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Anal fissure: reader's viewpoint

Thank you to ‘Sinbad', age 35, from the USA for sharing how he tackled an anal fissure.

I suffered from an excruciating anal fissure for nearly 1½ years. I am almost completely cured and I want to share my experience with everyone here. I hope that some of what I have to share will be helpful because I know how difficult leading a normal life can become for someone suffering from an anal fissure.

Symptoms. (1) The difficult passage of a very hard and very large stool, which caused the anal or rectal wall to rupture/tear. It was quite painful and was accompanied by anal bleeding (you may notice blood dripping into the toilet bowl, or your stool will be smeared with blood, or your tissue will be stained with blood). This was after 3–4 days of constipation. Constipation can be caused by eating food that contains no dietary fibre, or not drinking enough water and not getting enough activity (no walking, no running, very minimal movement and sitting for long periods). (2) Extreme anal pain so that I was unable to focus on anything. I was unable to sit in one place because of the pain. I noticed an absence of pain after a long sleep (overnight) and was able to continue with life as normal in the absence of pain.  But the pain resumed after defaecating – spasms of pain radiating outwards from the anus to the genital area – regardless of whether it was a hard or soft stool. These spasms could last for 1–2 hours before reducing in intensity, and the pain could last for 10–12 hours after defaecation.

What the doctors said. The first doctor who examined me confirmed it was an anal fissure and confirmed there was no visible sign of an infection in the area. He recommended I take fibre tablets (two tablets twice a day with one tall glass of water, 500 ml or more), that I get plenty of fresh fruit and vegetables but no spicy food, and that I take a hot (sitting) bath with the water up to my waist, for 20 minutes twice a day. He advised me to keep my anus extremely clean and use a wet wipe after I defaecated. After 2 weeks he re-examined me and asked me how I was doing. Since the pain had not subsided and the bleeding had not stopped, he suggested a colonoscopy to ensure there was no bigger problem. After the colonoscopy he asked me to take two low-strength laxative tablets each night before going to bed, for 2 weeks. He said that my stool needed to be completely watery for the injury to get a chance to recover. He also advised me to continue with the hot water baths, and prescribed nitroglycerin for external application on the fissure twice a day. This helps dilate the blood vessels around the applied area and helps in healing the wound faster. He also prescribed lidocaine for the pain instead of the oral painkiller I had been taking for 2 months before my colonoscopy.

Another doctor examined me and asked me about my history. She said it was important I had found out from the colonoscopy that it was an anal fissure and nothing else. She advised me to do the following: (1) Eat five (any) servings of fruit every day. (2) Drink plenty of water (10–12 glasses or more) regularly during the day. (3) Continue with the hot water baths. (4) Keep the anus very clean. (5) Insert one glycerin anal suppository each night before going to bed (available at any pharmacy off the shelf). She said this would lubricate the passage and also help in protecting the wound. (6) Perform 4–6 contraction exercises (to contract the rectal muscles) every hour. Contract, hold for 5 seconds, release. She said this would improve blood circulation to the area and help heal the wound. (7) Eat one tablespoon of raw honey (it looks like solidified fat or butter) and drink one tall glass of very warm water after the honey. She said the honey and hot water kickstart the gastrointestinal system each morning and produce the urge to defaecate. (8) Drink one glass of prune juice every day. She did not prescribe a single medicine, but her advice cured me.

What you can do to help yourself. I am not a doctor, so please do not think this is a foolproof method, but if you cannot afford to see a doctor or if you think your doctor is not being helpful you can try these by yourself:

  • Drink one glass of water, without fail, every waking hour of the day.
  • Take two (not one, but two) laxative pills each night before going to bed, so that you have a watery movement the next morning. They take 4–8 hours to take effect. The laxatives give the wound time to heal and close.
  • Take at least one hot water bath for 20 minutes every day (maximum two). These help draw blood to the anus for faster healing. They also provide lasting relief from any residual pain I experienced during the day, and helped me feel warm and clean.

After you have done the above three steps for 2 weeks, do the following every day:

  • Stop taking the laxatives. Instead, use a glycerin suppository dipped in some petroleum jelly directly after your bath because you will be very clean at this time. It is a mild laxative, but control the urge to defaecate and keep it in; after 30 minutes the urge will go away. Tip: try using this when your bowel is totally empty, if you can. It took 1–2 days to get back to regularity but the suppository helped a lot in getting me back to normalcy.
  • Drink one glass of water, without fail, every waking hour of the day.
  • Take at least one hot water bath for 20 minutes every day (maximum of two).
  • Eat five fruits (high fibre) a day, and drink a glass of water after each fruit. Any fruit will do.
  • Drink one glass of prune juice every day (in addition to your five fresh fruits).
  • Perform 5 or 6 contraction exercises every 1–2 hours every day.
  • Avoid greasy and spicy foods. Trust me, your health will be better and you will heal faster.

 I really hope that some or all of you can use this information. I am not a doctor, but I can share my experience and want to help anyone else who had this problem get better soon. Good luck!!

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Edited by: embarrassingproblems.com
Last updated: Friday, November 9th 2012

 


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Comments on this article

Posted by None on 16/03/2017 at 06:29

For how long did you do the secomd part with prune juice suppositories and contractions?

Posted by Optional on 16/02/2017 at 01:22

I found it very helpful. Thankyou so much for sharing this article.

Posted by Optional on 26/01/2017 at 12:20

I know how much painful it is to handle with this problem for months/years.I have been suffering with anal fissures on and off since 6 years.This don't have any permanent solution to cure completely we have to take certain precautions to lead a quality life without suffering with this problem daily.I am here to share few tips that I follow which might help you.. 1.Drink natural coconut water daily at least two glasses it helps to reduce the heat in your body,as this is one of the reasons for this problem. 2.Avoid processeced foods like pizza,chocolates,burgers,pastries etc and take food containing high fiber,eating brown rice,corn or jowar(it really softens your stool and helps to poop at one go without much pressure) 3.Drink lots of water and make a habbit of walking. 4.Dont sit at one place for long hours as it prevents your blood flow near the anus and it may irritate the anal region.Try to take small breaks to getup and relax even when you work. 5.Eat fruits especially watermelon,guava,custard apple,apples to help cure the problem. 6.Apply any suggested ointments to the anal region,and applying coconut oil to the fissures or piles would help you heal the would very quickly do this regularly after completing your bowel and night before going to bed also apply a little amount of coconut oil to your upper anal area and inside the anus with your finger it really reduces the inflammation and pain within few days I personally experienced it within three days I was able to feel painless side by following a diet. 7.Do regular 15-20 mins of sitz bath with a warm water in a tub it reduces the pain temporarily but gives a scope to relax blood vessels. 8.This is a very important thing to know,many use laxatives and other suppositions and end up saying they did not work for them,but it also depends on how we take and utilise to work,Just complete your dinner by 8 pm and give time for the food you have taken to digest don't eat anything after 8 Pm.Before going to bed like at 11 Pm take a laxative I suggest ducoflex as it worked for me,I took 1 ducoflex tablet before going to sleep and then it takes atleat 7 hours to work and after getting up in the morning you get a soft stool.follow this method daily by following strict diet until you stop bleeding,this laxative really helps alot to stop your fissure from bleeding. By following these tips your fissures might heal within 1 month,I feel like sharing this with you all as it may help you..

Posted by Sara on 24/01/2017 at 08:01

I have been suffering with Anal Fissure from a long time just readed your article i hope that will help me Thank you

Posted by Optional on 29/07/2016 at 07:21

The glycerin suppositron burns like he'll if you have an analysis fissure.

Posted by Optional on 30/01/2016 at 09:05

Thank you.

Posted by Optional on 21/12/2015 at 03:27

I have chronic reflux and anal fissures..I was told not to take Fybogel (psyllium husk) because of my slight swallowing problems but I am advised to have it for my bowel. I am advised to use GTN cream but also keep cleaning my bottom..how do i keep the cream on me? Alot of the oily things which help food slip through easily are a no no for reflux! I cant take most painkilling tablets as they constipate and I cant have amitryptilline for my anxiety over it all as it clashes with GTN!

Posted by Molly on 19/07/2015 at 09:11

Hi, my name is Molly and I have been suffering from a severe rectal fissure for about two years. It started when i became very stressed one month and eventually constipated, leading to a very forced and uncomfortable BM. My first doctor recommended sitz baths and suppositories, didn't work. Second doctor recommended lidocaine ointment and stool softeners, didn't work. After this they recommended the surgery which I eventually ended up going through with. The surgery slowly helped heal the wound and I felt like I was back to normal for about two weeks, then I had a harder bowel movement. I was back to where I had started. Right now I am on 2 ducolax tablets a day along with applying a nitroglycerine/lidocaine ointment before every BM, and also taking miralax once a day. I think my biggest problem is that I have not been drinking enough water therefore my stools are not as soft and the stool softeners cannot take full effect. Right now, whenever I have a BM I suffer from moderate pain, but that can fluctuate, sometimes a slight amount of blood and a consistent ache in my rectum for about three hours. Since you had been suffering for about the same amount of time that I have been, I think I will take up your advice and hopefully it will help. I wish the best of luck from anyone else suffering from this unfortunate thing.

Posted by Optional on 21/06/2015 at 10:45

Can I tell a Very simple method. It works . No long process . Get your hands on enough bottles of liquid paraffin so that you don't worry about it finishing . Start taking 10ml thrice a day after every meal. Religiously. Plenty of water and fruits as everyone says. After 2-3 days itself you will see the difference. Then reduce to 5 ml , 5 ml and 10 ml at night for at least a month or till you feel confident that the fissure or piles has healed. Always keep stock of it at home.

Posted by Optional on 24/03/2015 at 09:17

Had horrible pain after a#2 finally after 3 months. Pain totally quit.I spent hours in the tub soaking in hot water took nitroglycerin 0.4%Rectiv ate a balanced diet.drank lots of water.avoided chocolate and limited dairy.

Posted by Optional on 25/02/2015 at 02:42

I had an anal fissure. I went to the doctors and they prescribed me some cream, and I used it after every BM, morning, and at night. It wasn't working, which was worrying the crap out of me. I don't want surgery. I got told that you need to eat HIGH fibre diet. So every morning I would eat my shredded wheat (the big ones with no sugar) and almond milk. I also juiced a few times, and I ate exceptionally healthy, and exercising. After just over a month it went away. I stopped eating as healing, and then it came back a few weeks later. So now, I need to start eating high fibre again, and exercising. They take a long time before they fully heal. But I suggest getting rid of as much processed foods as possible, eating lots of fiber, walking a lot, drinking lots of water, juicing (from a juicer - fruits and veggies), and wearing loose cotton underwear! Good luck!!

Posted by Tiff on 18/01/2015 at 03:57

I've been suffering with an anal fissure for 2 years now and it's been on and off depending on my diet and health. I've been pretty careless and I stopped eating my high fibre diet which then caused me constipation again which then lead to me developing the anal fissure again this year. It's nearly 4am and I can't go to sleep because it's too painful. Like a shooting pain that just won't go away. I'm too embarrassed to go to the doctors and I dont know what else I can do, surgery is not an option. Thank you for the tips I'll try them and let you know :)

Posted by Optional on 02/01/2015 at 03:24

I have had a fissure for 9 months now, at times it was like pooing broken glass. I've broken bones, torn ligaments.. Nothing compares to this pain. My sympathies to you all. I saw on a different site someone used a product called Dr. Wheatgrass balm. I bought it in shear desperation thinking it was probably bs. It has not healed my fissure, however, it has helped stop the muscle spasms and pain. Very know minimal pain when going to the bathroom. It was a god send, started feeling less pain within a week. It's not a cure but it has improved my quality of life big time. I went from taking serious amount of pain killers, 4-6 at a time, to none now. Now I can get through the day I need to figure out how to heal it once and for all

Posted by Misery halved on 10/12/2014 at 09:29

These are great advices - I've started following them to the T since last night. Unfortunately, the laxative my GP prescribed doesn't seem strong enough. I had 30ml of Lactulose before sleeping last night, and ended up passing wind all day long. I really, REALLY, hope that this works for me. I did use my rather disgusting method of having a BM without crying though. I'll share so it could help someone else: I have a special basin which I fill with hot water, like a sitz bath, except I "go" in it. It's still painful to pass the eternally large and rock-hard (I've felt it with a rubber glove on) poop, but it's manageable. I keep dumping the whole thing into the toilet as the poop comes out, and rinse and refill the basin. I shower and wash everything with soap afterwards. For the ladies: anti-bacterial soap gave me yeast infections, so I'd advice against it. You have to be content with regular soap. I ended up with a fissure from childbirth tearing. It still hasn't healed after eight months. What's worse, I don't feel the urge to go anymore. I don't realize that my rectum is full until the fissure is getting pressed on from the inside. No on-line source says anything about epidurals causing this, but I have a suspicion that it's related. I didn't feel the urge to urinate for almost five months after giving birth. I'd suddenly feel urine almost leaking. Thus I had to watch the clock and go regularly on purpose...

Posted by daniel on 10/12/2014 at 06:11

i have these pains on my rectum they come and go have stomack pains abdominal pains been to several clinics and they dont tell me whats wrong they do blood work and say there nothing wrong with me but i know something is wron cause i feel this pain mainly at night when i go to lay down i have bad rectum pains i take a tramadol and it helps or sometimes a warm bath helps not all the time but im worried because they never find nothing wrong with me i dont sleep much cause im up and down all night long.

Posted by Optional on 06/12/2014 at 03:31

Mine comes and goes periodically. It starts with hemorrhoids and I guess the constant wiping makes it worse. I eat pretty well, but I notice when I eat pizza, pastries, too much bread and the like, it gets worse. Has anybody tried honey. I read an article and the person swears by it. I tried it once and helped a little but the inconvenience stopped me from doing it more often.

Posted by Optional on 06/11/2014 at 04:51

I had a colonoscopy performed in February as a normal routine part of turning 40 and my Dr. wanting baseline information due to my mother having precancerous polyps removed a few months prior. I have never had any bowel issues before in my life. I was as regular as the clock strikes 12. The day after the procedure severe diarrhea attacked and lasted for several weeks with the most horrific lower abdominal pain anytime I ate or drank anything and at the same time had pain in anal area with random bouts of blood and/or blood clots. This diarrhea and cramps eventually cleared itself up but the pain only got worse. So debilitating, can't stand, can't walk, can't sit, can't live. I was diagnosed with hemorrhoids and given several prescriptions along routine therapy to help heal them. The pain intensified and the problem got worse. At this point I am in almost constant excruciating pains that you can not get away from with no sight of relief on the horizon and tears are the outlet. My Dr finally got approval for a referral to a Surgical Specialist who found a large fissure, probably from the trauma of the Colonoscopy but no one will say for sure. The characteristics of fissures were actually causing hemorrhoids with the contractions and severe spasmodic action that you are not able to control. Set for surgery and hopefully this can be repaired.

Posted by Alex on 04/11/2014 at 10:20

I also have a chronic anal fissure, I have already used 3 boxes of suppository Anusol, h-preparation,with their creams, etc antibaotics (amoxillin, etc)but no healing for full 2-months. What step shall I take form here. The pain is severe. I always have to drug my self with pain killers.

Posted by mk on 26/08/2014 at 02:30

Helpful reading all comments, and can relate--have had pressure and pain for nearly a year.--had colonoscopy, endoscopy, and cat scan--and found internal hemorrhoids--nothing said about fissure. Finally first week of Aug--another gastro doc said it was a fissure---have been using $$$$$ steroid suppositories for months. Pain nearly same as in beginning. Will try some of these suggestions--my husband bought me a kid sized inflatable "dinghy"--for my sitz baths. Wonder if these expensive suppositories are worth it! Will try the glycerine. Yes, it is depressing, as had to give up all my fun activities. Doctors are not supportive, and insurance companies don't cover any of these meds. Disgustig!

Posted by AK on 01/06/2014 at 06:04

There is a good treatment available in Homeopathy medicine for fissures. The name of medicine is Ratanhia 200. This needs to be taken 3-5 drops three times a day. It will show the results in 2-3 days.

Posted by But hurt on 21/05/2014 at 03:43

Ridiculous how the pain is dismissed as manageable with OTC medications. I could not get rx for nitro cream dr would not prescribe the 2 %. And the Rectiv would of been $200 with our insurance. There is a coupon online for $40 but my fine insurance did not qualify. I made my own topical ointment. Crushed up a muscle relaxer, dabbed it on with some useless prep. h. With in 30 min there was a noticeable improvement. I hate all the phone calls with dr office then pharmacy over and over with still no help. I was desperate!!! Of course were all eating lots of fiber the pain dictates it!!!!! Hang in there everyone.

Posted by Shabbir on 28/02/2014 at 08:03

I have been suffering from fissure pain , thanks I'll try whole thing Some of which I'm also trying , I'll do the following also which I'm not doing : 1.warmth bath everyday 2.taking fruit without water and one to two servings instead five 3.suppository before sleep

Posted by Optional on 11/04/2013 at 07:03

I am amazed that Doctors have not been helpful. I have been treated with the upmost respect and consideration. However, after colonoscopy I was given the all clear of cancer but no one mentioned the fissure. 18 months later I went back to another Doctor and have been referred yet again this time for thee fissure. No complaints about my treatment though, just wonder why I wasn't re referred immediately. I'm getting used to having my bum looked at now.

Posted by Optional on 06/03/2013 at 03:30

Im scared i been having this problem for 6 weeks n its not getting better i see. A dr n all he said was that i need surgery for it :(

Posted by ChennaiGuy on 26/01/2013 at 02:26

This advise looks interesting along with medicines mentioned here. I am currently having the same set of medicines. I hope I will come out it pain-free sooner.

Posted by Carole Anne on 24/06/2012 at 01:25

I have had IBS diarreha for over 30 years. I am a 73 year old female. Yesterday after watching a dance recital, I came home and peed normally. Later on I was passing quiet wind,that doesent make noise. After I got up from the toilet there was a lot of bright RED BLOOD.A while ago when I wiped I felt upon the anus some very-very> tiny bumps.This morning like last night I peed and NO blood with urine, but realised that after wiping anus just to check the toilet paper there was again BLOOD and in the toilet too. This has never happened to me before I will call my doctor tomorrow, and sure shell have me come in. If anyone sees this, and has any advice or experience as ive had, please post your comment to this. I am kind of frightened. I DO see my internist every 3 months. TUVM.

Posted by didyrobo on 14/05/2012 at 02:18

i hope this helps me , 8 month and no better than day one

Posted by Optional on 20/01/2012 at 12:16

Thank you very much, you were very helpful.

Posted by Optional on 05/07/2011 at 08:39

thank you. I had this problem for a while. Dr are not that helping. Your information is very helpful. I will do it.

Posted by Mr Palmer on 26/05/2011 at 07:24

I have those exact symptoms, I'm going to try this diet and get in touch with my doctor. NHS Direct gave me a link to this site. They are great for diagnosis too! Thanks!

Posted by amiina on 16/01/2011 at 11:39

thank you very much for your info my doc is very unhelpful and dismissive but your symptoms match mine exactly and i can make sense of it all now and will definitely be asking for a colons-copy

Posted by Donnie Williams on 15/01/2011 at 07:19

I too have an anal fissure that gives me problems all the time. You mention 2 laxatives a day. What is the name of the laxative?

Posted by J. Bingham on 11/01/2011 at 05:13

I have been experiencing the fissure for five months after major surgery. I am depress and glad to know that I can try something that will help me. Sometimes I think my anal internal and eternal is asleep. Thanks for your advice.

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