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Old 03-24-2007, 10:26 AM   #1
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NoSleepSeattle HB User
Red face Fissure after Hemorrhoidectomy

My doctor gave me some cream called Analpram HC however it didn't seem to work. I used it 4 weeks. Instead of working it seems to have made the skin down there really, really, red. Anyone else out there had a reaction to an HC cream? I'm now in my sixth month and trying to recover from all of this. The doctor says a musclespasam is keeping the fissure from healing. He didn't mention anything about any other way to aviod a surgery. He's pushing me to have a lateral sphinterectomy. He has said that it doesn't hurt like the first surgery. He said it would take about 2 months to recover from it. I'm really scared I definitely don't want another surgery. I'm praying for God's great mercy to heal me so I don't have to have another surgery. Anyone else in this situation?

 
Old 03-25-2007, 12:53 PM   #2
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Re: Fissure after Hemorrhoidectomy

Yes, I have the same exact problem that you do. I had a hemorrhoidectomy that led me to having a fissure which is more painful than my hemorrhoids.

PLEASE stop using the hydrocortisone!!! I have only heard that it causes thinning of the tissue down there which is NOT what you want.

Any doctor that wants to do surgery right away for a fissure should not be trusted. What type of doctor are you seeing for your fissure? You need to see a colorectal doctor. You need to get one of the following prescription creams for fissures: nitroglycerin cream 0.2%, nifedipine, or dialitezem (sp). These medicines help to relax the muscle that is in spasm. I am presently using the nitro and have finally seen some improvement in my pain and healing. If the creams don't work for me then my second line of defense is doing to be a Botox injection down there. It is supposed to relax the muscle in spasm also.

I do NOT want the sphincerotomy (LIS) surgery either. That surgery has a very small chance of leaving you fecally incontinent. I know the risks of this are small but I have been in contact with someone from this board who was left incontinent from the surgery 9 years ago. Please change doctors if you must to get one of the three prescriptions that I mention above.

If you have any other questions, please don't hesitate to ask. I have had my fissure since November and am on my third doctor as most docs just don't understand the pain and severity of a fissure and what medicines to use for them. I point blank asked my second colorectal doctor for those topical meds listed above he wouldn't prescribe them for me so I moved on to my present colorectal doctor who has had a lot of success using them with his patients.

Please be your own advocate. Stop the Analpram HC and call for those other medicines. What I have found about fissures is the longer you have one the longer it takes to heal one. I kick myself for not leaving my second doctor quicker as I may be farther along with my healing by this point.

Healing prayers to both of us,
ericollin

 
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Old 03-25-2007, 07:13 PM   #3
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Re: Fissure after Hemorrhoidectomy

Hello, I have posted on this once or twice before and i hate to see you guys suffer with your fissures. Believe me! I let myself suffer for over two years. I was so affraid to have the LIS surgery for the fissures. I was so affraid of incontinence.

But let me tell you, I just could not take the pain anymore and I tried everything from Nitro to other creams and nothing helped. My surgeon could not even believe how I was suffering.

I had to do it, And let me tell you....I felt better the very next day!!
I can't believe i let myself suffer that long....the surgery was nothing!
I don't have any incontinence what so ever. I have my life back!

Your body will tell you when your ready, It took me two years and the pain was worse than the incontinence fear i had. I should have nerver waited that long because my fissures were so deep...I could have caused myself more harm.

Please be sure to have a colonrectal surgeon do the surgery. I don't think
you will have a problem with incontinence. My surgeon told me that he always cuts the muscle a little less than cutting more and he assured me that if I had incontinence he could repair the muscle too.

I hope this gives you guys some hope....Feel free to ask me questions.

 
Old 03-25-2007, 07:58 PM   #4
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Re: Fissure after Hemorrhoidectomy

I have been on this board for awhile. On another thread here I ran into a man that had a LIS surgery performed by the same colorectal surgeon that I was seeing this past Nov-Jan. This man had his LIS surgery in 1998 and has been incontinent ever since!!! This man has also had a sphincterplasty done by another colorectal surgeon to try and fix this incontinence and it didn't fix it. This has scared the living-daylights out of me. I am NO longer seeing that surgeon but the chance of it is always there if you have that surgery performed.

However, I cannot have any more rectal surgery. The hemorrhoidectomy and aftermath of it is the worst thing I have EVER experienced. I don't wish it on anyone but the surgeon who performed my hemorrhoidectomy. He told me that I would be all better in two weeks. It has been 6 months and I am still in pain on a daily basis. The creams can help heal a lot of fissures so NoSleepSeattle needs to know that those should be tried as a first round method. Surgery should not be tried until all other methods fail. That is my 2 cents.

 
Old 03-25-2007, 08:28 PM   #5
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2good2bthru HB User
Angry Re: Fissure after Hemorrhoidectomy

I had a hemmoroidectomy in early July, followed by the hell of convincing my surgeon that I had developed an abcess. I went to an emergencency room in another town and they did a cat scan and found out it was already 4.5 cms large. When the surgeon came in though, he found out that it was one of his buddies that had operated on me and insisted that I go back and let him correct the "mistake." I was in so much pain and when we contacted the surgeon again, the ER surgeon had talked to him so he had me admitted to the hospital. He told me I didn't have an abcess and let that thing grow to over 7 cm while trying antibotics! I finally told him I couldn't take the pain anymore so he did a cat scan and did surgery the next day. He missed finding the fistula though, so the pain returned and as my husband was doing wound care he found the fistula. The surgeon said he never would have found it. He did the 3rd surgery and cut me open like a fileted fish. My husband, who used to work on ambulance runs, got sick when he saw it saying oh my God, what has he done to you?! This was in early August and I am still having to take showers after every bowel movement because the hole never closed. The surgeon wants to go in and do a 4th surgery, but we have found someone to take over thank God. I hope to be normal again soon!My bowel movements shoot straight throug me now and I hate to eat anything.

 
Old 03-25-2007, 09:46 PM   #6
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Talking Re: Fissure after Hemorrhoidectomy

Thank you for the replies and advise. I recently moved to Seattle so I had to change from the Dr. who did the Hem. surgery to a new C.R. doctor. I know there are a lot of positive stories on the L.I.S. surgery but I'm still really nervous to have it done. I've had the fissure probably about since mid-feb. so around 10 weeks or so. The pain is actually improved tremendously since I first felt the burn of the tear. It was much worse with the Analpharm HC cream and poking the cream up there. Now I just get a tiny drop of blood on the TP. I know the surgery could turn out okay but not sure about the risk of pooping my pants.

EricCollin - I stopped the HC cream entirely and already my external part of my 'bon bon' is improving. I've soaked in Epsom salt water mixed with Aveeno Oatmeal bath. Very nice. I haven't checked to see if the redness is gone yet. I'm to afraid to spread my cheeks for a look. The BMs are a little rough but the pain feels manageable. I'm trying not to lift the kids and stay off the feet. It's just a little raw when exercising or walking. I've had some itching too but baby powder seems helpful. The new doc. said don't wash the area. Just can't do that--too stinky--so Johnson's baby wash is working great.

I haven't taken any Metamucil or Citrucil like a lot of others because I don't want to ingest any "phenolaline (sp)?-type" chemicals. Usually, if I drink 4 to 6 oz of prune juice, fluids, beans, and veggies I get a pretty soft stool. I've also taken Phillips stool softner and Milk of Magnesia on days when I've broken down and drank to much cow's milk. The poops not toothpaste consistensy but I can't figure a way to get it any softer. I'm planning on trying some cod liver oil/fish oil this week before I eat any meals for the day. Anyone else tried this?

??? What I can't figure out is why on earth the internal sphincter muscle wouldn't just relax over time? Anyone ever studied anatomy or medicine? I'd like to know. Anywho, after both my c-sections I had some musclespasams in my abdominal area but as you heal the muscles relax. I can't imagine that the internal sphincter muscles down there wouldn't stretch on their own after some time passed.

I'm so glad that we have this messageboard. My husband is getting tired of my poop stories I'm afraid and my sex life is in the toilet right now due to this situation. Thanks for the support.

NoSleepSeattle
P.S. Does anyone else think this thing looks like poop jumping up and down?

 
Old 03-26-2007, 05:32 AM   #7
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Re: Fissure after Hemorrhoidectomy

I agree...I tried and failed all other methods of treatment for the past 2 years. And like I said before ...The pain took over my fear for the surgery. I just could not go in any longer. I was willing to take the chance for surgery....And I made the
right choice. I'm all better.

I sorry to see you guys suffer like this. If you live in the Pittsburgh area, I can give you the name of my surgeon.

Take care.

 
Old 03-26-2007, 07:03 AM   #8
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Re: Fissure after Hemorrhoidectomy

As with any ailment it is up to you to decide how you want to pursue treatment. I suffered from a horrible fissure for almost 8 months last year and in August decided I could no longer take the pain and disruption to my life and decided to have the LIS surgery. Best darn thing I ever did, for ME. I tried all other conservative methods, fiber, fluids, stool softeners, ointments, sitz baths, etc. and none helped. The longer it takes the fissure to heal the less your chances are of completely healing it and KEEPING IT HEALED. To me, that was the key, keeping it healed and not having to deal with it again in the future. Just make sure you are seeing a good colon/rectal surgeon. Do you research! As with any doctor in any field, unfortunately, there are quacks who don't know what they are doing. Of course, they are going to tell you they know what they are doing, they want your money. These days we have to be proactive about these kinds of things. I researched my doctor thoroughly, and yes, this required me paying a small fee for a report. You can also contact the AMA. The resources are out there, all one has to do is take the time to look. But, I would rather pay 15.00 for a report to find out how darn good my doctor really is as opposed to blindly trusting them and being messed up for life. The decision to continue conservative treatment or have the surgery is entirely up to you and no one else. Don't let posts from people who have had bad ordeals scare you. I did and this caused me to postpone having my surgery by several months becasue I was so scared. I feel terrible that some of you have had such bad experiences with your doctors and surgery outcomes but everyone is different and how we approach our healthcare as individuals also plays a role in the success one achieves. Just for the record, I DO NOT suffer from any incontinence. And thank my colon/rectal surgeon EVERYDAY OF MY LIFE for giving me my life back. My surgeon has 24 years experience doing this and did not hesitate to offer me names and numbers of former patients whom he had performed the LIS on as references. I offered up my name after my surgery and have no problem telling people who ask me that I think he is wonderful! As shygrl2 said, I felt better the very next day. I was out of work for 5 days then came back part time for a week after as I sit at a computer all day. I have normal bowel movements, no pain or discomfort and certainly do not poo in my pants. Ask questions, inform yourself and research your doctor. Take all of that information along with the state your life is in now and make your decisions. I hope you find relief soon and can put this behind you and move on with your life. Take care.

 
Old 03-26-2007, 10:05 AM   #9
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NoSleepSeattle HB User
Re: Fissure after Hemorrhoidectomy

Purpleladyfish, I'll do my homework before surgery. I actually hava a surgery scheduled for this Friday but I think I'm going to cancel it because when I asked the receptionist for success stories she said the Dr. has never lost anyone. The doctor is approved by the American Board of Colon and Rectal Surgery but I still don't think I trust him. He said the surgery success rate is that out of 1000 patients it works for about 950 people or so. I just worry about being in the group of "50."

 
Old 03-26-2007, 05:25 PM   #10
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Re: Fissure after Hemorrhoidectomy

NoSleepSeattle,

If you don't feel comfortable with your surgeon and his office staff's reply to your questions then by all means keep looking for one you are comfortable with. I don't know how much research you have done on the surgery but I did a ton, literally. As I stated before, don't be put off by other people's experiences, I truly believe that the success of the surgery hinges on you having an experienced surgeon. My surgeon has been a colon/rectal surgeon for 24 years. I felt that his age alone dictated true experience in the field. Some people feel that the younger a doctor the better they are because they are up on the new stuff but keep in mind that even the oldies have to keep up with the new stuff only they have actual experience under their belts as opposed to some of the newer, younger doctors who may have been the best in their class but I only want the best working on my a*s (a little humor, never hurts, LOL) Keep looking for a new doctor, do your research, ask questions and by all means, feel comfortable with your choice. You'll know, trust me, your gut tells you. There is no reason for you to suffer and have your life disrupted. I was exactly where you are now, one year ago. At this time then, I had my fissure for about ten weeks such as yourself. And I tried everything, diligently, I never missed a beat with the fiber, the fluids, sitz baths, ointments, etc. and still it would heal then reopen. I went through that for another 4 1/2 months. At my last checkup the fissure was healed 99%. The doctor told me to keep doing what I was doing and I only needed to come back if necessary. Well 4 days after that the damn thing reopened all the way and tore into the muscle. I was in a constant spasm and decided on day 5 that I wanted the surgery. I was tired of living in constant pain, not being able to plan or go out and do things. Not to mention the time missed from work. Thank god my boss is understanding. I was scared but in the end it was the best decision I had made. Not once from the first time I saw my surgeon did he ever offer up surgery right off the bat. We discussed my fissure, what I needed to try and that if those other conservative options to heal it failed, there was a surgical procedure he could do to heal it and prevent it from coming back. Even at the appt. where it opened back up and into the muscle he never suggested the surgery. He asked me what I wanted to do. That really impressed me. Most surgeons seem to jump right on the surgery wagon so it impressed me that he never once even suggested that I have it. He only informed me of it and answered my questions. I hope you have success in finding another doctor and whether you decide to have the surgery or not, hang in there. Keep me posted on what you decide, if you don't mind.

 
Old 03-27-2007, 03:27 PM   #11
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Re: Fissure after Hemorrhoidectomy

Well, I did look up the Dr. and he seems very reputable but a little younger. He's worked around 10 years in the field. Suprisingly I think I know him from a state I used to live in and it just dawned on my why so maybe that was why I was uncomfortable. Also, he is the same age as me. I didn't recognized him at all until I looked up more info. on him. When you are ten or eleven years old people look a lot different. Anyway, I'd like to feel better ASAP. I'm putting off finding a job because of the pain. My health insurance is terrible so it doesn't help. It doesn't cover much of the cost of the surgery so I'd be looking at about 3,000 or so in debt with no way to pay it right away unless the surgery is really, really great and I feel better in a hurry so that I can work. I had stopped work about three weeks or so after the initial surgery. I cancelled the surgery for Friday for both reasons: cost/fearfactor. I also called my former Doc. who I know has a long track record and asked what he would recommend. He's out of state though so I don't think my insurance would cover for me to go back there for a surgery. Thanks for the support PurpleLadyFish...

 
Old 03-27-2007, 05:27 PM   #12
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chigs489 HB User
Re: Fissure after Hemorrhoidectomy

if the fissure persists for over 3-4 months, I recommend surgery (LIS).

I had a battle with a fissure that became chronic that was just horrible. The fissure itself had been there 10 YEARS! Finally one day, it decided not to cooperate anymore and I started bleeding after every BM.

I tried ointments, including diltiazam, which worked initially, but the fissure came back. I lost 25 pounds!

Overwhelmed with pain, I elected to have the surgery, and I felt better the next day. The procedure is a breeze -I was only under a few minutes. Gradually everything healed up down there.

2 1/2 years later I have NO problems. I can eat anything. I should have had the surgery done much, much earlier.

The incontinence fears are way overblown. My surgeon has performed over 100 of these operations and no one has ever had a problem with that.

 
Old 03-27-2007, 05:43 PM   #13
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purpleladyfish HB User
Re: Fissure after Hemorrhoidectomy

NoSleepSeattle,

Talk about your small world. Do what feels right for you. I understand about the insurance thing. My insurance isn't the greatest and I actually had to borrow money from a friend to pay down on my deductible as a good faith gesture. I figured I would worry about the remaining balance after and make arrangements for payments which I what I have done. I had been in pain and so miserable for so long that I didn't care what the cost was, I was having the surgery. I can tell you that my recovery was very short. Surgery on Friday, back to work the following Thursday, 3-4 hours a day. That lasted for another full week then I was right back to a full 9-hour day, with a pillow. So, roughly, 2 weeks. Maybe your old doctor out of state can recommend another doctor in your area. I really hope you find some relief soon. I know how painful and debilitating this can be. I hope you have some family or friends that you are able to vent to. It helps. I had my husband and thankfully some of the most caring people at my job. But its hard to talk about this kind of thing with just anyone so being able to talk to other people who have been through it or going through it really helps. My thoughts are with you and if you do decide to have the surgery and have any questions I will be glad to answer what I can for you based on my experience.

 
Old 03-27-2007, 05:53 PM   #14
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purpleladyfish HB User
Re: Fissure after Hemorrhoidectomy

chiggins1066,

I absolutely agree. How on earth did you live with one for 10 years.... I only had mine 8 months and couldn't take it anymore. I also agree with you about the incontinence being overblown. I'm not saying it doesn't happen but I believe it happens in the hands of an unskilled surgeon. My surgeon had 24 years under his belt and has performed hundreds of them. It is seven months since my surgery and like you I eat anything I want. I do try to go light on the things I know can be binding for me but I just make sure I drink plenty of fluids daily and maintain a high fiber diet through both supplement and food. And the weight loss... I lost 62 pounds and even more, I have managed to keep it off. For the people who didn't know what I was going through and kept asking me what weight loss program I was on, I had to laugh and tell them you don't want this weight loss program. Take care.

 
Old 11-17-2007, 10:13 PM   #15
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brad36 HB User
Post Anal Fissure

Hello! I just discovered this board and thank goodness for that! First, it appears that I am the only male who has yet to respond to the topic at hand. What's that all about? Any who, I had been experiencing pain (for about 2 months) whenever I went to "pass a bowel movement." Finally, after about another month (making it 3 months in total) I decided to visit the doc. He informed me I had a left anal fissure. And that it probably occurred as a result of a hard bowel. He sent me to a colorectal doc/surgeon who immeidately prescribed Nifedipine. It is an ointment that must be manufactured/produced by a pharmacist (not an over the counter drug), therefore, a CVS or Rite-Aide is NOT an option. You must go to a "real" pharmacy - one that makes drugs. So today is my first useage of the ointment. I am to take it twice a day (every 12 hours). If the fissure does not heal, as well as the pain eradicating, in about 3 to 4 weeks, then we will talk about other course(s) of treatment. So hope all goes well.

By the way, my doc also recommended that I take a Metamucil type fiber supplement. I used it for about two days and said enough of that! I went to the bathroom once after about two days useage of Metamucil, and I thought that I was about to "meet my maker." The pain was EXCRUTIATING, and I never passed that bowel. I had to get up and come back later. And then it was painful as all heck! It was as if the bowel(s) were so large that they stuck upon exiting the canal. Note: the first attempt, in passing a bowel, never left the anus. Who knew something so innocuous/common as passing a bowel could be SO PAINFUL!

Funny story - About seven years ago I had to take my dog (also male) to the Vet because whenever he went to "make," he would wence. The problem you ask? He had a closed left anal fissure. The Vet prescribed prednisone and informed me that in a few weeks it would heal. And, it did! And what do I have, you ask? A left anal fissure. Go FIGURE! Let's hope surgery is NOT necessary.

Thanks for all the info on the board, concerning surgery. I will pursue any and all options but surgery. Unless of course, it is the only option left.

 
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